HIV in the Urgent Care Setting: Treatment and Prevention (Infectious Disease CME, HIV CME, and Pharmacology CME)

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Delivery Method:	Online
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Publication Date: June 2024 (Volume 3, Number 6)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 06/01/2027.

Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME credits, 4 HIV CME credits, and 2 Pharmacology CME credit, subject to your state and institutional requirements.

Authors

Peer Reviewer

Abstract

With appropriate care and antiretroviral therapy, persons with HIV can achieve undetectable viral loads, resulting in the virtual elimination of opportunistic infection risk, an improved quality of life, and a normal life expectancy. The optimal urgent care management of persons with HIV includes the diagnosis of new cases, the prevention of HIV acquisition, and the provision of services for re-engagement and reconnection of out-of-care persons with HIV back to the care of an HIV clinician. This issue of Evidence-Based Urgent Care reviews the role of urgent care clinics and clinicians in preventing, screening for, and diagnosing new HIV infections. The urgent care management of persons with HIV is also discussed, including patients who have suppressed viral loads and patients with untreated HIV.

Case Presentations

A 28-year-old man with HIV presents to urgent care with a productive cough and fever for 5 days...

• The patient states that he has well-controlled HIV and says his last CD4 count a few weeks ago was 550 cells/mcL.
• You wonder how to approach diagnosis and treatment for his respiratory infection in the setting of his HIV disease...

A 42-year-old woman with HIV presents to urgent care with a complaint of diarrhea...

• She says she has had up to 3 episodes of diarrhea a day for the past 3 weeks.
• She denies pain, melena, rectal bleeding, and fever. Her laboratory test results are unremarkable.
• You wonder whether additional testing is needed and whether sending her home is appropriate…

A 31-year-old man requests testing for “all” sexually transmitted infections...

• He reports engaging in condomless vaginal intercourse with a partner with unknown HIV status 12 hours earlier.
• In addition to being evaluated for STIs, he wants to make sure he does not contract HIV.
• You wonder if HIV PEP is indicated for this patient…

A 24-year-old woman presents to urgent care with fever of unknown origin...

• She describes having fevers to 101°F, swollen lymph nodes, and diffuse maculopapular rash. Several of her friends are ill with upper respiratory viral infections and she wonders if this is the same illness.
• She is sexually active but denies any known history of STIs.
• You consider the differential and testing options for this patient…

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.