A Guide to Primary Care of People with HIV/AIDS - Canadian Public ...

A Guide to Primary Care of People with HIV/AIDS
Chapter 18: Keeping Up-To-Date: Sources of Information for the Practicing Clinician
Are AIDS conferences useful for providers who
are not HIV experts?
A number of national conferences provide opportunities
to obtain cutting-edge information (see Table 18-1). The
range of offerings usually meets the needs of providers
just learning about HIV as well as providers who are
already HIV experts.
What if you practice in a remote area?
In remote geographic areas, the nearest HIV expert may
actually be far away and attendance at conferences
and meetings may not be feasible. In this situation,
the regional AETC can be contacted to determine
how to obtain direct educational programming. When
distance prevents on-site attendance at educational
programs, newer technologies may enable long distance
participation. Satellite broadcasting and down-linking
to local facilities may be available and has been a useful
approach in various parts of the United States. Distance
learning and web-based information also provide
important sources of education when other programming
is unavailable. Many sessions are videotaped or
audiotaped. Videocassettes and audiocassettes may be
distributed or purchased for a modest price.
Is clinical consultation possible even if you are
not affiliated with an HIV specialty practice?
In areas of the country with no HIV clinical experts, a
number of consultative and co-management options
are available through the AETCs or statewide education
initiatives to assure that patient care is of the highest
quality. Informal discussions with experienced providers
in the region are probably the easiest way to access
expertise, especially since these providers may be
available for formal clinical consultation when decisions
are made about ART, such as when to initiate, modify, or
discontinue therapy.
Clinical consultations are available not only through
the regional AETCs, but also from the National HIV
Clinical Consultation Center, based at the University of
California San Francisco (UCSF). This service provides
a “warmline” — a toll-free phone number staffed
from 6:00 a.m. to 5:00 p.m. PST by physicians, nurse
practitioners, and pharmacists who are available to
answer providers’ questions. During other times, or
when the phone line is busy, voicemail messages can
be left and calls returned. The HIV experts discuss
options with callers, presenting pros and cons of various
approaches with the goal of improving the capability
of the provider to manage the current situation and
others like it. The Center also refers callers to their local
resources for expertise, consultation and training.
National HIV/AIDS Clinical Consultation
Center Warmline: 1-800-933-3413
WRITTEN RESOURCES
What books and journals are most useful for
primary care providers?
Although a basic textbook of HIV/AIDS medicine
provides a basic reference of core knowledge, it becomes
outdated nearly as quickly as it is published, particularly
in relation to ART. Small books such as the Pocket Guide
included in this guide contain quick reference materials,
are more frequently updated, and provide summaries
that can be useful at the point of care. Other books
provide specialized information related to the care of
specific groups of persons with HIV. For example, A
Guide to the Clinical Care of Women with HIV offers an
excellent comprehensive overview of issues pertaining to
the care of women, with useful tables, photographs, and
practical information for the provider.
Most major journals include articles about HIV. Clinical
trials and review articles periodically appear in the
major internal medicine journals. Two important peerreviewed
HIV-specific journals, AIDS and JAIDS (Journal
of the Acquired Immune Deficiency Syndromes and Human
Retrovirology), include studies and review articles in the
domains of basic science, epidemiology, clinical care,
and HIV prevention. Other regularly published bulletins
and journals offer review articles on basic aspects of
clinical management that are useful summaries for the
primary HIV care provider. The Johns Hopkins HIV Report
provides summaries of current issues and controversies
in HIV care authored by experts from the Hopkins HIV
Service. Question and answer sessions with experts
are often included as part of these publications. See
Table 18-2 for a list of recommended publications.
Also, a comprehensive list of HIV professional journals
can be found at http://www.mednets.com/index.cfm/
fuseaction/articles_aids_aidsjournals Accessed 3/04.
Can journal articles be accessed on the internet?
To keep up with all of the HIV journals is impossible,
especially when a practice is not exclusively devoted
to HIV care. Several websites post information about
newly published articles and can easily be scanned to
seek relevant or noteworthy information (see Table 18-
3). Medscape, which has a specific section dedicated to
HIV, and HIVInSite are two good sources of news. An
abstract of almost any article can be retrieved through
the National Library of Medicine’s website at PubMed.
A useful list of websites, references and news may also
be found at Medline Plus. The Kaiser Daily HIV/AIDS
Report offers a daily news summary that includes
both newspaper articles and major clinical or scientific
releases that anyone can subscribe to by registering at
the website. The Aegis website links to news summaries
that can be quickly accessed to obtain the desired
summary.
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U.S. Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau
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