title: HIV Prevention and Treatment: The Evolving Role of the Emergency Department.
abstract: Historically, the role of the emergency physician in HIV care has been constrained to treating sick patients with opportunistic infections and postexposure prophylaxis for occupational exposures. However, advances in HIV care have led to medications that have substantially fewer issues with toxicity and resistance, opening up an exciting new opportunity for emergency physicians to participate in treating the HIV virus itself. With this new role, it is crucial that emergency physicians be familiar with the advances in testing and medications for HIV prevention and treatment. To our knowledge, to date there has not yet been an article addressing this expansion of practice. We have compiled a summary of what the emergency physician needs to know, including misconceptions associated with antiretroviral therapy, medication complexity, toxicity, resistance, and usability. Additionally, we review potential indications for prescribing these drugs in the emergency department, including the role of the emergency physician in postexposure prophylaxis, preexposure prophylaxis, and treatment of acute HIV, as well as how emergency physicians can engage with chronic HIV infection.
authors.affiliation: Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address: kstanley@usc.edu.
authors.forename: Kristi
authors.initials: K
authors.lastname: Stanley
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Lora
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Merjavy
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Arora
authors.affiliation: Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Menchine
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Jacobson
mesh_terms: D000208:Acute Disease; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002908:Chronic Disease; D004635:Emergency Medicine; D004636:Emergency Service, Hospital; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D009784:Occupational Diseases / Q000517:prevention & control* / Q000821:virology; D056990:Post-Exposure Prophylaxis; D017410:Practice Guidelines as Topic; D065129:Pre-Exposure Prophylaxis; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents