Case Studies in Family Planning and Treatment of People with HIV During Pregnancy (WEB)

A. Switch her to Dolutegravir and emtricitabine/tenofovir alafenamideB. Switch to long-acting Cabotegravir/RilpivirineC. Switch to twice daily Darunavir/ritonavir and emtricitabine/tenofovir alafenamideD. Maintain her current regimen

Congratulations. The best choice is D. In most cases, people with HIV who are receiving antiretroviral therapy and present for pregnancy care should continue their current regimen, provided that the regimen is well tolerated, safe, and effective in suppressing viral replication.

Sorry, the correct answer is D. TIn most cases, people with HIV who are receiving antiretroviral therapy and present for pregnancy care should continue their current regimen, provided that the regimen is well tolerated, safe, and effective in suppressing viral replication.

A. 0%B. Less than 0.1%C. Less than 1%D. 5%

Congratulations. The best answer is C. While many small studies evaluating breastfeeding women on suppressive ART have shown no HIV transmissions, others have shown that a few transmissions do still occur with an average rate of HIV transmission of 0.3 percent at six months and 0.6 percent at 12 months.

Sorry, the best answer is C. While many small studies evaluating breastfeeding women on suppressive ART have shown no HIV transmissions, others have shown that a few transmissions do still occur with an average rate of HIV transmission of 0.3 percent at six months and 0.6 percent at 12 months.

A. The DDI will cause lower drospirenone exposure, resulting in decreased contraceptive effectiveness.B. The DDI will cause higher drospirenone exposure, resulting in a higher risk of hyperkalemia.C. The DDI will cause higher ethinyl estradiol exposure, resulting in greater risk for blood clots.D. The DDI will cause lower ethinyl estradiol exposure, resulting in more hormone related acne.

Congratulations. The best answer is A. While more modern antiretroviral regimens result in less drug-drug interactions, concomitant medications should still be screened for potential DDIs. Carbamazepime is a CYP3A inducer, which may result in lower exposure to both drospirenone and ethinyl estradiol. Lower drospirenone may decrease the risk of contraceptive effectiveness. Lower estradiol exposure may increase the risk of breakthrough bleeding, and may contribute to contraceptive effectiveness to a lesser extent than the progestin component. SG’s antiretroviral regimen should also be screened for DDIs with carbamazepime.

Sorry, the best answer is A. While more modern antiretroviral regimens result in less drug-drug interactions, concomitant medications should still be screened for potential DDIs. Carbamazepime is a CYP3A inducer, which may result in lower exposure to both drospirenone and ethinyl estradiol. Lower drospirenone may decrease the risk of contraceptive effectiveness. Lower estradiol exposure may increase the risk of breakthrough bleeding, and may contribute to contraceptive effectiveness to a lesser extent than the progestin component. SG’s antiretroviral regimen should also be screened for DDIs with carbamazepime.

YesNoRemained the same

	Strongly Agree (5)	Agree (4)	Neutral (3)	Disagree (2)	Strongly Disagree (1)
The content covered was useful and relevant to my current or future scope of practice.
The activity was fair, balanced, and free of bias.
The activity improved my knowledge of this clinical issue.
The learning objectives for this activity were achieved.
I am better able to: Communicate/collaborate with other members of the care team on this issue.
I am better able to: Improve access to care and treatment for underrepresented patient groups or geographies because of what I learned.
The information learned during this activity will help improve my skills or judgment within the next six months.
The content was presented clearly.
The educational activity was well planned and presented.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I intend to: Modify/change my practice or the practice of my team based on this educational activity.
I intend to: Work with my team to create/revise protocols, policies, and/or procedures with my care team.
I intended to: Share what I learned with other members of my care team.
I intend to: Make changes in how I communicate with/educate my patients.
I intend to: Seek additional information on topics discussed during the activity.
On average, I utilized the patient treatment strategies described in this educational activity prior to my participation.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
My office and practice systems can accommodate the above changes.
My patients can accommodate the above changes.
Patient access to the treatments provided will be a barrier to implementing the above changes.

	Excellent (5)	Good (4)	Acceptable (3)	Poor (2)	Very Poor (1)
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Case Studies in Family Planning and Treatment of People with HIV During Pregnancy

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