The Academy Exchange: HIV Today & Tomorrow

Bonus Episode: IAS 2023 Conference Highlights Dr. William Short and Dr. Laura Armas-Kolostroubis join Bruce to talk about the research coming out of the 12th IAS Conference on HIV Science that took place July 23-26, 2023. They discuss some of the groundbreaking studies presented at the conference and how the research can be translated into clinical practice. They talk about research on zero transmission, studies looking at the next steps in long-acting technologies, and findings from a clinical trial on the use of statins to prevent cardiovascular disease for those with HIV. They also explore the latest on doxycycline PEP for STI prevention and highlight findings from the ANCHOR study on anal cancer and how to prevent it in people with HIV. About Dr. Short and Dr. Armas-Kolostroubis William R. Short, MD, MPH, AAHIVS, is an Associate Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania. He is also associate director of the HIV Clinical Trial Unit at the University of Pennsylvania and the co-director of the Clinical Core for the Penn Center for AIDS Research. He is chair of the board of directors of the American Academy of HIV Medicine. Laura Armas-Kolostroubis, MD, FACP, AAHIVS, is the founder and CEO of Human Centered Consulting and Care. In clinical practice for more than 20 years, Dr. Armas-Kolostroubis was a practicing physician and Chief Medical Officer at CAN Community Health, and she was a clinical director for the Texas/Oklahoma AIDS Education and Training Center. She sits on the board of directors for the American Academy of HIV Medicine. Resources: IAS 2023, the 12th IAS Conference on HIV Science - https://www.iasociety.org/conferences/ias2023 ANCHOR Study - https://anchorstudy.org/ REPREIVE Trial - https://www.reprievetrial.org/ ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Bruce is joined by Dr. Daniel Lee, who discuss HIV-associated weight changes – both gaining and losing weight. First, they examine weight gain in those with HIV and how it can accelerate aging as well as contribute to other diseases, such as hypertension and diabetes. They also discuss losing weight with HIV, although HIV-related weight loss is not as common today as it was in the early days of the HIV epidemic. They emphasize the importance of a healthy diet and maintaining physical activity for people with HIV, especially for those who reduced their activity levels because of the COVID-19 pandemic. About Dr. Daniel Lee: Daniel Lee, MD, AAHIVS, is a clinical professor of medicine at UC San Diego Owen Clinic. He is an HIV primary care provider who has been caring for people with HIV for nearly 25 years. He's also the clinical director for the Pacific AIDS Education Training Center HIV Learning Network, and the Founder and Director of the Owen Lipid/Lipodystrophy Clinic, which is a subspecialty clinic focused on managing metabolic complications of antiretroviral therapy. Resources: CDC Healthy Living with HIV POZ Magazine: Weight Gain and HIV NAM: Weight Gain and HIV Treatment ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Dr. Donna Sweet and Bruce discuss the history of the HIV epidemic through the lens of Dr. Sweet’s personal experience as a practitioner. They talk about the early experiences of treating and managing HIV and AIDS before tests, empirical treatments, and sufficient knowledge about the virus. They discuss how antiretroviral therapy and new clinical case definitions in the 1990s and 2000s allowed for better treatment and management of HIV. Throughout the conversation, they mention how the stigma surrounding HIV and homosexuality remains prevalent and unnecessary and the danger of continuing misinformation. They conclude with an outlook on the future of HIV medicine, vaccinations and cure. About Dr. Donna Sweet: Donna Sweet, MD, AAHIVS, MACP, is a professor of internal medicine at the University of Kansas School of Medicine in Wichita, Kansas, and has been credentialed with the Academy since its inception. She has an HIV program in her clinic with federal Ryan White, Parts B, C, D and F funds, where she cares for approximately 1,400 patients with HIV. Resources: Timeline of the HIV epidemic - https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline UCSF AIDS History Project Collections - https://www.library.ucsf.edu/archives/aids/collections/ Future directions - https://www.niaid.nih.gov/diseases-conditions/future-hiv-treatment ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Dr. Milena Murray joins Bruce to discuss the implications of aging and HIV. Since nearly half of Americans living with HIV are over the age of 55, it is important to recognize their unique care needs as well as the risk of HIV in people over 55 generally. Bruce and Dr. Murray talk about the use of PrEP and how people can approach sexual health discussions with their providers. They also talk about what to expect with the use of antiretroviral therapies in conjunction with other medications people commonly use when they age. They emphasize how care should be tailored for the individual and why it’s important for patients and providers to have open communication about their drug regimens. About Dr. Milena Murray: Milena Murray, PharmD, MSc, BCIDP, AAHIVP, FCCP, is an associate professor of pharmacy practice at the Midwestern University College of Pharmacy, Downers Grove Campus. She is also a system level HIV infectious diseases clinical pharmacist at Northwestern Medicine. She completed her Doctor of Pharmacy at the Philadelphia College of Pharmacy and her postgraduate training consisted of a pharmacy residency at Maimonides Medical Center in Brooklyn, New York, and an infectious disease pharmacotherapy fellowship at Northwestern Memorial Hospital. Resources: HIV.gov’s Aging with HIV - https://www.hiv.gov/blog/resources-hiv-and-aging/ National Institutes of Health: HIV, AIDS, and Older Adults - https://www.nia.nih.gov/health/hiv-aids-and-older-adults Positively Aware: HIV and Aging - https://www.positivelyaware.com/hiv-aging ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Bruce is joined by Dr. Hannan Braun to talk about substance use disorder and its overlap with the HIV epidemic. They discuss what a substance use disorder is and the risks of HIV for those who inject illicit substances. They also cover the HIV pre-exposure prophylaxis (PrEP) that is available for those who have a substance use disorder and the benefits for using PrEP. As well, Dr. Braun covers the various options available for treating a substance use disorder and highlights the ways people can recover with successful intervention. He also touches on some of the hurdles that providers face when trying to treat a substance use disorder and some of the ways that providers can help prevent HIV in those who are using substances. About Dr. Braun Hannan Braun, MD, AAHIVS, is an HIV primary care doctor and addiction medicine specialist in the Division of General Internal Medicine at Denver Health in Denver, Colorado. He completed his residency in internal medicine-primary care at Boston Medical Center and a fellowship in addiction medicine at Brown University. His clinical and scholarship interests include low-barrier substance use disorder treatment, HIV prevention for people who use drugs, harm reduction, LGBTQ+ health, and inpatient addiction medicine. Resources: Substance Abuse and Mental Health Services Administration - https://www.samhsa.gov/ CDC: Recovery is For Everyone - https://www.cdc.gov/drugoverdose/featured-topics/recovery-SUD.html HIV.gov: Substance Use Disorders and HIV - https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/substance-use-disorders-and-hiv ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Dr. Heather Quaile joins Bruce to talk about trauma-informed care (TIC) and why it’s important for people to receive TIC whenever they visit a health care provider. A TIC approach means that providers understand the implications of traumatic events on patients and work to create a safe and supportive environment for all patients. This episode covers the ways that promoting a culture of trust and collaboration between providers and patients is a foundation for improving patient health. Not only do patients benefit from TIC, but providers and their staff also experience improvements in their wellness and well-being. About Dr. Quaile Heather Quaile DNP, WHNP-BC, AFN-C, CSC, IF, FAANP, is a clinical and academic leader as well as a double board-certified women’s health nurse practitioner and advanced forensic nurse. She also is trained and certified as an AASECT sex counselor and sexual assault nurse examiner, providing sexual health education, trauma-informed care, and information to patients of all ages. She is widely published in the field of women’s health and trauma-informed care. Resources: Sexual Medicine Society of North America - https://www.smsna.org/ The Center for Health Care Strategies: Trauma-Informed Care Implementation Resource - https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/ National Alliance on Mental Illness - https://www.nami.org/Home ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Bruce is joined by Angela Kapalko, PA-C, AAHIVS, to talk about the current state of the HIV Workforce and the needs of the future. As the generation of providers who started treating HIV at the beginning of the epidemic approach retirement, the need for a new generation of clinicians to care for the now aging population of people with HIV is greater than ever. Bruce and Angela discuss current trends and needs in the HIV workforce, specifically with regards to Nurse Practitioners and Physician Assistants and their unique role in filling that gap. They also discuss specific initiatives that are helping to encourage younger practitioners to specialize in HIV care. About Angela Kapalko: Angela has been practicing medicine since 2007, with her entire career in the HIV healthcare space. Her passion is in education of both patients as well as healthcare students and new clinicians. She lectures at a number of Physician Assistant programs throughout the Philadelphia area, hosting students for clinical preceptorships and assisting those who want to continue in the work with future jobs. In 2022, with the help of the academy, she started the PA Preceptorship Program, with the goal of connecting PA students throughout the country with practicing PAs in HIV prevention and medicine for clinical rotations to increase the knowledge and ultimately the workforce for the future. Resources: CDC: HIV Self-Tests - https://www.cdc.gov/hiv/basics/hiv-testing/hiv-self-tests.html AAHIVM PA Preceptorship Program - https://aahivm.org/papreceptorship/ ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

In the first episode of our second season you can learn about transgender and gender diverse care from a health care provider’s perspective. Dr. Michelle Collins-Ogle joins Bruce to discuss her experience providing gender affirming care to her transgender and gender diverse patients. They talk about what makes up gender-affirming care, the misconceptions around it, what it isn’t, and all the ways it can be applied in a health care setting. As well, they cover the ways that being transgender can affect the type of health care a person can access. You’ll find out more about a variety of topics, including the definitions of cisgender, transgender, gender diverse and gender fluid; the history of transgender people in the United States; and how to help people feel comfortable in the space they are in. About Dr. Collins-Ogle: Dr. Michelle Collins-Ogle is the Medical Director at the Montefiore Adolescent and Youth Sexual Health Clinic in Bronx, New York. She also is associate professor of pediatrics and faculty at Einstein College of Medicine in New York. Resources: World Professional Association for Transgender Health - https://www.wpath.org/ National Center for Transgender Equality - https://transequality.org/ Transgender Law Center - https://transgenderlawcenter.org/resources/health ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Dr. Richard Silvera joins Bruce to discuss Mpox and Meningococcus and how the lessons learned from HIV outbreak response are applicable to these infectious diseases. They discuss the epidemiology of Mpox and meningococcus disease and the nuances between sexually transmitted infections and those spread by intimate contact. With the public being more aware of the importance of vaccines, it’s important to understand how healthcare providers can best respond to outbreaks of Mpox and meningococcus. About Dr. Silvera: Dr. Richard Silvera is an Assistant Professor of Infectious Diseases and the Associate Program Director of the Infectious Diseases fellowship at the Icahn School of Medicine at Mount Sinai. Resources: CDC Risk Reduction RecommendationsAnti-stigma Communication RecommendationsNew Vaccine Eligibility Recommendations******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Heterosexual women are not the typical demographic that is targeted in HIV research and treatments. But their risk factors for HIV are different and require unique methods to address. Bruce and clinical HIV Specialist™ Dr. William R. Short discuss the needs of women and HIV with a focus on women who are pregnant or may become pregnant. For more information about the Antiretroviral Pregnancy Registry, visit http://www.apregistry.com/. About Dr. Short: William R. Short, MD, MPH, FIDSA, AAHIVS, is an Associate Professor of Medicine with a secondary appointment for Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania. He serves as Associate Director of AIDS Clinical Trials Unit at the University of Pennsylvania and Co-Director of the Clinical Core at the Penn Center for AIDS Research. ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are potential game changers in efforts to reduce the prevalence of HIV across the globe. But uptake continues to be lackluster, especially in traditionally underserved populations. Bruce and clinical HIV Pharmacist™ Dr. Carly Floyd discuss how PrEP has evolved over the last decade in clinical use for HIV prevention and share strategies for increasing PrEP and PEP access and uptake to populations that have not yet been adequately reached. PrEP is available in both oral and injectable formulations and, when taken routinely can prevent the transmission of HIV, whether through blood, sexual exposure, or injection. PrEP and PEP are key pillars in the U.S. National HIV/AIDS Strategy to end the HIV epidemic. About Dr. Floyd: Dr. Floyd is a clinical pharmacist at Southwest Care Center in Albuquerque, New Mexico and clinical director of the University of New Mexico’s AIDS Education and Training Center. Resources: HIV Risk Transmission ChartACA implementation part 47 www.gileadadvancingaccess.com/copay-coupon-cardwww.viivconnect.com/for-providers/viivconnect-programs/medications/www.copays.org/diseases/hiv-aids-and-preventionwww.mygooddays.org/patients/diseases-covered/hiv-aids-treatment-and-preventionwww.gileadadvancingaccess.com/ nastad.org/prepcost-resources/prep-assistance-programsreadysetprep.hiv.gov/******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org

Academy Executive Director, Bruce Packett, is joined by clinical HIV Pharmacist™ Dr. Brooke Stevens to discuss new and novel antiretroviral therapies including single pill regimens and long-acting injectables. These new regimens allow antiretroviral therapy to be administered less frequently, making it potentially easier for patients to remain adherent. They discuss who might be good candidates to consider switching to novel formulations and modalities, as well as trends in which patients are interested in switching. But there are some barriers to uptake of these novel treatments, including prior authorization requirements and challenges with rolling out new therapies. About Dr. Stevens: Dr. Brooke Stevens is the specialty pharmacy clinical manager at Indiana University Health in Indianapolis, Indiana and a clinical pharmacist at LifeCare Clinic at Methodist Hospital as well as the Ryan White Center for Pediatric Infectious Disease and Global Health at Riley Hospital for Children at Indiana University Health. ******** Questions about this topic? E-mail podcast@aahivm.org to get connected with Bruce or any of our guests. Are you a medical provider and want to join the conversation? Make your voice heard in the Academy Communities and connect with other HIV clinicians! To learn more about the Academy, visit www.aahivm.org