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ONLINE LEARNING CENTER

PERINATAL HIV PREVENTION: GUIDELINES FOR Labor, Delivery and Infant Prophylaxis (17HH01)

Jason Zucker, MD, Internal Medicine Chief Resident, Rutgers-New Jersey Medical School, University Hospital and David Cennimo, MD, FACP, FAAP, AAHIVS, Assistant Professor, Department of Medicine and Pediatrics, Division of Infectious Disease, Rutgers-New Jersey Medical School


 
 
 

Release Date: December 1, 2014
Expired: November 30, 2016
Activity Code: 17HH01

IMPORTANT:
CREDIT IS NO LONGER AVAILABLE FOR THIS ACTIVITY.
This content is being provided for informational purposes only.

If you have any questions about this process, please email the Center for Continuing and Outreach Education at ccoereg@ca.rutgers.edu or call CCOE Enrollment Services at (800) 227-4852.
As seen in the Winter 2014 edition of


ACTIVITY INFORMATION

Sponsor

Sponsored by François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey and the Center for Continuing and Outreach Education at Rutgers Biomedical and Health Sciences.

Funding

This activity is supported by an educational grant from the New Jersey Department of Health (NJDOH)—Division of HIV, STD and TB Services, through an MOA titled “Education and Training for Physicians and other Healthcare Professionals in the Diagnosis and Treatment of HIV/AIDS.”

Statement of Need

With the advent of antiretroviral drugs, women have the option of child bearing regardless of their HIV status. Although HIV-infected women, children born to these women do not have to be born positive as long as the mother knows her infection status, receives the adequate care and treatment during pregnancy, labor and delivery and once the infant is born. A breakthrough for pediatric HIV/ AIDS came in 1994 with the successful clinical trial that showed if pregnant women adhered to antiretroviral use during pregnancy, infants could expect a 70% decrease in becoming infected with the virus. Since then, children born to women who are HIV-infected have been on the decline.

Statewide data shows the overall total number of cases of pediatric infected children is 1,380 while the number of perinatally exposed is 4,752 reported in 2013. In 2009 there were 5 cases of infants born with HIV. Although the absolute number is low, New Jersey strives to bring this number to 0, suggesting that there is still work to do, most importantly, “Every diagnosis of an infant who is infected with HIV represents a missed opportunity for prevention” (Burr, 2012).

This year the guidelines around treatment for HIV exposed infants were updated. An excerpt from the guidelines states that the “the potential benefit of combining zidovudine infant prophylaxis with additional antiretroviral (ARV) drugs must be weighed against the potential risks to infants of multiple drug exposure. There is a spectrum of transmission risk that depends on a number of maternal and infant factors, including maternal viral load, mode of delivery, and gestational age at delivery.”

This activity will seek to educate those to the new information in treatment recommendations using an evidenced based approach to continue to lessen the number of infants that are exposed to HIV and the medical and practical steps in treating potential HIV exposure.

Target Audience

This activity is designed for physicians, nurses, health educators, and other health care professionals in New Jersey who are involved in the care of women and newborns.

Method of Participation

Participants should read the learning objectives, review the activity in its entirety, and then complete the self-assessment test, which consists of a series of multiple-choice questions. Upon completing this activity as designed and achieving a passing score of 70% or more on the self-assessment test and submitting a course evaluation, participants will receive a printable credit statement.

Learning Objectives

Upon completion of this activity, participants should be able to:

  1. Describe the circumstances in which the 1-drug or 2-drug therapy is used to treat HIV exposed infants.
  2. Recognize clinical scenarios where pediatric infectious disease specialist consultation is recommended.
  3. Describe the consideration of the pediatric infectious disease specialist when prescribing a prophylactic regimen for infants at high risk for HIV infection.

Faculty

Activity Directors/CME Academic Advisors

Shobha Swaminathan, MD, Assistant Professor, Division of Infectious Diseases, Department of Medicine, Rutgers New Jersey Medical School

Margaret Evans, MSN, RN, CCOE Primary Nurse Planner; Nurse Manager for Education and Performance Improvement at Robert Wood Johnson Medical Group.

Planning Committee

Mary Jo Hoyt, MSN, Director, Education and Capacity Development, FXB Center, Rutgers

John Nelson, PhD, CPNP, Program Director, AETC, NRC

Andrea Norberg, MS, RN, Executive Director, FXB Center, Rutgers

Joanne Phillips, RN, MS, Education Specialist, FXB Center, Rutgers

Michelle Thompson, Program Manager, FXB Center, Rutgers

Elizabeth Ward, MSJ, Executive Director, Rutgers CCOE

Activity Authors

Jason Zucker, MD
Internal Medicine Chief Resident
Rutgers-New Jersey Medical School
University Hospital

David Cennimo, MD, FACP, FAAP, AAHIVS
Assistant Professor, Department of Medicine and Pediatrics
Division of Infectious Disease
Rutgers-New Jersey Medical School

Accreditation

Credit is no longer available for this activity.

Peer Review

In order to help ensure content objectivity, independence, and fair balance, and to ensure that the content is aligned with the interest of the public, CCOE has resolved all potential and real conflicts of interest through content review by non-conflicted, qualified reviewers. This activity was peer-reviewed for relevance, accuracy of content and balance of presentation by Mary Jo Hoyt, MSN and Joanne Phillips, RN, MS.

Field Test:
This activity was field tested for time required for participation by Debra Chew, MD, Noa’a Shimoni, MD, MPH, Howard A. Grossman, MD, Anna M. Haywood, RN, MSN, Juanita Howell, RN, MSN, and Laura Bogert, RN, BSN.

Disclosure Disclaimer

In accordance with the disclosure policies of Rutgers University and to conform with ACCME and FDA guidelines, individuals in a position to control the content of this educational activity are required to disclose to the activity participants: 1) the existence of any relevant financial relationship with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients, with the exemption of non-profit or government organizations and non-health care related companies, within the past 12 months; and 2) the identification of a commercial product/ device that is unlabeled for use or an investigational use of a product/ device not yet approved.

Disclosure Declarations

The authors, activity directors, all other planning committee members, peer reviewers and field testers have no relevant financial relationships to report.

Off-Label Usage Disclosure

This activity does not contain information of commercial products/devices that are unlabeled for use or investigational uses of products not yet approved.

Content Disclaimer

The views expressed in this activity are those of the faculty. It should not be inferred or assumed that they are expressing the views of NJDOH – Division of HIV, STD and TB Services, any manufacturer of pharmaceuticals or devices, or Rutgers University. It should be noted that the recommendations made herein with regard to the use of therapeutic agents, varying disease states, and assessments of risk, are based upon a combination of clinical trials, current guidelines, and the clinical practice experience of the participating presenters. The drug selection and dosage information presented in this activity are believed to be accurate. However, participants are urged to consult all available data on products and procedures before using them in clinical practice.

Copyright © 2014 Rutgers University

All rights reserved including translation into other languages. No part of this activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval systems, without permission in writing from Rutgers University.

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