Objective: The primary objective of this inter-phase is to create a forum where HIV providers can gain simple, uncomplicated, state of the art information on topics of current interest in HIV/AIDS treatment. All Programs are currently ACPE/CME approved and with time, the website will be set up (hopefully in the next grant cycle) so that providers can earn actual CE credits. The CONSULTANT will develop a “mini-home page” for each of the programs currently listed in our catalog by providing a program description as well as a listing of learning objectives and possible 5 pre and post-test questions.

1.1.1. Clinical Manifestations of Acute Primary HIV Infection INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Understand the circumstances that lead to transmission of the HIV virus. Recognize the signs and symptoms associated with the sero-conversion illness that follows acute primary HIV infection. Be able to understand the relationship between STDs and HIV infection, to recognize instances when HIV transmission may have occurred and to recommend testing and further referral to HIV providers especially in minority communities with high prevalence of incarceration, alcohol, drug and substance abuse, STDS and HIV infection. Be able to understand the relationships between viral loads and T-lymphocyte counts and to counsel and refer patients to AIDS treatment clinics when necessary. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1. 1.2. Understanding the Reverse Transcriptase Inhibitors INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Describe the mechanism of action and the biological basis for the action of the reverse transcriptase inhibitors in antiretroviral treatment. Understand the three major therapeutic categories of reverse transcriptase inhibitors, namely the nucleosides, the non-nucleoside and the nucleotide reverse transcriptase inhibitors. Describe the dosage regimens, food and hydration requirements, side effects and major long-term toxicities of individual reverse transcriptase inhibitors. Be able to use these agents in combination therapies for HIV infection, named HAART or highly active antiretroviral therapy. Purpose: The reverse transcriptase inhibitors continue to be the backbone for the crafting of the cocktails or combination regimens that have dramatically changed the outcomes for persons infected with the HIV virus for the past several years. Presently three groups of agents are available, namely the oldest of the group, the nucleoside reverse transcriptase inhibitors exemplified by the oldest agent for treatment of HIV, zidovudine or Retrovir, the non-nucleoside reverse transcriptase inhibitors exemplified by nevirapine (Viramune) and efavirenz (Sustiva), and finally by the sole nucleotide, tenofovir disoproxil fumarate (Viread), recently developed by Gilead Sciences. This monograph will discuss the mechanism of antiretroviral action, dosage regimens, side effects and long-term toxicities associated with the reverse transcriptase inhibitors. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1.1.3. Understanding the Protease Inhibitors INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Understand the mechanism of action and the role of the protease inhibitors in the combination antiretroviral treatment called “HAART”, highly active antiretroviral therapy. Understand the dosages, dose requirements (food and hydration) of each agent. Understand the side effects, short-term and long-term toxicities of the protease inhibitors and how to manage these. Understand the long-term complications and class adverse effects of the protease inhibitors and product selection in individual patients with co-morbities along with HIV infection. Purpose: The advent of the protease inhibitors towards the end of 1995 revolutionized the drug management of HIV disease. Beginning with saquinavir mesylate, a poorly bio-available compound which was first released as the hard gel capsule (Invirase) and subsequently improved by a soft gel formulation (Fortovase), the protease inhibitors in combination with the reverse transcriptase inhibitors, provided HIV clinicians, for the first time with regimens described as “highly active antiretroviral therapy” or HAART and led to dramatic reductions in mortality due to this virus. Today, there are 5 single-ingredient protease inhibitors with one fixed combination boosted PI, (lopinavir ritonavir, as Kaletra) providing numerous possibilities for single and boosted protease inhibitor containing regimens The highlights of each of these antiretroviral agents will be presented. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1.1.4. Management of Side effects and Toxicities of Antiretroviral Medications INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Describe the prevalence, severity, duration and functional impact of various types of HAART side effects. To offer recommendation for preventing or managing the symptoms of these side effects. To appreciate the role of side effects in disrupting adherence to HAART therapy. To appreciate the relationship between non-adherence and long-term viral suppression. To understand the side effects of HAART on major organ systems such as the skin and mucocutaneous membranes, the GI, CNS, PNS, liver, kidney, metabolic, hematologic and endocrine organs. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1.1.5. The AIDS Epidemic in the African-American Community INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Understand the epidemiology and pathogenesis of transmission of the HIV virus. Understand the reasons why persons in minority communities are at greater risk of contacting the HIV virus. Understand the interplay of drug and substance abuse, incarceration, high prevalence of STDs and high risk sexual behavior in minority communities. Understand the routes of transmission of the virus and the role of circumcision in minority communities. Be able to increase the index of suspicion of minority providers to HIV transmission and be able to counsel patients for HIV testing when they have risky behaviors that suggest opportunities to transmit the HIV virus. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1.1.6. The old and the new in the management of HIV disease INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Understand the basics of the clinical pharmacology of the reverse transcriptase inhibitors as well as the protease inhibitors including their adverse effects. Understand combinations of HAART and how to use them in the treatment of HIV disease. Understand the side effects, long-term toxicities, including metabolic complications of HAART medications, and how to avoid and circumvent these. Understand adherence, issues of pill burden in a disease where treatment is life-long; understand resistance and the role of adherence in improving outcomes while decreasing emergence of resistance strains. Be able to educate HIV-infected patients and to counsel them on HAART regimens they are receiving for this life-long disease. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1.1.7. Treatment of Opportunistic Infections Associated with advanced HIV Infection INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Discuss common opportunistic infections (OIs) in HIV infection, their presentation and appropriate intervention. Discuss current OIs in terms of suppressive treatment and prophylaxis. Discuss updates on when to stop prophylaxis when immune system improves with HAART (highly active antiretroviral therapy). ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.

1.1.8. The Role of Male Circumcision in the Prevention of HIV in Communities of High HIV Prevalence. INTENDED AUDIENCE: Physicians, Physician assistants, nurses, nurse practitioners and advanced practice nurses, pharmacists and dentists involved in the treatment and care of persons infected with the HIV virus. EDUCATIONAL OBJECTIVES: Upon completion of this monograph, the participant should be able to: Understand the role of male circumcision in the transmission of the HIV virus. Become familiar with the landmark studies that have shed light on this phenomenon. Understand the relationships between especially the ulcerative sexually transmitted Diseases (STDS), (herpes virus infections, syphyllis, gonococcal urethritis and chancroid), male circumcision and HIV transmission. Be able to counsel parents, young adults and adult males about circumcision and its role in HIV prevention. ACCREDITATION: this material, at the point of presentation, will be approved for continuing education credit by the American Council on Medical Education (CME), the American Council of Nursing Education and the American Council of Pharmaceutical Education (ACPE). DISCLOSURE In accordance with the Accreditation Council for Continuing Medical and Pharmaceutical education Standards for Commercial Support, the Course Director for this activity has been asked to complete a disclosure form. Disclosures are described below: Dr. Tina Edmunds-Ogbuokiri, Pharm.D., FASCP Associate Professor of Clinical Pharmacy, Xavier University of Louisiana College of Pharmacy and Consultant Clinical Pharmacist, HIV Outpatient Clinic, 136 S. Roman Street, Medical Center of Louisiana at New Orleans. Grant/Research Support: National Minority AIDS Education and Training Center, Funding Agency Grant Number: 1H4A HA 00066-01.