ART Initiation and Adherence

ART Initiation and Adherence

Med-IQ Select
Expiring Soon
Online Course | Specialties: Family Medicine, Primary Care
Released: 10/22/2020
Expires: 10/21/2021
Max Credits: 0.5
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Lisa Fitzpatrick, MD, MPH, MPA  
Founder and CEO, Grapevine Health  
Clinical Professor of Medicine  
George Washington University
School of Medicine and Health Sciences  
Washington, DC 
David J. Malebranche, MD, MPH
Board-Certified Internal Medicine Physician
Sexual Health and HIV Specialist
Atlanta, GA
Activity Planners
Stephanie Larson, PhD 
Clinical Content Manager 
Baltimore, MD 
Laura Rafferty, ELS 
Senior Managing Editor 
Baltimore, MD 
Samantha Gordon, MS 
Accreditation Manager 
Baltimore, MD 
Jennifer S. Price, MA 
Education Manager 
Southern Medical Association 
Birmingham, AL 
Mandy Stone 
CME Compliance Manager 
Southern Medical Association 
Birmingham, AL 
Monica Nicosia, PhD
Nicosia Medical Writer LLC
Bryn Mawr, PA

Learning Objective
Upon completion, participants should be able to:
  • Integrate early initiation of and sustained treatment with antiretroviral therapy into the ongoing medical care of patients with a new HIV diagnosis
Target Audience
This activity is intended for primary care providers in the South. 
Statement of Need
In 2019, the United States (US) Department of Health and Human Services proposed the “Ending the HIV Epidemic: A Plan for America” initiative, with the ambitious goal of reducing new HIV infections by 75% in 5 years and by 90% in the coming decade. This plan is based on the substantial body of evidence that suggests that available prevention and treatment strategies, together with enhanced HIV testing efforts, have the potential to radically reduce new HIV transmissions in the US. The first phase of this project focuses on geographic hotspots that are hardest hit by the HIV epidemic; one-half of the 48 counties and all 7 states designated as priority areas are located in the South. Although a high number of people are living with HIV in the South, many primary care providers (PCPs) in this region do not possess robust, up-to-date knowledge about HIV risk assessment, prevention, and treatment in their practice setting. This project aims to increase PCP knowledge about how HIV testing, treatment, and prevention can reduce new HIV infections, as well as improve the ability of PCPs to implement components of an HIV-prevention framework in the primary care setting. 
Collaboration Statement
This activity was developed by Med-IQ in collaboration with the Southern Medical Association.
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Accreditation/Designation Statements
The Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The Southern Medical Association designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Medium/Method of Participation
This is a 0.5-credit CME activity. To receive credit, read the introductory CME material, complete all of the modules, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: October 22, 2020
Expiration Date: October 21, 2021
Estimated Time to Complete This Activity: 30 minutes

Disclosure Policy
The Southern Medical Association and Med-IQ require any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. The Southern Medical Association and Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. The Southern Medical Association and Med-IQ also require faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 

Lisa Fitzpatrick, MD, MPH, MPA, has indicated no real or apparent conflicts.

David J. Malebranche, MD, MPH 
Consulting fees/advisory boards: Gilead Sciences, Inc.
Fees received for promotional/non-CME activities: Gilead Sciences, Inc.

The writer, peer reviewers, and activity planners have no financial relationships to disclose.

Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, the Southern Medical Association and Med-IQ have a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. The Southern Medical Association is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

The Southern Medical Association or Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

Contact Information
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.
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Acknowledgment of Commercial Support
This activity is supported by an educational grant from Gilead Sciences, Inc.
© 2020 Med-IQ, Inc.

The following material has been developed to accompany this activity:

ART Initiation and Adherence: Companion Guide

Note: This material is not accredited for CME and, therefore, does not offer any CME/CE credit.


Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.
Over the last 30 years, ART regimens have shifted from regimens with high pill burdens, treatment-limiting toxicities, and incomplete virologic suppression to simplified regimens that lessen pill burden, reduce toxicity, and maximize viral suppression.
Module 1: Goals of Antiretroviral Therapy

  • ART goals have changed from delaying HIV progression to improving quality of life and maximizing viral suppression
  • When taken as prescribed, ART reduces individuals’ viral load to an undetectable level, keeping them healthy and effectively eliminating the risk of transmitting the virus to an HIV-negative individual

Module 2: Initiating Antiretroviral Therapy

  • ART should be started as soon as possible after a person receives an HIV diagnosis, regardless of CD4 count
  • Prior to starting ART, the following should be completed: a baseline health assessment, laboratory tests, and a conversation on the benefits of ART, the importance of adherence, anticipated barriers to adherence, and patient treatment goals

Module 3: Available First-Line Regimens

  • The 5 recommended first-line regimens for most people living with HIV are considered to be highly effective and are associated with a low risk of adverse effects and drug interactions
  • Three of the recommended first-line regimens are available as single-tablet regimens, which have a lower pill burden and are associated with improved adherence and virologic suppression

Module 4: Common Adverse Effects of Antiretroviral Therapy

  • Common side effects of ART include nausea, diarrhea, difficulty sleeping, headache, and fatigue               

Module 5: Supporting Adherence at Follow-Up Visits

  • Adherence should be assessed and reinforced at every clinic visit
  • Strategies for improving adherence include using positive reinforcement, identifying barriers to adherence, and using effective interventions to address suboptimal adherence

View reference list.

Click "Continue" to proceed through this activity and receive credit, or select a specific module from the menu on the left. To receive credit and a certificate, you must complete all of the modules in this activity.

By clicking "Continue," you confirm that you have reviewed the CME information.


Unless otherwise indicated, photographed subjects who appear within the content of this activity or on artwork associated with this activity are models; they are not actual patients or doctors.

The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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