John F. Toney, MD, FACP, FIDSA
Faculty, Florida/Caribbean AETC
Director, Southeast STD/HIV Prevention Training Center
Professor of Medicine, Division of Infectious Diseases and International Medicine, University of South Florida College of Medicine

How can we, as practitioners, prevent HIV infection from occurring?  Recently [October 2011] I had the opportunity to hear Dr. Michael Saag from the University of Alabama at Birmingham present during the Infectious Diseases Society of America (IDSA) Annual conference in Boston on “30 Years of HIV/AIDS – Where We Have Been and Where Are We Going.” This wonderful historical review included a brief discussion of HIV prevention measures and focused on recent microbicides and pre-exposure prophylaxis data. His presentation caused me to reflect on past recommendations from the CDC, NIH, and HIVMA/IDSA in 2003 regarding the incorporation of HIV prevention into the medical care of persons living with HIV.  This strategy involves obtaining a sexual history, identifying risky behaviors that may increase their risk of STD infection, and screening sexually active HIV-positive individuals for sexually transmissible infections at least annually (or more frequently if their risk is significant) as part of their ongoing clinical management. We understand that an individual's untreated STD infection(s) increases their chance of acquiring HIV, and conversely, an HIV-positive individual with an ulcerative or inflammatory STD is more likely to transmit HIV in genital secretions or direct sexual contact.

Halley Cornell, BA AETC Liaison
Ronald H. Goldschmidt, MD Director
National HIV/AIDS Clinicians' Consultation Center,
University of California, San Fransisco

Pre-exposure prophylaxis (PrEP), specifically the daily use of oral antiretroviral drugs as an HIV prevention measure, has been an increasingly hot topic in the HIV world since studies emerged in 2010 showing promising transmission prevention results among medication-adherent men who have sex with men (MSM). Further studies that failed to confirm the efficacy of PrEP regimens in certain populations, along with considerations that PrEP has the potential for drug toxicity and the not-yet-observed development of drug resistance, have increased the scope of conversation, but not the availability of answers. Clinicians are anxious to learn whether PrEP, combined with condom use and other safe sexual practices, can be a useful tool in their disease prevention arsenal. Official clinical guidelines on PrEP have not yet been released, however, and FDA approval of the principal drugs for this indication is currently under consideration. For the meantime, providers must base decisions on the CDC’s interim guidance on MSM PrEP(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6003a1.htm), current literature, their own best judgments, and clinical consultation from experienced, HIV-expert providers.

Judy Collins
Program Coordinator, AETC National Resource Center

The AETC National Resource Center (NRC) wrapped up its Social
Media Workgroup in November 2011 with a web-based debate entitled “To Tweet or Not to Tweet, That is the Question: AETCs and Social Media,” a tongue-in-cheeky, yet, comprehensive review on the pros and cons of social media and how the AETCs can utilize it in their practices.  We came away feeling positive - most of the webinar participants were on board with social media and were advocates for its practical use in the professional/healthcare setting.   There were a few skeptics, but overall the consensus was that social media is alive and growing and it behooves us to get on the bandwagon before it leaves us behind. Here’s a recap of some of the ways the AETCs can integrate social media (blogs, Facebook, Twitter and LinkedIn, in particular) into their practice.

Anna M. Haywood, RN, MSN
New York/New Jersey AETC Local Performance Site Coordinator 
François-Xavier Bagnoud Center
School of Nursing, University of Medicine & Dentistry of New Jersey

In 2010 the François Xavier Bagnoud Center (FXB), a division of the School of Nursing at the University of Medicine & Dentistry of New Jersey, became a new Local Performance Site for the northern New Jersey area as part of the New York/New Jersey AIDS Education and Training Center.  The role of the AETC Local Performance Site (LPS) is to assist healthcare professionals through education and training, to provide optimum quality services and sensitive care to HIV-positive persons, and to provide access to current research and treatment of HIV/AIDS.  The LPS at the FXB Center serves the northern New Jersey healthcare community by providing HIV/AIDS education and training to treat, manage, diagnose or counsel individuals with HIV infection or to help prevent high risk behaviors that lead to HIV transmission.