RxCe - HIV/AIDS and Florida Prevention Programs Materials

HIV/AIDS AND FLORIDA PREVENTION PROGRAMS

Faculty:

Steven Malen, PharmD, MBA

Steven Malen graduated with a dual degree in Doctor of Pharmacy (PharmD) and Master of Business Administration (MBA) from the University of Rhode Island. Steven Malen has worked as a clinical pharmacist in the retail, specialty, and compounding sectors.

Pamela Sardo, PharmD, BS

Pamela Sardo, PharmD, BS, is a freelance medical writer and licensed pharmacist. She is the founder and principal at Sardo Solutions in Texas. Pam received her BS from the University of Connecticut and her PharmD from the University of Rhode Island. Pam’s career spans many years in retail, clinics, hospitals, long-term care, Veterans Affairs, and managed health care responsibilities across a broad range of therapeutic classes and disease states.

Abstract

The human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS). HIV can significantly depress immune system function, leading progressively to AIDS. Antiretroviral therapy (ART) has reduced the morbidity and mortality associated with HIV-1 infection and AIDS, enabling HIV-infected individuals to live longer and have an improved quality of life. Advances in ART have allowed many patients with HIV to achieve viral suppression. Remaining aware of a comprehensive overview of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), including key distinctions between the conditions and current epidemiologic trends, is important for a personalized approach to patients presenting with HIV or AIDS. Comprehension of prevention, transmission, infection control practices, antiretroviral management, and patient counseling contributes to optimizing care. The activity also addresses regulatory considerations, highlighting federal and Florida-specific laws governing HIV testing, confidentiality, partner notification, and reporting requirements, equipping health care professionals with the strategies needed to support safe practice and ensure compliance with applicable legal and public health standards.

Accreditation Statements

In support of improving patient care, RxCe.com LLC is jointly accredited by the Accreditation Council^TM for Continuing Medical Education (ACCME^®), the Accreditation Council for Pharmacy Education (ACPE^®), and the American Nurses Credentialing Center (ANCC^®), to provide continuing education for the healthcare team.

Joint Universal Activity Number: The Joint Accreditation Universal Activity Numbers assigned to this activity are as follows:

Pharmacists: JA4008424-0000-26-102-H02-P

Pharmacy Technicians: JA4008424-0000-26-102-H02-T

Credits: 1 contact hour(s) (0.1 CEU(s)) of continuing education credit.

Credit Types:

Pharmacy - 1 Credit(s)

Type of Activity: Knowledge

Media: Computer-Based Training (i.e., online courses)

Estimated time to complete activity: 1 contact hour(s) (0.1 CEU(s)), including Activity Pre-Test, Post-Test, and Activity Evaluation.

Release Date: July 1, 2026 Expiration Date: July 1, 2027

Target Audience: This educational activity is for Pharmacists and Pharmacy Technicians

How to Earn Credit: From July 1, 2026, through July 1, 2027, participants must:

Read the “learning objectives” and “author and planning team disclosures;”

Take the “Educational Activity Pre-Test;”

Study the section entitled “Educational Activity;” and

Complete the Educational Activity Post-Test and Activity Evaluation. The Educational Activity Post-Test will be graded automatically. Following successful completion of the Educational Activity Post-Test with a score of 70% or higher, a statement of participation will be made available immediately. (No partial credit will be given.)

CE Credits: Credits for this course will be uploaded to CPE Monitor^® for pharmacists and pharmacy technicians.

Statement of Need

Healthcare professionals have a critical role in HIV prevention, early detection, and long-term management; however, gaps persist in knowledge related to evolving transmission risks, healthcare setting strategies, and current antiretroviral treatment strategies. Florida consistently reports some of the highest rates of new HIV diagnoses, so it is important for pharmacy professionals to demonstrate familiarity with state-specific legal requirements, including HIV testing, confidentiality, partner notification, and perinatal screening mandates. Recent updates to treatment guidelines and infection control standards require ongoing education to ensure safe and effective patient care. This activity aims to address these gaps by reinforcing knowledge of HIV and AIDS, enhancing understanding of prevention and transmission risks, and ensuring compliance with applicable federal and Florida laws, with the ultimate goal of improving competence, confidence, and public health outcomes.

Learning Objectives: Upon completion of this educational activity, participants should be able to:

Meet the continuing education requirements of the Florida Administrative Code, Rule 64B16-26.103(1)(a) and 64b16-26.103(4)(a)

Define HIV and AIDs

Discuss the epidemiology of HIV and AIDS

Identify how HIV/AIDS is transmitted

Discuss universal precautions to reduce the risk of HIV transmission

Identify common secondary infections associated with HIV and AIDS

Identify methods of prevention for HIV/AIDS transmission

Identify clinical management strategies for HIV and AIDS

Discuss federal and Florida laws (including Florida Statute 381.004) pertaining to HIV and AIDS testing, confidentiality, partner notification, pregnancy testing, and reporting

Disclosures

The following individuals were involved in planning, developing, and/or authoring this activity: Steven Malen, PharmD, MBA; and Pamela Sardo, PharmD, BS. None of the individuals involved in developing this activity has a conflict of interest or financial relationships related to the subject matter. There are no financial relationships or commercial or financial support relevant to this activity to report or disclose by RxCe.com or any of the individuals involved in the development of this activity.

Educational Activity Pre-Test

HIV is primarily transmitted through

contact with infected blood and through sexual contact.

casual social contact with an infected person.

insect bites after the insect bites an infected person.

blood transfusion from HIV-contaminated blood.

Tuberculosis (TB) can be difficult to diagnose in persons who have HIV because

HIV-infected persons are at a reduced risk for extrapulmonary TB.

TB, like HIV, is a retrovirus.

it may present with other pulmonary infections.

radiographic presentations of TB are always normal.

Nonoccupational post-exposure prophylaxis (nPEP) should be offered to individuals who are at greater risk of exposure to HIV. In 2025, the CDC added the following individuals to this group:

healthcare workers.

homeless adults and minors.

all pregnant women.

sexual assault victims and injection drug users.

Educational Activity

HIV/AIDS and Florida Prevention Programs

Introduction

The human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS). HIV can significantly depress immune system function, leading progressively to AIDS. Antiretroviral therapy (ART) has reduced the morbidity and mortality associated with HIV-1 infection and AIDS, enabling HIV-infected individuals to live longer and have an improved quality of life, but there is no cure. HIV and AIDS remain serious health problems requiring ongoing education and federal and state resources. Florida law guides Florida clinicians in screening, diagnosing, and reporting HIV/AIDS. Florida law reflects existing recommendations from the Centers for Disease Control and Prevention (CDC) and other national organizations focused on HIV testing and methods to prevent disease transmission through voluntary testing. Pharmacy professionals’ understanding of transmission, progression, treatment of HIV and AIDS, and Florida regulations provides opportunities to mitigate transmission and support patients and health care colleagues at risk for, or presenting with, infection. Florida remains one of the states with the highest burden of new diagnoses, particularly in the South.¹

Takeaway

Approximately 1.2 million people in the U.S., have HIV. About 13 percent of them are unaware and need testing.²

Defining HIV and AIDS

HIV is a retrovirus.^3,4 An HIV infection involves viral entry into the body, attachment of HIV to the cell membrane of CD4+ T-cells in the immune system, which help the body fight infection. The entry of HIV into those cells and subsequent viral replication makes it difficult to fight the infection.⁵

Stages of HIV Infection

When a person becomes infected with HIV, the progression of the infection may be described in stages. The National Institute of Health (NIH) describes the stages as (1) acute HIV infection, (2) chronic HIV infection, and (3) acquired immunodeficiency syndrome (AIDS).⁶

The Acute HIV Infection Stage develops within 2 to 4 weeks after exposure. During this stage, HIV RNA levels are very high, increasing transmission risk.

The Chronic HIV Infection is characterized by clinical latency and few (if any) symptoms.^7,8 During this stage, there is a consistent decline in CD4 cell count, a stable viral load that can last several years, even without treatment, before progressing to AIDS.^7,8

AIDS is defined as the CD4 cell count falling below 200 cells/µL or when the patient develops an AIDS-associated opportunistic infection, with a severely impaired immune function. At this stage, the patient is at risk of developing opportunistic infections and neoplasms.⁸

Epidemiology of HIV and AIDS

Understanding epidemiology is important because the human immunodeficiency virus remains prevalent among specific population groups.^9,10 Approximately 1.2 million people live with HIV infection.¹¹ In 2022, about 31,800 people acquired HIV in the U.S, representing a 12% decrease from 2018.¹¹ It is estimated that 13% of new HIV infection cases are undiagnosed.^11,12 While HIV cases have been decreasing nationally, Florida cases have fluctuated between increases and decreases depending on the time frame studied, e.g., HIV cases increased by 9.14% between 2013 and 2019, with a four percent decrease from 2018 to 2019 and a more significant reduction in 2020.¹² The decline in 2020 may have been due to decreased HIV testing during the COVID-19 pandemic and stay-at-home orders.¹² Health care providers should carefully identify any breakdowns in the HIV care continuum, especially in the testing and diagnosis phase.¹² Among the high-risk groups, most new HIV diagnoses today are among Black/African American transgender women.¹³ In 2022, gay, bisexual, and other men who have sex with men accounted for 67% (21,400) of estimated new HIV infections.¹⁴

HIV Transmission

The human immunodeficiency virus can be found in essentially any type of body fluid or secretion: blood, semen, vaginal fluids, feces, gastric secretions, sputum, and other body fluids.^15-17 HIV is transmitted through specific body fluids: blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk. Transmission requires contact with mucous membranes, damaged tissue, or direct entry into the bloodstream. Per-act risk is highest for anal sex (approximately 138 per 10,000 exposures with detectable viral load) and sharing needles or injection equipment.¹⁵ In contrast, the risk of infection with other body fluids is considered rare unless they are visibly contaminated with blood.^16,17

The human immunodeficiency virus can also be transmitted perinatally from a mother to a child during pregnancy, delivery, and even through breast milk (which accounts for nearly 50% of pediatric HIV infections each year).¹⁸

Exposure to HIV occurs in public (nonoccupational exposure) and in the health care setting (occupational exposure).^15,17 A person exposed to HIV who becomes infected is expected to show signs of infection within the first 2 to 4 weeks.^6,19

The human immunodeficiency virus can be transmitted by transfusion of contaminated blood.^20,21 The risk has been reduced due to screening.²¹ Health care worker-to-patient and patient-to-healthcare worker HIV transmission through blood exposure, such as needlesticks.²²

Blood is the primary source of HIV transmission in health care settings. Other body fluids, such as amniotic fluid, cerebrospinal fluid, pericardial fluid, pleural fluid, and synovial fluid, are also considered potentially infectious.^22,23 Feces, gastric secretions, nasal secretions, saliva, sputum, sweat, tears, and urine may contain low amounts of HIV but are not generally infectious unless they are visibly contaminated with blood.²⁴

An exposure that places health care workers at risk includes contact of the worker’s mucous membrane or exposed skin with blood, tissues, or other potentially infectious body fluids.²⁵ The risk is highest when the worker’s skin is chapped, abraded, or inflamed (dermatitis), or when the contact is prolonged or involves an extensive area.²⁵

An exposure that places health care workers at the greatest risk for infection with HIV is needlesticks.^25,26 The CDC estimates that hospital-based health care personnel sustain 385,000 needlesticks and other sharps-related injuries annually. One study found that the risk of transmission of HIV infection from percutaneous exposure to infected blood is ~0.3% for each exposure.²⁴ The CDC estimates one HIV seroconversion for every 200 contaminated needlesticks.²⁴ HIV infection is influenced by the injury depth, blood volume, and patient viral load. Health care professionals should treat every patient as potentially HIV-positive.²⁴

Prevention of HIV Transmission

HIV is largely preventable, since it is frequently spread through sex or needle sharing. Prevention is key to stopping the spread of HIV through infection control and universal precautions.^17,27,28 If HIV negative, but at risk for the virus, offer pre-exposure prophylaxis (PrEP) to individuals who may continue to face ongoing exposure risks.^28,29

Pre-exposure prophylaxis may benefit a person who has tested negative for HIV but has any of the following risk factors:²⁸

The person had anal or vaginal sex in the past 6 months, and

has a sexual partner with HIV (especially if the partner has an unknown or detectable viral load), or

has not consistently used a condom, or

has been diagnosed with an STD in the past 6 months.

The person injects drugs and

has an injection partner with HIV, or

shares needles, syringes, or other injection equipment.

The person has been prescribed PEP (post-exposure prophylaxis)

reports continued risk behavior or

has used multiple courses of PEP

These individuals may include those in a relationship with an HIV-positive partner, non-monogamous gay or bisexual men, for example, recently HIV negative and diagnosed with an STD, or after anal sex without a condom.²⁹ High-risk individuals also include heterosexual men recently HIV negative after unprotected sex with partners of unknown HIV status. Injection drug users who have shared needles within the past six months or are in a drug treatment program are also at risk. A daily combination of tenofovir and emtricitabine is a PrEP treatment.^28,29

Pause and Ponder

If you believe a patient would benefit from HIV prevention strategies, how would you start the conversation?

Non-occupational Prevention Strategies

Sexual Transmission

Prevention strategies for sexually transmitted diseases (STDs) include medical interventions (such as ART) and preventive behaviors.^10,17 Counsel patients on behavioral changes in the type of sexual activity, minimizing the number of sexual partners, strongly encouraging the use of condoms, and avoiding substance use.^17,30

Condoms are effective in preventing the transmission of HIV if used properly.^31,32 Their effectiveness has been estimated to range from 60 to 90%.^31,32 Circumcision decreases HIV infection significantly;³³ however, it does not appear to decrease the risk of male-to-female transmission.³⁴

Injection Drug Use

Injection drug use is a potential risk for HIV exposure.³⁵ Sharing needles or other drug-injection equipment should never occur.³⁶ Providing intravenous drug users with sterile syringes aims to reduce needle sharing and can help decrease the incidence of HIV infections.³⁶ Intravenous drug users with an HIV-positive partner, people who share injection equipment, and those who have recently undergone drug treatment but are not currently injecting drugs may benefit from pre-exposure prophylaxis.³⁵

Clinical Pearl

Counsel patients not to share needles and to dispose of needles or syringes safely after use.

Mother-to-Infant Transmission

Without antiviral treatment, the risk of transmission of HIV from infected mothers to their children is approximately 15-30% during pregnancy and labor, with an additional 10-20% transmission risk attributed to prolonged breastfeeding.³⁷ If a mother and infant receive prophylactic ART and the infant is not breastfed, this risk is approximately 0.1%.³⁸ The American Academy of Pediatrics has advised that, regardless of viral load and/or the use of ART, HIV-positive mothers should not breastfeed to prevent exposing their infants to HIV in breast milk.³⁹

Transfusions and Organ Donations

Donated blood or blood products, such as packed red blood cells, fresh frozen plasma, platelets, whole blood, etc., can be contaminated with HIV.⁴⁰

Regarding donor eligibility, the Food and Drug Administration (FDA) recently revised its guidance.⁴¹ For example, the FDA eliminated the screening questions specific to MSM and women who have sex with MSM.

Pause and Ponder

What strategies do you provide to your patients to prevent the risk of HIV transmission?

Occupational Prevention Strategies

If a health care worker has HIV, taking HIV treatment can keep the worker’s viral load undetectable, which reduces the risk of transmission.^17,42 When handling any blood or other bodily fluid, health care providers should always take the same precautions and assume that it could potentially be infected with a bloodborne pathogen (such as HIV). Safety rules to prevent HIV transmission need to be observed daily.^24,27,43

Adherence to the bloodborne pathogen standard established by the Occupational Safety and Health Administration (OSHA) is mandatory for all hospitals and health care facilities.⁴⁴ To comply, employers must establish a written plan for controlling exposure to bloodborne pathogens.⁴⁴ Pharmacy personnel should remain vigilant regarding an annual plan, which includes the following:⁴⁴

Implementing standard precautions and ensuring that employees know how to use them

Provide personal protective equipment (PPE) at no cost and educate on when PPE should be donned

Provide initial and annual training on bloodborne pathogens to all employees.

Use engineering controls to control the risk of exposure to bloodborne pathogens

Using work practice controls for the proper handling and disposal of blood, specimens, contaminated waste, and the proper cleaning and decontamination of equipment and patient rooms

Offer vaccination against hepatitis B to all employees with exposure risk

Action plan for employee exposure occurrence

Disposable gloves must be discarded as soon as possible after they have become contaminated, punctured, or torn. Employees must wash their hands immediately after removing gloves. Employees must wash their hands after contact with blood or other potentially infectious material and before and after performing patient care.^44,45

Cover the mouth and nose when coughing or sneezing. Make sure all equipment, surfaces, and devices are properly disinfected. Ensure that any contaminated materials are handled and disposed of in accordance with health and safety guidelines.

What to Do if Exposed to HIV?

After a health care worker is exposed to HIV (especially the first 6 to 12 weeks, when most infected persons are expected to show signs of infection), the exposed health care worker should follow standard recommendations for preventing transmission of HIV.

Guidelines for health care workers who have been exposed to HIV include the following precautions and immediate steps:^27,46

Eyes and affected mucous membranes should be flushed with water.

Wounds should be washed with soap and water

Health care workers should notify their department handling occupational exposures to bloodborne pathogens

Seek medical attention immediately

If possible, conduct rapid HIV testing on the source patient (as well as testing for bloodborne pathogens, such as hepatitis B and C)

Test for the presence of HIV with follow-up testing at 6 weeks, 12 weeks, and 6 months

Start post-exposure prophylaxis (PEP), discussed below, preferably within 72 hours of exposure. Do not delay while awaiting HIV test results

Post-exposure Prophylaxis for All HIV Exposures

Exposure to HIV may occur within an occupational setting or a nonoccupational setting. After a potential exposure to HIV, the exposed person should be treated with PEP (referred to as nonoccupational post-exposure prophylaxis (nPEP) in the case of exposure outside the workplace).²⁹ In the workplace, this treatment protocol recommends flushing mucous membranes or washing wounds, notifying occupational health staff, and seeking medical attention as needed. Rapid HIV testing of the source patient is recommended, and the use of antiretroviral medications over a short period of time to reduce the risk of becoming HIV infected.²⁹

In nonoccupational exposure settings, common situations that give rise to exposure are sexual activity or injection drug use.²⁹ In 2025, the CDC also added sexual assault victims and injection drug users to the people who should consider nPEP regimens.²⁹

Per the 2025 CDC guidelines, initiate nPEP as soon as possible (ideally within 24 hours, no later than 72 hours) for substantial-risk exposures. The recommended duration of treatment is 28 days, and follow-up includes HIV testing at baseline, 4-6 weeks, 12 weeks, and 6 months, with transition to PrEP if ongoing risk.²⁹

The updated CDC guidelines in May 2025 recommend using second-generation integrase strand transfer inhibitors, such as bictegravir or dolutegravir, plus tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF), plus emtricitabine or lamivudine as the preferred regimens for nPEP in most adults and adolescents. Both TAF and TDF are used in these regimens, with TAF generally having fewer bone and renal side effects.⁴⁷

PEPline Hotline: call 1-888-448-4911

The National Clinicians Consultation Center PEPline is a consultation service for occupational post-exposure prophylaxis. The PEPline has trained physicians to give information, counseling, and treatment recommendations for needle stick injuries.⁴⁸

Risk of Needlestick Injuries

All needles and syringes should be disposed of properly in a sharps container, and needles should never be recapped after use to avoid accidental stick injuries. For point-of-care testing, the proper use of gloves and the immediate disposal of testing supplies can significantly reduce the risk of needlesticks and exposure to bloodborne pathogens. Exercise caution and diligence when handling a patient’s supplies.

HIV Screening and Testing

The CDC recommends screening to detect HIV for everyone aged 13 to 64 years, women who are pregnant or may become pregnant, anyone who is in a high-risk group, anyone who seeks treatment for an STD, and all patients who are diagnosed with hepatitis B or tuberculosis.⁴⁹ Updates to the perinatal HIV guidelines include revisions to virologic testing schedules for infants exposed to HIV, aligning them with changes in antiretroviral management.⁵⁰

As trusted health care professionals, gently encourage patients to openly communicate with their partner(s) regarding sexual and drug-use history, HIV status, and consider getting tested together. Suggest testing every 3-6 months for sexually active gay or bisexual men, and test during each pregnancy.⁴⁹

A person who tests negative but has been involved in high-risk behavior within three months of the test could still have an HIV infection.^49,51 Three primary types of HIV tests are antibody tests, nucleic acid tests, and combination tests.⁵² Antibody tests are the most common and test for antibodies to the virus. It may take three to 12 weeks for antibodies to be measurable. Nucleic acid tests identify the presence of the virus in the blood. There are also tests that may be quicker to identify antibodies produced by the immune system, as well as antigens.⁵³

Home Screening Tests

The FDA has approved two home screening tests to detect HIV: OraQuick^® and Home Access HIV-1 Test System.^54-56 OraQuick uses an oral swab and a test liquid, with results available in 20-40 minutes.⁵⁵

Florida Omnibus AIDS Act

The Florida Omnibus AIDS Act aims to educate the public about HIV and reduce the spread of HIV.⁵⁷ This Act includes Florida Statute, section 381.004, which deals with HIV testing.⁵⁸ It attempts to create an environment in which people will agree to or seek out HIV testing and ensures the privacy of those seeking testing. It prohibits HIV testing without a person's knowledge and consent. Exceptions are very narrow.^58,59 Exceptions include medical emergencies where consent is unobtainable, occupational exposures, hospitalized infants, and pregnancy. In the case of a pregnant patient, Florida Statute, section 384.31, requires the treating physician to test the patient for HIV, but the patient has the right to refuse the test.⁵⁹ Section 384.31 states that the patient must be informed of the test and of her right to refuse testing. If a patient objects to testing, a written statement of objection, signed by the woman, must be placed in the patient's medical record, and no testing can occur.⁵⁹ This gives the patient control over who learns of the HIV test results.

Infants and young children are treated as unable to make an informed decision, and consent of their parents or legal guardians is required. Florida specifically forbids telling parents the fact of the minor's consultation, examination, or treatment for an STD, such as HIV infection, either directly or indirectly (such as by billing a parent or their insurer for an HIV test without the child's permission).⁵⁸

The Act protects confidentiality and amends civil rights laws to prohibit discrimination against persons who have, or are believed to have, the infection.⁵⁷ These provisions apply to employment, housing, public services, public accommodations, and health and life insurance, as stated within Florida Statutes, section 760.50.⁶⁰

Under subsection (2)(a) of section 381.004, informed consent extends beyond general consent for HIV testing because the patient must be explicitly informed about the test and give specific consent.⁵⁸ It can be verbal, as long as it is clearly documented.⁵⁸

Subsection (5)(c) of section 381.004 states that fines, license suspension, or revocation can occur if these steps are not followed. Any breach of HIV confidentiality is a first-degree misdemeanor subject to up to a year in prison.⁵⁸ Breach of confidentiality of STDs maliciously or for monetary gain is a third-degree felony.⁵⁸ Civil lawsuits are also possible for infractions.

Section 381.004, subsection (d), requires confirmation of testing results prior to notifying the patient, and reasonable steps are required to locate and notify the patient of the results.⁵⁸ The patient must be informed that the provider is required to report positive results and the patient's name to the local health department.⁵⁸ The patient must be informed that the test can be performed anonymously at a site and provided with the site location. The patient must also be informed of their confidentiality rights regarding the test results. Other requirements vary based on the patient’s age, mental status, and language skills.

Limited scenarios do not require informed consent. One reason is when testing is medically necessary in an emergency, but the patient is unable to provide consent.^58,59 Another example is when an individual is acutely ill, and test results are medically necessary for diagnosis and treatment, and consent would be detrimental. Consent is not required for convicted criminals, prostitutes, and individuals whose offense involves the transmission of bodily fluids.^58,59 Abandoned infants and tissue and organ donors are also exempt.^58,59

Pause and Ponder

Florida Statute § 381.004 shapes how HIV-related information is handled in practice, especially regarding testing, reporting, confidentiality, and partner-notification responsibilities.

Consider how these comprehensive requirements should influence the pharmacist’s role in education, documentation, and patient communication.

Confidentiality

Situations where disclosure without consent is permitted in statutes include the following:⁵⁸

Department of Health to comply with reporting and control laws regarding HIV spread

Reporting child sex abuse to appropriate authorities

Partner notification by licensed providers of sex or needle-sharing partners

Facilities and providers engaged in tissue or body part transfer

Authorized researchers

Additional guardrails around confidentiality apply. Although historical mandatory pre-test and post-test counseling has been deemed possibly burdensome and is no longer mandatory in many cases, county health departments and various sites throughout Florida perform confidential and anonymous testing and must provide pre-test and post-test counseling.⁵⁷

Providers may disclose HIV test results to a third party if written patient consent is obtained.⁵⁸ The human immunodeficiency virus results may be released based on a court subpoena. Even when authorized, further disclosure is prohibited without the patient's written consent.⁵⁸ The HIV test information is considered need-to-know and limited to direct patient and patient’s fluid or tissue handling.

Patients presenting with HIV or AIDS are not required to inform employers or service providers about their HIV status. Standard precautions and health and safety guidelines mandated by licensing boards are robust to protect public health and safety.

Patient Rights

HIPAA is a federal health law that protects protected health information (PHI).⁶¹ This includes HIV test results, medications, viral load, and CD4 counts.

The Rehabilitation Act of 1973 is a foundational U.S. federal civil rights law.⁶² Individuals with disabilities cannot be denied benefits, excluded from participation, or discriminated against in any program that receives federal funds. Employers and organizations covered by the Act are required to provide reasonable accommodations to qualified individuals with disabilities, unless doing so creates an "undue hardship."⁶²

The Americans with Disabilities Act (ADA) states that persons with HIV, both symptomatic and asymptomatic, have physical impairments that substantially limit one or more major life activities or major bodily functions and are, therefore, protected by the law.⁶³ The ADA prohibits discrimination in all employment practices. This includes hiring, firing, job application procedures, job assignment, training, and promotions.⁶³ It also includes wages, benefits, leave, and all other employment-related activities. The employer should provide a “reasonable accommodation,” which is a modification or adjustment to a job, the job application process, or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process, perform the essential functions of the job, or enjoy the benefits and privileges of employment.⁶³

The Family and Medical Leave Act (FMLA) is a federal law that provides up to 12 weeks of unpaid, job-protected leave for qualifying family and medical reasons.⁶⁴ The human immunodeficiency virus qualifies as a serious medical condition. The individual must have worked at the company for at least 12 months. It includes individuals with a serious health condition that keeps them from doing their job or who are caring for a spouse, child, or parent with a serious health condition.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) serves as a bridge when a person leaves a job or when work hours are reduced.⁶⁵ It allows an employee’s current health insurance to be maintained for up to 18 months. It can be costly. It does ensure doctors and HIV medications stay covered.

The Ryan White HIV/AIDS Program (RWHAP) works with cities, counties, states, and local community-based organizations to provide HIV primary medical care, medications, and essential support services to low-income people living with HIV.⁶⁶ Over half the people with diagnosed HIV in the United States receive services through RWHAP each year.

The Fair Housing Act prohibits discrimination on the basis of disability and other protected classifications.⁶⁶ It defines persons with a disability as individuals with mental or physical impairments that substantially limit one or more major life activities.⁶⁶ The term mental or physical impairment may include conditions such as blindness, hearing impairment, mobility impairment, or HIV infection.

Myths About HIV and AIDS

Misinformation and myths still circulate in society about HIV and AIDS. One such myth surrounds whether there is a cure for HIV/AIDS. While there is no cure for HIV, treatment with HIV medicines can slow or prevent HIV from advancing from one stage to the next, allowing people with HIV to live long, healthy lives.⁶

Another myth is that HIV and AIDS are the same illness. HIV is a virus that attacks a person’s immune system. AIDS is the advanced, final stage of an HIV infection.⁶ Infection with HIV is considered a chronic condition, like having high blood pressure or diabetes.⁶ Another myth is that HIV can be transmitted through casual contact, such as from tears or kissing.¹⁵

Clinical Management

Clinical management focuses on prevention, antiretroviral treatments, PrEP, and the management of comorbidities.

Pre-Exposure Prophylaxis (PrEP)

Pre-exposure prophylaxis is taken by HIV-negative individuals at high risk of infection to prevent contracting HIV, including those who have recently had a bacterial STD, have a high number of sexual partners, have a history of inconsistent or no condom use, or are sex workers.^67,68 Pre-exposure prophylaxis is >99% effective in preventing sexual transmission of HIV when taken as prescribed.⁶⁷

The CDC recommends two oral medications: emtricitabine and tenofovir disoproxil fumarate (Truvada®), and emtricitabine and tenofovir alafenamide (Descovy®).⁶⁸ They are approved for daily use as HIV PrEP.⁶⁸ In addition to the oral medications, the FDA has approved cabotegravir extended-release injectable for intramuscular use as HIV PrEP.⁶⁸ Emtricitabine and tenofovir alafenamide may be used as PrEP in men and transgender women.⁶⁸ Twice-yearly injectable lenacapavir (YEZTUGO^®) is indicated as a PrEP for adults and adolescents weighing 35 kg or greater.^69,70

Post-Exposure and Brief Overview of Antiretrovirals

Antiretroviral therapy, ART, is the recommended treatment for HIV.^71,72 Some sources refer to this treatment as HAART, or highly active ART; however, ART has effectively replaced the term HAART.^71,72

In the U.S., the recommendation is to begin ART early, within days, for patients who have an infection with HIV.^71-73 Treatment is focused on three goals: 1) Managing the infection with ART, 2) Monitoring and treating complications, and 3) Preventing transmission of HIV.^71-73 Reaching these goals can restore and preserve immunologic function, reduce HIV-associated morbidity, and prolong survival and quality of life.

There are nine classes of ART drugs that can be used and include: 1) non-nucleoside reverse transcriptase inhibitors (NNRTIs), 2) nucleoside reverse transcriptase inhibitors (NRTIs), 3) protease inhibitors (PIs), 4) fusion inhibitors, 5) chemokine receptor antagonists (CCR5 antagonists), 6) integrase strand transfer inhibitors (INSTIs), 7) post attachment inhibitors, 8) attachment inhibitors, and 9) capsid inhibitors.⁷⁴

Select ART Daily Combination Products:^75-83

Bictegravir 50 mg, emtricitabine 200 mg, tenofovir AF 25 mg daily

Bictegravir 30 mg, emtricitabine 120 mg, tenofovir AF 15 mg daily

Darunavir 800 mg, cobicistat 150 mg, emtricitabine 200 mg, tenofovir AF 10 mg daily

Dolutegravir 50 mg, abacavir 300 mg, lamivudine 300 mg daily

Dolutegravir 5 mg, abacavir 60 mg, lamivudine 30 mg daily

Dolutegravir 50 mg, lamivudine 300 mg daily

Dolutegravir 50 mg, rilpivirine 25 mg daily

Doravirine 100 mg, lamivudine 300 mg, tenofovir DF 300 mg daily

Efavirenz 400 mg, lamivudine 300 mg, tenofovir DF 300 mg daily

Efavirenz 600 mg, emtricitabine 200 mg, tenofovir DF 300 mg daily

Efavirenz 600 mg, lamivudine 300 mg, tenofovir DF 300 mg daily

Elvitegravir 150 mg, cobicistat 150 mg, emtricitabine 200 mg, tenofovir AF 10 mg daily

Elvitegravir 150 mg, cobicistat 150 mg, emtricitabine 200 mg, tenofovir DF 300 mg daily

Rilpivirine 25 mg, emtricitabine 200 mg, tenofovir AF 25 mg daily

Rilpivirine 25 mg, emtricitabine 200 mg, tenofovir DF 300 mg daily

Drug-drug Interactions

Drug-drug interactions are very common considerations in patients presenting with HIV or AIDS. It is imperative that the prescribing information for each ingredient be consulted to optimize outcomes and minimize impeding the mechanism of action. When considering treatment, select the medication with the lowest likelihood of adverse interactions. Acid-reducing agents and products that inhibit or induce CYP3A4 must be considered. Select medications that interact with NNRTIs include azole antifungals, rifamycins, benzodiazepines, HMG-CoA reductase inhibitors, and methadone. Protease inhibitors have significant interactions with other medications.^84,85 Select examples include narcotic analgesics, antiarrhythmics, anticonvulsants, and antidepressants.

AIDS and Concomitant Disorders

As HIV destroys the immune system, the body loses its ability to fight off infections and certain cancers. The concurrent illnesses, called opportunistic infections, are a cause of severe illness and death in people with untreated AIDS. Once a patient with HIV progresses to AIDS, several different organ systems can be affected.⁸⁶ Comorbidities, such as endocrine conditions, liver disease, cardiovascular disease, neurologic disease, oral lesions, and pulmonary disease, can indicate that a patient with HIV has progressed to AIDS.^86-88

Tuberculosis and Other Pulmonary Diseases

Pulmonary disease is a typical complication of AIDS. Sinus infections, bacterial and fungal pneumonia, and tuberculosis are common in people with AIDS.^89,90 There is a high incidence of chronic pulmonary disease and respiratory symptoms in HIV-infected individuals.⁹⁰

Tuberculosis is a leading cause of infectious disease death globally.⁹⁰ Tuberculosis reportedly surpassed HIV/AIDS in terms of morbidity/mortality rates, and in 2018, an estimated 1.5 million deaths worldwide resulted from a TB infection, of which 251,000 deaths involved HIV-positive individuals.⁹⁰

The CDC guidelines recognize that “TB disease can be difficult to diagnose in persons with HIV infection because of nonclassical or normal radiographic presentation or the simultaneous occurrence of other pulmonary infections. HIV-infected patients are also at greater risk for extrapulmonary TB.”⁹¹ Health care workers exposed to suspected or confirmed infectious TB should consider an N95 disposable respirator.⁹²

Additional infections and neoplasms, considered to be AIDS-defining diseases, may include bacterial infections, candidiasis, cervical cancer, cytomegalovirus, Kaposi sarcoma, Pneumocystis pneumonia, Burkitt lymphoma, or mycobacterium avium complex, among others.^93-95

Different ART regimens are used for children, pregnant women, people who have been previously treated with ART, and people who have specific medical problems.^96-98 Prior to beginning ART, a patient’s medical, psychological, and surgical history should be reviewed, as well as the prescription, over-the-counter medications, and supplements the patient is currently taking.⁹⁹ The patient should receive vaccinations for influenza, hepatitis A, hepatitis B, pneumonia, and varicella.⁹⁹ The live-attenuated influenza vaccine is contraindicated.⁹⁹ Two doses of the live-attenuated varicella vaccine should be administered, 3 or more months apart, to people living with HIV who are varicella non-immune and have a CD4 count > 200 cells/mm.⁹⁹ This vaccine is contraindicated in patients who are pregnant or have a CD4 count < 200 cells/mm.⁹⁹

Despite the effectiveness of ARTs, HIV/AIDS remains a US and global public health issue.^98,99 As such, monitoring laboratory values is needed to evaluate the effectiveness of ART and monitor for adverse drug effects.⁹⁹

Resistance remains a problem in patients presenting with HIV or AIDS.¹⁰⁰ Clinically significant resistance can occur quickly. A single mutation can alter the medication's effectiveness. Treatment failures are partly driven by the emergence of resistant viral strains resulting from poor treatment adherence, leading to virologic failure associated with rebound viremia, worsening immune function, and increased morbidity and mortality.^98,99 Address these failures by recommending that the interdisciplinary team perform genotypic resistance testing. The objective of therapy after treatment failure is to choose a regimen that is well-tolerated, affordable, minimally burdensome, and capable of rapidly and consistently achieving virologic suppression.^98,99

Additional Resource:

FLORIDA AIDS HOTLINE

English: 1-800-FLA-AIDS

Spanish: 1-800-545-SIDA

Creole: 1-800-AIDS-101

TTY: 1-888-503-7118

Summary

The prognosis for patients presenting with HIV or AIDS continues to improve. Remaining current regarding diagnosis and major improvements in the medical treatment and prognosis for individuals with HIV/AIDS contributes to optimizing outcomes. HIV/AIDS transmission, including mother-to-infant transmission, sexual transmission, occupational exposure, and potential risk factors affecting disease outcomes, results in increased morbidity, mortality, and risk to patients, partners, and health care teams. All health care professionals should emphasize the importance of risk-reduction strategies and adherence to ART. Patients who adhere to treatment can often live symptom-free, enjoy their lives for many years, and avoid developing AIDS. Protecting patients and improving quality of life include medications but also involve being aware of patients’ rights and the laws enacted to protect them.

References

HIV gov. U.S. Statistics. Fast Facts. HIV.gov. Updated: February 25, 2026. Accessed June 18, 2026. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

Forney DJ, Sheehan DM, Dale SK, et al. The Impact of HIV-Related Stigma on Racial/Ethnic Disparities in Retention in HIV Care Among Adults Living with HIV in Florida. J Racial Ethn Health Disparities. 2024;11(4):2498-2508. doi:10.1007/s40615-023-01715-1

Meissner ME, Talledge N, Mansky LM. Molecular Biology and Diversification of Human Retroviruses. Front Virol. 2022;2:872599. doi:10.3389/fviro.2022.872599

Wilen CB, Tilton JC, Doms RW. HIV: cell binding and entry. Cold Spring Harb Perspect Med. 2012;2(8):a006866. Published 2012 Aug 1. doi:10.1101/cshperspect.a006866

Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in sero-different couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316 (2):171-181.

HIVinfo.NIH.gov. Understanding HIV. Fact Sheets. The Stages of HIV Infection. HIVinfo.NIH.gov. March 31, 2025. Accessed June 18, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection

Coffin JM, Hughes SH, Varmus HE, editors. Retroviruses. Cold Spring Harbor (NY): Cold Spring Harbor Laboratory Press; 1997. Course of Infection with HIV and SIV. Accessed June 18, 2026. https://www.ncbi.nlm.nih.gov/books/NBK19374/

Vidya Vijayan KK, Karthigeyan KP, Tripathi SP, Hanna LE. Pathophysiology of CD4+ T-Cell Depletion in HIV-1 and HIV-2 Infections. Front Immunol. 2017;8:580. Published 2017 May 23. doi:10.3389/fimmu.2017.00580

Hurt CB, Nelson JAE, Hightow-Weidman LB, Miller WC. Selecting an HIV Test: A Narrative Review for Clinicians and Researchers. Sex Transm Dis. 2017;44(12):739-746. doi:10.1097/OLQ.0000000000000719

Gandhi RT, Bedimo R, Hoy JF, et al. Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2022 Recommendations of the International Antiviral Society-USA Panel. JAMA. 2023;329(1):63-84. doi:10.1001/jama.2022.22246

HIV gov. U.S. Statistics. Fast Facts. HIV.gov. Updated: February 25, 2026. Accessed June 18, 2026. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics

HIV gov. HIV Care Continuum. HIV.gov. Updated: February 26, 2026. Accessed June 18, 2026. https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum

Grov C, D'Angelo AB, Mirzayi C, et al. The American Transformative HIV Study: Protocol for a US National Cohort of Sexual and Gender Minority Individuals With HIV. JMIR Public Health Surveill. 2025;11:e66921. Published 2025 May 22. doi:10.2196/66921

Centers for Disease Control and Prevention. HIV. Fast Facts: HIV in the United States. CDC. April 22, 2024. Accessed June 18, 2026. https://www.cdc.gov/hiv/data-research/facts-stats/index.html

HIVinfo.NIH.gov. Understanding How HIV is Transmitted. HIVinfo.NIH.gov. Last Reviewed: September 15, 2025. Accessed June 18, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/understanding-hiv-transmission

Centers for Disease Control and Prevention. How HIV Spreads. CDC. November 25, 2024. Accessed June 18, 2026. https://www.cdc.gov/hiv/causes/index.html

HIVinfo.NIH.gov. HIV Prevention. The Basics of HIV Prevention. HIVinfo.NIH.gov. April 9, 2025. Accessed June 18, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/basics-hiv-prevention

Njom Nlend AE. Mother-to-Child Transmission of HIV Through Breastfeeding Improving Awareness and Education. A Short Narrative Review. Int J Womens Health. 2022;14:697-703. Published 2022 May 13. doi:10.2147/IJWH.S330715

HIVinfo.NIH.gov. HIV Overview. HIV.info NIH.gov. March 31, 2025. Accessed June 18, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection#:~:text=Acute%20HIV%20infection%20is%20the,the%20risk%20of%20HIV%20transmission

Committee on Pediatric AIDS. Policy Statement: Infant feeding and transmission of human immunodeficiency virus in the United States. Pediatrics. 2013;131(2):391-396.

Nishiya AS, Ferreira SC, Salles NA, Rocha V, Mendrone-Júnior A. Transfusion-Acquired HIV: History, Evolution of Screening Tests, and Current Challenges of Unreported Antiretroviral Drug Use in Brazil. Viruses. 2022;14(10):2214. Published 2022 Oct 8. doi:10.3390/v14102214

Centers for Disease Control and Prevention. Blood Safety. Clinical Testing Guidance for Blood Safety. CDC. September 24, 2025. Accessed June 18, 2026. https://www.cdc.gov/blood-safety/hcp/diagnosis-testing/?CDC_AAref_Val=https://www.cdc.gov/bloodsafety/basics.html

Centers for Disease Control and Prevention. HIV. HIV Occupational Transmission. CDC. September 23, 2024. Accessed June 18, 2026. https://www.cdc.gov/hiv/causes/occupational-transmission.html

Wyżgowski P, Rosiek A, Grzela T, Leksowski K. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities. Ther Clin Risk Manag. 2016;12:989-994. Published 2016 Jun 14. doi:10.2147/TCRM.S104942

Tsega D, Gintamo B, Mekuria ZN, Demissie NG, Gizaw Z. Occupational exposure to HIV and utilization of post-exposure prophylaxis among healthcare workers at St. Peter's specialized hospital in Addis Ababa, Ethiopia. Sci Rep. 2023;13(1):7021. Published 2023 Apr 29. doi:10.1038/s41598-023-34250-4

Abadie RB, Brown EM, Campbell JR, et al. Incidence and Risks of HIV Infection, Medication Options, and Adverse Effects in Accidental Needle Stick Injuries: A Narrative Review. Cureus. 2024;16(1):e51521. Published 2024 Jan 2. doi:10.7759/cureus.51521

Centers for Disease Control and Prevention. Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program. CDC. Undated. Accessed June 18, 2026. https://www.cdc.gov/infection-control/media/pdfs/sharps-safety-workbook-2008-p.pdf?CDC_AAref_Val=https://www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf

HIVinfo.NIH.gov. Living with HIV. Pre-Exposure Prophylaxis (PrEP). HIVinfo.NIH.gov. Updated: February 12, 2026. Accessed June 19, 2026. https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis

Tanner MR, O'Shea JG, Byrd KM, et al. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025. MMWR Recomm Rep. 2025;74(1):1-56. Published 2025 May 8. doi:10.15585/mmwr.rr7401a1

HIVinfo.NIH.gov. Living with HIV. HIV and Substance Use. HIVinfo.NIH.gov. Last Reviewed: September 16, 2025. Accessed June 19, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-substance-use

Liu H, Su Y, Zhu L, Xing J, Wu J, Wang N. Effectiveness of ART and condom use for prevention of sexual HIV transmission in serodiscordant couples: a systematic review and meta-analysis. PLoS One. 2014; 9(11):e111175.

Giannou FK, Tsiara CG, Nikolopoulos GK, et al. Condom effectiveness in reducing heterosexual HIV transmission: a systematic review and meta-analysis of studies on HIV serodiscordant couples. Expert Rev Pharmacoecon Outcomes Res. 2016;16(4):489-499. doi:10.1586/14737167.2016.1102635

Cohen MS, Council OD, Chen JS. Sexually transmitted infections and HIV in the era of antiretroviral treatment and prevention: the biologic basis for epidemiologic synergy. J Int AIDS Soc. 2019;22 Suppl 6(Suppl Suppl 6):e25355. doi:10.1002/jia2.25355

Baeten JM, Donnell D, Kapiga SH, et al. Male circumcision and risk of male-to-female HIV-1 transmission: a multinational prospective study in African HIV-1-serodiscordant couples. AIDS. 2010;24(5):737-744. doi:10.1097/QAD.0b013e32833616e0

Ball LJ, Puka K, Speechley M, et al. Sharing of Injection Drug Preparation Equipment Is Associated With HIV Infection: A Cross-sectional Study. J Acquir Immune Defic Syndr. 2019;81(4):e99-e103. doi:10.1097/QAI.0000000000002062

Des Jarlais DC, Nugent A, Solberg A, Feelemyer J, Mermin J, Holtzman D. Syringe service programs for persons who inject drugs in urban, suburban, and rural Areas - United States, 2013. MMWR Morb Mortal Wkly Rep. 2015; 64(48):1337-1341.

Volmink J, Marais B. HIV: mother-to-child transmission. BMJ Clin Evid. 2008;2008:0909. Published 2008 Feb 5.

Clinical Info. HIV.gov. Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States. Care of Infants With Perinatal Exposure to HIV. Clinical Info. HIV.gov. December 19, 2024. Accessed June 18, 2026. https://clinicalinfo.hiv.gov/en/guidelines/perinatal/management-infants-diagnosis-hiv-infection-children#:~:text=Infants%20aged%20

Powell AM, Knott-Grasso MA, Anderson J, et al. Infant feeding for people living with HIV in high resource settings: a multi-disciplinary approach with best practices to maximise risk reduction. Lancet Reg Health Am. 2023;22:100509. Published 2023 May 29. doi:10.1016/j.lana.2023.100509

van den Berg K, van Hasselt J, Bloch E, et al. A review of the use of blood and blood products in HIV-infected patients. South Afr J HIV Med. 2012;13(2):87-104. doi:10.4102/sajhivmed.v13i2.146

National Institute of Health. Clinical Center. Can I Donate If...?. NIH. Undated. Accessed June 18, 2026. https://www.cc.nih.gov/bloodbank/can-i-donate

HIV gov. HIV Treatment as Prevention. HIV.gov. Updated: April 2, 2026. Accessed June 19, 2026. https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/hiv-treatment-as-prevention

Alhumaid S, Al Mutair A, Al Alawi Z, et al. Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review. Antimicrob Resist Infect Control. 2021;10(1):86. Published 2021 Jun 3. doi:10.1186/s13756-021-00957-0

Occupational Safety and Health Administration. Bloodborne pathogens. Standard CFR 1910.1930. Undated. Accessed June 18, 2026. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=10051

Centers for Disease Control and Prevention. Infection Control. Disinfection and Sterilization Guideline. CDC. December 7, 2023. Accessed June 18, 2026. https://www.cdc.gov/infection-control/hcp/disinfection-and-sterilization/?CDC_AAref_Val=https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html

Centers for Disease Control and Prevention. Dental Infection Prevention and Control. Best Practices for Occupational Exposure to Blood. CDC. December 15, 2023. Accessed June 18, 2026. https://www.cdc.gov/dental-infection-control/hcp/dental-ipc-faqs/occupational-exposure.html?CDC_AAref_Val=https://www.cdc.gov/oralhealth/infectioncontrol/faqs/occupational-exposure.html

Mallon PW, Brunet L, Hsu RK, et al. Weight gain before and after switch from TDF to TAF in a U.S. cohort study. J Int AIDS Soc. 2021;24(4):e25702. doi:10.1002/jia2.25702

Gutierrez D, Tan A, Strome A, Pomeranz MK. Dental dams in dermatology: An underutilized barrier method of protection. Int J Womens Dermatol. 2022;8(1):e008. Published 2022 Mar 22. doi:10.1097/JW9.0000000000000008

Centers for Disease Control and Prevention. HIV Testing. Getting Tested for HIV. CDC. February 11, 2025. Accessed August 14, 2025. https://www.cdc.gov/hiv/testing/index.html

Centers for Disease Control and Prevention. HIV. Preventing HIV with Condoms. CDC. April 24, 2024. Accessed June 18, 2026. https://www.cdc.gov/hiv/prevention/condoms.html?CDC_AAref_Val=https://www.cdc.gov/hiv/basics/hiv-prevention/condoms.html

Centers for Disease Control and Prevention. HIV Infection: Detection, Counseling, and Referral. CDC. 2021. Accessed June 18, 2026. https://www.cdc.gov/std/treatment-guidelines/hiv.htm

Getting tested for HIV. Centers for Disease Control and Prevention. February 11, 2025. Accessed July 10, 2026. https://www.cdc.gov/hiv/testing/index.html

US Food and Drug Administration. Information regarding the OraQuick In-Home HIV Test. June 3, 2020. Accessed June 18, 2026. https://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/PremarketApprovalsPMAs/ucm311895.htm

OraQuick®. HIV Self-Test. 2025. Accessed June 18, 2026. http://www.oraquick.com/

US Food and Drug Administration. Information regarding the Home Access HIV-1 Test System. FDA. March 7, 2018. Accessed June 18, 2026. https://www.fda.gov/vaccines-blood-biologics/approved-blood-products/information-regarding-home-access-hiv-1-test-system

Hartog J, Robinson G. Florida's OMNIBUS AIDS Act: A Brief Legal Guide for Health Care Professionals. Florida Department of Health. August 2013. Accessed July 10, 2026. https://www.floridahealth.gov/wp-content/uploads/2025/08/Omnibus-booklet-update-2013.pdf

Section 381.004, Fla. Stat. 2025

Section 384.31, Fla. Stat. 2025

Section 760.50, Fla. Stat. 2025

Information is powerful medicine. US Department of Health and Human Services. February 3, 2025. Accessed July 10, 2026. https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/information-is-powerful-medicine/index.html

The Americans with Disabilities Act and Persons with HIV/AIDS. US Department of Justice Civil Rights Division. February 25, 2020. Accessed July 10, 2026. https://archive.ada.gov/hiv/ada_qa_hiv.htm

Family and Medical Leave Act. US Department of Labor. January 26, 2026. Accessed July 10, 2026. https://www.dol.gov/agencies/whd/fmla

Continuation of Health Coverage. US Department of Labor. Accessed July 10, 2026. https://www.dol.gov/general/topic/health-plans/cobra

Paying for HIV Care and Treatment. HIV.gov. February 25, 2026. Accessed July 10, 2026. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/paying-for-hiv-care-and-treatment

Fair Housing Act. Civil Rights Division. US Department of Justice. June 22, 2023. Accessed July 10, 2026. https://www.justice.gov/crt/fair-housing-act-1 .

Centers for Disease Control and Prevention. Let's Stop HIV Together. CDC. Last Reviewed: February 18, 2025. Accessed June 18, 2026. https://www.cdc.gov/stophivtogether/hiv-prevention/prep.html

Centers for Disease Control and Prevention. HIV Nexus: CDC Resources for Clinicians. Clinical Guidance for PrEP. CDC. April 30, 2026. Accessed June 18, 2026.
https://www.cdc.gov/hivnexus/hcp/prep/index.html

YEZTUGO- lenacapavir sodium tablet, film coated YEZTUGO- lenacapavir sodium kit. Prescribing Information. Gilead Sciences, Inc. Updated February 12, 2026. Accessed June 18, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1c241af1-ce62-4b0a-9eb7-f6b626174f01

Patel RR, Hoover KW, Lale A, Cabrales J, Byrd KM, Kourtis AP. Clinical Recommendation for the Use of Injectable Lenacapavir as HIV Preexposure Prophylaxis - United States, 2025. MMWR Morb Mortal Wkly Rep. 2025;74(35):541-549. Published 2025 Sep 18. doi:10.15585/mmwr.mm7435a1

Centers for Disease Control and Prevention. HIV. Treating HIV. CDC. April 12, 2024. Accessed June 18, 2026. https://www.cdc.gov/hiv/treatment/index.html

World Health Organization. Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy. WHO. July 1, 2017. Accessed June 18, 2026. https://www.who.int/publications/i/item/9789241550062

Centers for Disease Control and Prevention. HIV Nexus: CDC Resources for Clinicians. Clinical Care of HIV. CDC. February 10, 2025. Accessed June 18, 2026. https://www.cdc.gov/hivnexus/hcp/clinical-care/index.html

HIVinfo. NIH.gov. FDA-Approved HIV Medicines. HIV.info NIH.gov. June 8, 2026. Accessed June 18, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/fda-approved-hiv-medicines

Genvoya. Prescribing information. Gilead Sciences. January 2022. Accessed July 10, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/207561s029lbl.pdf

Stribild. Prescribing Information. Gilead Sciences. August 2017. Accessed July 10, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/203100s030lbl.pdf

Odefsey. Prescribing information. Gilead Sciences. October 2018. Accessed July 10, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/208351s006lbl.pdf

Rilpirivine, emtricitabine, tenofovir DF. Prescribing information. Mylan Pharmaceuticals. December 14, 2024. Accessed July 10, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d9a4185e-43fa-4aeb-9b0f-8db01b166038

Biktarvy. Prescribing Information. Gilead Sciences. July 2025. Accessed July 10, 2026. https://www.gilead.com/~/media/files/pdfs/medicines/hiv/biktarvy/biktarvy_pi.pdf

Symtuza. Prescribing information. Janssen Products. March 2023. Accessed July 10, 2026. https://www.jnjlabels.com/package-insert/product-monograph/prescribing-information/SYMTUZA-pi.pdf

Triumeq. Prescribing information. Viiv Healthcare. October 2025. Accessed July 10, 2026. https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Triumeq/pdf/TRIUMEQ-PI-MG-IFU.PDF#page=1

Juluca. Prescribing information. Viiv Healthcare. October 2025. Accessed July 10, 2026. https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Juluca/pdf/JULUCA-PI-PIL.PDF

Dovato. Prescribing information. Viiv Healthcare. October 2025. Accessed July 10, 2026. https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Dovato/pdf/DOVATO-PI-PIL.PDF

Efavirenz. Prescribing information. Par pharmaceuticals. January 2017. Accessed July 10, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/pepfar/202990PI.pdf

Norvir. Prescribing information. Abbvie. June 2017. Accessed July 10, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209512lbl.pdf

HIV.gov. Symptoms of HIV. HIV.gov. June 9, 2025. Accessed June 18, 2026. https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/symptoms-of-hiv/

American Heart Association. As HIV patients live longer, heart disease might be their next challenge. AHA. June 3, 2019. Accessed June 18, 2026. https://www.heart.org/en/news/2019/06/03/as-hiv-patients-live-longer-heart-disease-might-be-their-next-challenge

Triant VA. Cardiovascular disease and HIV infection. Curr HIV/AIDS Rep. 2013;10(3):199-206. doi:10.1007/s11904-013-0168-6

Fitzpatrick ME, Kunisaki KM, Morris A. Pulmonary disease in HIV-infected adults in the era of antiretroviral therapy. AIDS. 2018;32(3):277-292. doi:10.1097/QAD.0000000000001712

Al Abri S, Kasaeva T, Migliori GB, et al. Tools to implement the World Health Organization End TB Strategy: Addressing common challenges in high and low endemic countries. Int J Infect Dis. 2020;92S:S60-S68. doi:10.1016/j.ijid.2020.02.042

Jensen PA, Lambert LA, Iademarco MF, Ridzon R; CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005;54(RR-17):1-141.

Ehrlich R, Spiegel JM, Adu P, Yassi A. Current Guidelines for Protecting Health Workers from Occupational Tuberculosis Are Necessary, but Not Sufficient: Towards a Comprehensive Occupational Health Approach. Int J Environ Res Public Health. 2020;17(11):3957. Published 2020 Jun 3. doi:10.3390/ijerph17113957

Centers for Disease Control and Prevention. Recommendations and Reports. Appendix A. Aids-Defining Conditions. MMWR. 2008. Accessed June 18, 2026. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5710a2.htm

Centers for Disease Control and Prevention. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Early Release. 2009; 58:1–207.

Li Y, Zhao JK, Wang M, et al. Current antibody-based immunoassay algorithm failed to confirm three late-stage AIDS cases in China: case report. Virol J. 2010;7:58. Published 2010 Mar 15. doi:10.1186/1743-422X-7-58

Clinical Info. HIV.gov. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. What to Start: Initial Combination Antiretroviral Regimens for People With HIV. HIV.gov. September 12, 2024. Accessed June 18, 2026. https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/what-start-initial-combination-regimens

Clinical Info. HIV.gov. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. What to Start. Clinical Info. HIV.gov. September 30, 2025. Accessed June 18, 2026. https://clinicalinfo.hiv.gov/en/guidelines/pediatric-arv/regimens-recommended-initial-therapy-antiretroviral-naive-children?view=full

Foka FET, Mufhandu HT. Current ARTs, Virologic Failure, and Implications for AIDS Management: A Systematic Review. Viruses. 2023;15(8):1732. Published 2023 Aug 13. doi:10.3390/v15081732

Kasten MJ. Primary Care of the Person Living with HIV. Pathogens. 2022;11(4):380. Published 2022 Mar 22. doi:10.3390/pathogens11040380

HIV Treatment.Drug Resistance. HIVinfo.NIH.gov. July 10, 2026. Accessed July 10, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/drug-resistance

DISCLAIMER

The information provided in this course is general in nature, and it is designed solely to provide participants with continuing education credit(s). This course and materials are not meant to substitute for the independent, professional judgment of any participant regarding that participant’s professional practice, including but not limited to patient assessment, diagnosis, treatment, and/or health management. Medical and pharmacy practices, rules, and laws vary from state to state, and this course does not cover the laws of each state; therefore, participants must consult the laws of their state as they relate to their professional practice.

Healthcare professionals must consult their employer, healthcare facility, hospital, or other organization for guidelines, protocols, and procedures to follow. The information provided in this course does not replace those guidelines, protocols, and procedures, but is for academic purposes only, and this course’s limited purpose is for the completion of continuing education credits.

Participants are advised and acknowledge that information related to medications, their administration, dosing, contraindications, adverse reactions, interactions, warnings, precautions, or accepted uses is constantly changing. Any person taking this course understands that such a person must make an independent review of medication information before any patient assessment, diagnosis, treatment and/or health management. Any discussion of off-label use of any medication, device, or procedure is informational only, and such uses are not endorsed hereby.

Nothing contained in this course represents the opinions, views, judgments, or conclusions of RxCe.com LLC. RxCe.com LLC is not liable or responsible to any person for any inaccuracy, error, or omission with respect to this course or course material.

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