Overview: In this episode, Toyin Nwafor, MD, and Christian B Ramers, MD, draw on their experience in primary care, HIV and HIV prevention to highlight missed opportunities for HIV prevention and discuss strategies to help address gaps in the HIV care continuum. The views expressed are those of the panelist(s) and not necessarily Gilead Sciences, Inc. The information provided in this podcast is not intended to be and should not be understood to provide medical advice. Listeners should note that our discussions in this episode are relevant to the USA only and may not be appropriate for other regions. This episode was recorded in August 2025 and the content reflects the information available at that time. Guest: Toyin Nwafor, MD; Christian B Ramers, MD, MPH, FIDSA, AAHIVS For more information, please visit: https://www.pri-med.com/clinical-resources/curriculum/hiv-in-focus  References AIDSVu.org. Prevalence in the United States. 2022. Available from: https://map.aidsvu.org/ (Accessed June 25, 2025). AIDSVu.org was developed by the Rollins School of Public Health at Emory University in partnership with Gilead Sciences, Inc. Baeten J et al. Curr HIV/AIDS Rep 2013;10:142–51. CDC. Clinical testing guidance for HIV. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/diagnosis-testing/index.html (Accessed June 25, 2025). CDC. Discussing sexual health with your patients. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/sexual-history/index.html (Accessed June 25, 2025). CDC.gov. HIV diagnoses, deaths, and prevalence. 2025. Available from: https://www.cdc.gov/hiv-data/nhss/hiv-diagnoses-deaths-prevalence.html (Accessed June 25, 2025). CDC. National HIV prevention and care objectives: 2025 update. 2025. Available from: https://www.cdc.gov/hiv-data/nhss/national-hiv-prevention-and-care-objectives-2025.html (Accessed June 25, 2025). CDC. Preexposure prophylaxis for the prevention of HIV infection in the United States – 2021 update: a clinical practice guideline. 2021. Available from: https://stacks.cdc.gov/view/cdc/112360 (Accessed June 25, 2025). Doblecki-Lewis S et al. J Int Assoc Provid AIDS Care 2019;18:2325958219848848. DHHS. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. 2024. Available from: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (Accessed June 25, 2025). HIV.gov. Key EHE strategies. 2024. Available from: https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/key-strategies (Accessed June 2, 2025). HIV.gov. HIV treatment as prevention. 2023. Available from: https://www.hiv.gov/tasp (Accessed June 25, 2025). HIV.gov. US statistics. 2025. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics (Accessed May 21, 2025). HIV.gov. Viral suppression and undetectable viral load. 2025. Available from: https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/viral-suppression (Accessed July 18, 2025). HIV.gov. Who is at risk for HIV. 2025. Available from: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/who-is-at-risk-for-hiv (Accessed June 25, 2025). Johns Hopkins Bloomberg School of Public Health. What to know about PrEP. 2025. Available from: https://publichealth.jhu.edu/2025/who-needs-prep-for-hiv-prevention (Accessed June 25, 2025). Kamis KF et al. Open Forum Infect Dis 2019;6:ofz310. KFF. HIV testing in the United States. 2024. Available from: https://www.kff.org/hiv-aids/hiv-testing-in-the-united-states/ting in the United States | KFF (Accessed August 26, 2025). NIH. HIV and sexually transmitted infections (STIs). 2021. Available from: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-sexually-transmitted-infections-stis (Accessed June 25, 2025). Ramchandani MS et al. Curr HIV/AIDS Rep 2019;16:244–56. Saag MS et al. JAMA 2018;320:379–96. Sweeney P et al. J Acquir Immune Defic Syndr 2019;82(Suppl 1):S1–5. The White House. National

Overview: In this episode, Dr Gina Brown and Dr Sahar Khalili draw on their expertise in HIV prevention to provide an overview of the current PrEP landscape in the United States. They highlight advancements in HIV prevention and emphasize the importance of targeted programs to address disparities in access and uptake across population groups and geographic regions. The views expressed are those of the panelist(s) and not necessarily Gilead Sciences, Inc. The information provided in this podcast is not intended to be and should not be understood to provide medical advice. Listeners should note that our discussions in this episode are relevant to the USA only and may not be appropriate for other regions. This episode was recorded in August 2025 and the content reflects the information available at that time. Guest: Gina Brown, MD; Sahar Khalili, PharmD For more information, please visit: https://www.pri-med.com/clinical-resources/curriculum/hiv-in-focus  References ACOG. Preexposure prophylaxis for the prevention of human immunodeficiency virus. 2024. Available from: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/06/preexposure-prophylaxis-for-the-prevention-of-human-immunodeficiency-virus (Accessed June 25, 2025). ADAP Directory. About. 2024. Available from: https://adap.directory/about (Accessed June 25, 2025). Aidsmap. Condoms. 2023. Available from: https://www.aidsmap.com/about-hiv/condoms#toc-how-effective-are-condoms (Accessed June 25, 2025). AIDSVu. AIDSVu releases new PrEP data and launches PrEPVu.org, a new PrEP equity platform. 2024. Available from: https://aidsvu.org/news-updates/aidsvu-releases-new-prep-data-and-launches-prepvu-org-a-new-prep-equity-platform/ (Accessed June 25, 2025). AIDSVu.org was developed by the Rollins School of Public Health at Emory University in partnership with Gilead Sciences, Inc. AIDSVu. AIDSVu releases 2024 PrEP use data showing growing use across the U.S. 2025. Available from: https://aidsvu.org/news-updates/aidsvu-releases-2024-prep-use-data-showing-growing-use-across-the-u-s/ (Accessed July 18, 2025). AIDSVu.org was developed by the Rollins School of Public Health at Emory University in partnership with Gilead Sciences, Inc. AIDSVu. Location profiles: South. 2025. Available from: https://map.aidsvu.org/profiles/region/south/prevention-and-testing#1-2-PnR (Accessed July 31, 2025). AIDSVu.org was developed by the Rollins School of Public Health at Emory University in partnership with Gilead Sciences, Inc. AIDSVu. PrEP use significantly associated with decreasing new HIV diagnoses across U.S. states. 2025. Available from: https://aidsvu.org/news-updates/prep-use-significantly-associated-with-decreasing-new-hiv-diagnoses-across-u-s-states/ (Accessed June 25, 2025). AIDSVu.org was developed by the Rollins School of Public Health at Emory University in partnership with Gilead Sciences, Inc. Baeten J et al. Curr HIV/AIDS Rep 2013;10:142–51. Bekker LG et al. N Engl J Med 2024;391:1179–92. CDC. About ending the HIV epidemic in the US. 2024. Available from: https://www.cdc.gov/ehe/php/about/index.html (Accessed June 2, 2025). CDC. Clinical Guidance for PrEP. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/prep/index.html (Accessed June 25, 2025). CDC. Preexposure prophylaxis for the prevention of HIV infection in the United States - 2021 update. 2021. Available from: https://stacks.cdc.gov/view/cdc/112360 (Accessed June 25, 2025). Coates TJ et al. Lancet 2008;372:669–84. DHHS. Pre-exposure (PrEP) to prevent HIV during periconception, antepartum, ad postpartum. 2024. Available from: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/perinatal-hiv/pre-exposure-prophylaxis-prep-prevent-hiv-perinatal.pdf (Accessed June 25, 2025). Gandhi RT et al. JAMA 2023;329:63–84. HIV.gov. HIV treatment as prevention. 2023. Available from: https://www.hiv.gov/tasp (Accessed June 25, 2025). HIV.gov. Key EHE strategies. 2024. Available from:

Overview: In this episode, Dr Toyin Nwafor and Dr Andrew Zolopa provide an overview of the HIV treatment landscape both globally and in the United States. They highlight the current gaps in the HIV care continuum, emphasize the importance of rapid start and viral suppression in reducing HIV transmission through sex and describe initiatives and strategies aimed at closing these gaps to help end the HIV epidemic in the United States. The views expressed are those of the panelist(s) and not necessarily Gilead Sciences, Inc. The information provided in this podcast is not intended to be and should not be understood to provide medical advice. Listeners should note that our discussions in this episode are relevant to the USA only and may not be appropriate for other regions. This episode was recorded in August 2025 and the content reflects the information available at that time. Guest: Toyin Nwafor, MD; Andrew Zolopa, MD For more information, please visit: https://www.pri-med.com/clinical-resources/curriculum/hiv-in-focus  References AETC. Rapid (immediate) ART initiation and restart: guide for clinicians. 2023. Available from: https://aidsetc.org/resource/rapid-immediate-art-initiation-restart-guide-clinicians (Accessed June 25, 2025). Baxter A et al. J Acquir Immune Defic Syndr 2025;99:47–54. CDC. About ending the HIV epidemic in the US. 2024. Available from: https://www.cdc.gov/ehe/php/about/index.html (Accessed June 25, 2025). CDC. Clinical testing guidance for HIV. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/diagnosis-testing/index.html (Accessed June 25, 2025). CDC. Getting tested for HIV. 2025. Available from: https://www.cdc.gov/hiv/testing/index.html#cdc_testing_why_get_tested-why-get-tested (Accessed June 25, 2025). CDC. Laboratory testing for the diagnosis of HIV infection. 2014. Available from: https://stacks.cdc.gov/view/cdc/23446 (Accessed June 25, 2025). CDC. National HIV prevention and care objectives: 2025 update. 2025. Available from: https://www.cdc.gov/hiv-data/nhss/national-hiv-prevention-and-care-objectives-2025.html (Accessed June 25, 2025). Delaney KP et al. Am J Prev Med 2021;61(5 Suppl 1):S6–S15. DHHS. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. 2024. Available from: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (Accessed June 25, 2025). HIV.gov. EHE overview. 2025. Available from: https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview (Accessed June 25, 2025). HIV.gov. Global statistics. 2025. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics (Accessed June 25, 2025). HIV.gov. HIV Care Continuum. 2025. Available from: https://www.hiv.gov/federal-response/other-topics/hiv-aids-care-continuum (Accessed June 25, 2025). HIV.gov. Key EHE strategies. 2024. Available from: https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/key-strategies (Accessed June 25, 2025). HIV.gov. US statistics. 2025. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics (Accessed June 25, 2025). HIV.gov. Viral suppression and undetectable viral load. 2025. Available from: https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/viral-suppression (Accessed June 25, 2025). Mirzazadeh A et al. PLoS Med 2022;19:e1003940. NIH. HIV testing. 2025. Available from: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-testing (Accessed June 25, 2025). Palacio-Vieira J et al. BMC Public Health 2021;21:1596. Saag MS et al. JAMA 2018;320:379–96. The White House. National HIV/AIDS strategy for the United States 2022–2025. 2021. Available from: https://files.hiv.gov/s3fs-public/NHAS-2022-2025.pdf (Accessed June 25, 2025). WHO. Supporting re-engagement in HIV treatment services: policy brief. 2024. Available from: https://www.who.int/publications/i/item/9789240097339 (Accessed June 25, 2025).

Overview: In this episode, Dr Melissa Jones and Dr Christian Ramers discuss the importance of pan-viral screening for HIV and hepatitis. They emphasize the need for integrated testing and prevention strategies and the current barriers to implementation. The views expressed are those of the panelist(s) and not necessarily Gilead Sciences, Inc. The information provided in this podcast is not intended to be and should not be understood to provide medical advice. Listeners should note that our discussions in this episode are relevant to the USA only and may not be appropriate for other regions. This episode was recorded in August 2025 and the content reflects the information available at that time. Guest: Christian B Ramers, MD, MPH, FIDSA, AAHIVS; Melissa Jones, DNP, APRN-BC For more information, please visit: https://www.pri-med.com/clinical-resources/curriculum/hiv-in-focus  References AASLD/IDSA. HCV guidance: recommendations for testing, managing, and treating hepatitis C. 2025. Available from: https://www.hcvguidelines.org/ (Accessed June 10, 2025). Arora DR et al. ISRN AIDS 2013;2013:287269 Alter MJ. J Hepatol 2006;44:S6–9. Bazargan M, Cobb BMS, Assari S. Ann Fam Med 2021;19:4–15. Beard N, Hill A. Open Forum Infect Dis 2024;11:ofad666. Bottero J, Boyd A, Gozlan J et al. Open Forum Infect Dis 2015;2:ofv162. Brunetto, Maurizia Rossana et al. J Hepatol 2023;79:433–60. Calabrese SK, Krakower DS, Mayer KH. Am J Public Health 2017;107:1883–89. CDC. Status neutral HIV care and service delivery eliminating stigma and reducing health disparities. 2022. Available from: https://stacks.cdc.gov/view/cdc/129024 (Accessed June 10, 2025). CDC. Clinical guidance for PrEP. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/prep/index.html (Accessed June 10, 2025). CDC. Clinical screening and diagnosis for hepatitis C. 2025. Available from: https://www.cdc.gov/hepatitis-c/hcp/diagnosis-testing (Accessed June 10, 2025). CDC. Clinical testing and diagnosis for hepatitis B. 2025. Available from: https://www.cdc.gov/hepatitis-b/hcp/diagnosis-testing/  (Accessed June 10, 2025). CDC. Clinical testing guidance for HIV. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/diagnosis-testing/index.html (Accessed June 10, 2025). CDC. Getting tested for HIV. 2025. Available from: https://www.cdc.gov/hiv/testing/ (Accessed June 10, 2025). CDC. Hepatitis A vaccine. 2025. Available from: https://www.cdc.gov/hepatitis-a/vaccination/index.html (Accessed June 10, 2025). CDC. Hepatitis B vaccine. 2025. Available from: https://www.cdc.gov/hepatitis-b/vaccination/index.html (Accessed June 10, 2025). CDC. HIV infection among heterosexuals at increased risk--United States, 2010. MMWR Morb Mortal Wkly Rep 2013;62:183-8. CDC. Viral hepatitis among people with HIV. 2025. Available from: https://www.cdc.gov/hepatitis/hcp/populations-settings/hiv.html (Accessed June 10, 2025. Clinical info HIV.gov. Considerations for Antiretroviral Use in People With Coinfections, Hepatitis B Virus/HIV Coinfection. 2024. Available from: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/hepatitis-b-virus-hiv-coinfection (Accessed July 21, 2025). Cornberg M, Sandmann L, Jaroszewicz J et al. J Hepatol 2025; doi: 10.1016/j.jhep.2025.03.018. Coukan F, Murray KK, Papageorgiou V et al. HIV Med 2023;24:893–913. DHHS. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. 2024. Available from: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (Accessed June 25, 2025). GHTF. Breaking the silence: combating stigma and misinformation in the fight against hepatitis. 2024. Available from: https://www.globalhep.org/news-blogs/breaking-silence-combating-stigma-and-misinformation-fight-against-hepatitis (Accessed June 10, 2025) Grieb SM, Harris R, Rosecrans A et al. Ann Med 2022;54:138–49. HIV.gov. US statistics. 2025. Available fro

Overview: In this episode, Dr Joel Gallant gives a history of antiretroviral therapy and HIV drug resistance, drawing on his personal and professional experience beginning in the early 1980s. The views expressed are those of the panelist and not necessarily Gilead Sciences, Inc. The information provided in this podcast is not intended to be and should not be understood to provide medical advice. Listeners should note that our discussions in this episode are relevant to the USA only and may not be appropriate for other regions. This episode was recorded in August 2023 and the content reflects the information available at that time. Guest: Joel Gallant, MD, MPH  For more information, please visit: https://www.pri-med.com/clinical-resources/curriculum/hiv-in-focus    References AIDSVu.org. New HIV diagnoses. 2023. Available from: https://aidsvu.org/local-data/united-states/south/ (Accessed May 19, 2025) AIDSVu.org was developed by the Rollins School of Public Health at Emory University in partnership with Gilead Sciences, Inc. Alonso A, de Irala J. Strategies in HIV prevention: the A-B-C approach. Lancet 2004;364:1033. Available from: https://doi.org/10.1016/s0140-6736(04)17050-5 Bacheler L, Jeffrey S, Hanna G et al. Genotypic correlates of phenotypic resistance to efavirenz in virus isolates from patients failing nonnucleoside reverse transcriptase inhibitor therapy. J Virol 2001;75:4999–5008. Available from: https://doi.org/10.1128/jvi.75.11.4999-5008.2001 Barré-Sinoussi F, Chermann JC, Rey F et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science 1983;220:868–71. Available from: https://doi.org/10.1126/science.6189183 Bayer R, Edington C. HIV testing, human rights, and global AIDS policy: exceptionalism and its discontents. J Health Polit Policy Law 2009;34:301–23. Available from: https://doi.org/10.1215/03616878-2009-002 Centers for Disease Control and Prevention. Pneumocystis pneumonia – Los Angeles. MMWR Morb Mortal Wkly Rep 1981;30:250-2. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm Centers for Disease Control and Prevention. Preventing HIV. 2024. Available from: https://www.cdc.gov/hiv/prevention/index.html (Accessed May 22, 2025) Cohen MS, Chen YQ, McCauley M et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011;365:493–505. Available from: https://doi.org/10.1056/NEJMoa1105243 Cuevas JM, Geller R, Garijo R et al. Extremely high mutation rate of HIV-1 in vivo. PLoS Biol 2015;13:e1002251. Available from: https://doi.org/10.1371/journal.pbio.1002251 Department of Health and Human Services. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. 2024. Available from: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/optimizing-antiretroviral-therapy (Accessed May 19, 2025) Dragovic G. Acute pancreatitis in HIV/AIDS patients: an issue of concern. Asian Pac J Trop Biomed 2013;3:422–425. Available from: https://doi.org/10.1016%2FS2221-1691(13)60091-X Eron JJ, Benoit SL, Jemsek J et al. Treatment with lamivudine, zidovudine, or both in HIV-positive patients with 200 to 500 CD4+ cells per cubic millimeter. North American HIV Working Party. N Engl J Med 1995;333:1662–9. Available from: https://doi.org/10.1056/nejm199512213332502 Gandhi RT, Tashima KT, Smeaton LM et al. Long-term outcomes in a large randomized trial of HIV-1 salvage therapy: 96-week results of AIDS clinical trials group A5241 (OPTIONS). J Infect Dis 2020;221:1407–15. Available from: https://doi.org/10.1093/infdis/jiz281 Getting to Zero San Francisco. HIV epidemiology annual report 2017. 2022. Available from: https://gettingtozerosf.org/getting-to-zero-resources/hiv-report-2017/ (Accessed May 22, 2025) Global Fund. About the Global Fund. 2024. Available from: https://www.theglobalfund.org/en/about-the-global-fund/ (Accessed May 19, 2025) Gulick RM, Lalezar

Overview: Explore the evolving landscape of Alzheimer’s diagnosis, where blood tests are emerging as a critical tool in clinical practice. In this episode, we’ll examine how these tests add value to traditional diagnostic methods and the latest research validating their accuracy. Join us to discover the potential of blood tests in transforming Alzheimer’s diagnosis. Guest: Suzanne E. Schindler, MD, PhD, Associate Professor of Neurology, Washington University School of Medicine For more information, please visit: https://www.pri-med.com/clinical-resources/podcast/ceoi-alzheimers-diagnostics-pt-1 

Overview: With the foundational knowledge from Episode 1, we transition from theory to practice. As these diagnostic tools become more widespread, primary care clinicians are at the forefront of their implementation. Listeners will gain insights from real-world experiences, learning actionable strategies to overcome challenges such as logistical barriers and resource limitations. By the end of this episode, primary care clinicians will have a roadmap for implementing blood tests into their practice. Guest: Deanna Willis, MD, MBA, FAAFP, FNAP; Jared Brosch, MD For more information, please visit: https://www.pri-med.com/clinical-resources/podcast/ceoi-alzheimers-diagnostics-pt-2 

Overview: As blood tests for Alzheimer’s become more accessible, clinicians must navigate the ethical and emotional complexities of delivering life-changing results. We explore how to communicate these findings with care, manage the psychological impact on patients and families, and address uncertainty in ambiguous cases. Drawing on real-world experiences and research, discover practical guidance for balancing clinical responsibility with compassionate patient care.  Guest: Michelle M. Mielke, PhD; Allyson Rosen, PhD, ABPP-CN For more information, please visit: https://www.pri-med.com/clinical-resources/podcast/ceoi-alzheimers-diagnostics-pt-3 

Overview: In this episode, join us as we discuss the use of blood eosinophils as a biomarker in severe asthma and whether there is prognostic value in measuring eosinophil levels. Episode key references and resource links:  Bruselle GG, and Koppelman GH. N Engl J Med. 2022;386(2):157–171. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2023. Available from: https://ginasthma.org/2023-gina-main-report/. Access date [June 2023]. de Groot JC, et al. ERJ Open Research. 2015;1(1):00024–2015. Bousquet J, et al. N Engl J Med. 1990;323(15):1033–1039. Yancey SW, et al. J. Allergy Clin Immunol. 2017;140(6):1509–1518.  Guest: Dareen Siri, MD, FAAAAI, FACAAI and Matthew Mintz, MD, FACP 

Overview: In this episode, join us as we discuss the risks of elevated eosinophil levels and exacerbations, and the role a specialist can play in the management of severe asthma. Episode references and resource links:  Price DB, et al. Lancet Respir Med. 2015;3(11):849–858. Dougherty RH and Fahy JV. Clin Exp Allergy. 2008;39(2):193–202. Chung LP, et al. Respirology. 2020;25(2):161–172. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2023. Available from: https://ginasthma.org/2023-gina-main-report/. Access date [June 2023]. Agusti A, et al. Respir Med. 2021;187:106572.  Guest: Dareen Siri, MD, FAAAAI, FACAAI and Matthew Mintz, MD, FACP

Overview: In this episode, join us as we discuss the importance of blood eosinophil testing for improving diagnosis and phenotyping in severe asthma. Episode key references and resource links:  Bruselle GG, and Koppelman GH. N Engl J Med. 2022;386(2):157–171. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2023. Available from: https://ginasthma.org/2023-gina-main-report/. Access date [June 2023]. Heaney LG, et al. Chest. 2021;160(3):814–830. de Groot JC, et al. ERJ Open Research. 2015;1(1):00024–2015. Fitzpatrick AM, et al. J Allergy Clin Immunol Pract. 2020;8(2):452–463 Guest: Dareen Siri, MD, FAAAAI, FACAAI and Matthew Mintz, MD, FACP

This podcast will review the unique pathophysiology in older adults with long-term Type 2 diabetes that underlie requirements for combination insulin therapy. Please take a few minutes to answer this questionnaire to help us evaluate the impact of this program and plan for future educational programs. Click Here

This podcast reviews the specific considerations in appropriately individualizing care for older adults with T2D by reviewing health status, cognition, frailty and their living situation  Please take a few minutes to answer this questionnaire to help us evaluate the impact of this program and plan for future educational programs. Click Here

This podcast focuses on the exploration of treatment approaches in older patients with Type 2 diabetes who are insulin-requiring through case discussion with a focus on simplicity, minimization of hypoglycemia and importance of simplification/de-intensification utilizing an individualized approach by reviewingpsychological, medical, functional and social domains. Please take a few minutes to answer this questionnaire to help us evaluate the impact of this program and plan for future educational programs. Click Here

The complexity behind recurrent UTI management often leaves both patients and clinicians with questions on the optimal management strategy. Should they be treated as an uncomplicated UTI? Are there special considerations or prevention measures? Are there unforeseen or unknown factors contributing to disease incidence? In this second episode, we take a deep dive into the treatment and management of recurrent UTI and explore the impact that this disease has on patients. Disclaimers: This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.   References: Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963.  Foxman B, Brown P. Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs. Infect Dis Clin North Am. 2003;17(2):227-241. doi: 10.1016/s0891-5520(03)00005-9 Foxman B, Gillespie B, Koopman J, et al. Risk factors for second urinary tract infection among college women. Am J Epidemiol 2000; 151:1194. Ikäheimo R, Siitonen A, Heiskanen T, et al. Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women. Clin Infect Dis 1996; 22:91. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103. Markowitz MA, Wood LN, Raz S, Miller LG, Haake DA, Kim JH. Lack of uniformity among United States recommendations for diagnosis and management of acute, uncomplicated cystitis. Int Urogynecol J. 2019;30(7):1187-1194. doi:10.1007/s00192-018-3750-z. Labcorp Report – Antibiotic Resistance in Bladder Infections (2019). https://www.labcorp.com/organizations/data/insights[1]analysis#InsightAnalytics-Antibiotic. Accessed December 1, 2022. Langford BJ, Brown KA, Diong C, et al. The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults. Clin Infect Dis. 2021;73(3):e782-e791. doi:10.1093/cid/ciab116 Harding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ. 2022;376:e068229. Published 2022 Mar 9. doi:10.1136/bmj-2021-0068229

Uncomplicated UTIs (Urinary Tract Infections) can have a detrimental impact on emotional wellbeing. Patients may feel ignored by their clinicians, who face a diverse set of challenges when managing uncomplicated UTIs, all of which are important to address when keeping the plan patient-centered. In this podcast, we will discuss patient-clinician communication barriers and the importance of patient[1]centered outcomes in managing uncomplicated UTIs. Disclaimers: This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.   References: Hilt EE, McKinley K, Pearce MM, et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52(3):871-876. doi:10.1128/JCM.02876-13 Lindsay LE, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis 68, no. 10 (May 2, 2019): e83–110. https://doi.org/10.1093/cid/ciy1121 Advani SD, Polage CR, Fakih MG. Deconstructing the urinalysis: A novel approach to diagnostic and antimicrobial stewardship. Antimicrob Steward Healthc Epidemiol. 2021;1(1):e6. doi: 10.1017/ash.2021.167. Epub 2021 Jun 28. PMID: 34604864; PMCID: PMC8486290 FDA Drug Safety Communication. FDA. 2016. Accessed October 10, 2022 https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety[1]communication-fda-advises-restricting-fluoroquinolone-antibiotic-use-certain Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963 Thompson J, Marijam A, Mitrani-Gold FS, Wright J, Joshi AV. Activity impairment and health-related emotional wellbeing associated with an uncomplicated urinary tract infection among US females. Oral presentation at: IDWeek 2021; September 29-October 3, 2021; Virtual Conference. Session: UTIs; presentation 196 7.Colgan R, Keating K, Dougouih M. Survey of symptom burden in women with uncomplicated urinary tract infections. Clin Drug Investig. 2004;24(1):55-60. doi: 10.2165/00044011-200424010-00007 Thompson J, Marijam A, Mitrani-Gold FS, Wright J, Joshi AV. A survey study of healthcare resource use, and direct and indirect costs, among females with an uncomplicated urinary tract infection in the United States. Poster presented at: IDWeek 2021; September 29-October 3, 2021. Poster 1227 Grigoryan L, Mulgirigama A, Powell M, Schmiemann G. The emotional impact of urinary tract infections in women: a qualitative analysis. BMC Womens Health. 2022;22(1):182. doi: 10.1186/s12905-022-01757-3 Scott VC, Thum LW, Sadun T, et al. Fear and frustration among women with recurrent urinary tract infections: findings from patient focus groups. J Urol. 2021;206(3):688-695. doi: 10.1097/JU.0000000000001843 Lecky DM, Howdle J, Butler CC, McNulty CA. Optimising management of UTIs in primary care: a qualitative study of patient and GP perspectives to inform the development of an evidence-based, shared decision-making resource. Br J Gen Pract. 2020;70(694):e330-e338. doi: 10.3399/bjgp20X708173 Chwa A, Kavanagh K, Linnebur SA, Fixen DR. Evaluation of methenamine for urinary tract infection prevention in older adults: a review of the evidence. Ther Adv Drug Saf. 2019;10:2042098619876749. Published 2019 Sep 23. doi:10.1177/2042098619876749 Harding C, Mossop H, Homer T, etal. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicen

The controversy surrounding whether to collect urine cultures and which empiric treatment to prescribe in patients with uncomplicated UTI has left many clinicians unsure of the right approach. In this the first episode of a podcast series, we’ll discuss the definition of clinical cure and dive into the evidence behind grey areas in the diagnosis and management of uncomplicated UTI. Disclaimers: This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.   References: Gupta K, Hooton TM, Naber KG, et al.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103- e120. doi: 10.1093/cid/ciq2572. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963 Houlbar M, Meng L. SHC Clinical Pathway: Inpatient Management of Urinary Tract Infections – Adult Patients. Stanford Antimicrobial Safety and Sustainability Program. November 2017. https://med.stanford.edu/content/dam/sm/bugsanddrugs/documents/c linicalpathways/SHC-UTI-Inpatient-Guideline.pdf. Accessed November 30, 2022. Hooton TM, Gupta K. Acute simple cystitis in women. UpToDate. Updated March 15, 2021. Accessed November 9, 2022. https://www.uptodate.com/contents/acute-simple-cystitis-in-women Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011;84(7):771-776. Shafrin J, Marijam A, Joshi AV, et al. Impact of suboptimal or inappropriate treatment on healthcare resource use and cost among patients with uncomplicated urinary tract infection: an analysis of integrated delivery network electronic health records. Antimicrob Resist Infect Control. 2022;11(1):133. Published 2022 Nov 4. doi:10.1186/s13756-022-01170-3 Daneman N, Chateau D, Dahl M, et al. Fluoroquinolone use for uncomplicated urinary tract infections in women: a retrospective cohort study. Clin Microbiol Infect. 2020;26(5):613-618. doi:10.1016/j.cmi.2019.10.016 Bratsman A, Mathias K, Laubscher R, Grigoryan L, Rose S. Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning. Pharmacoepidemiol Drug Saf. 2020;29(6):701-707. doi:10.1002/pds.5018 FDA Drug Safety Communication. FDA. 2019. Accessed October 10, 2022 https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns[1]about-increased-risk-ruptures-or-tears-aorta-blood-vessel[1]fluoroquinolone-antibiotics Nicolle LE; AMMI Canada Guidelines Committee*. Complicated urinary tract infection in adults. Can J Infect Dis Med Microbiol. 2005;16(6):349- 360. doi:10.1155/2005/385768

Diagnosing and treating IBS-D can be challenging. On IBS-D(ecoded), host Susan Brazil gets the latest facts about IBS-D, and real life patients share their experiences living with IBS-D. In Episode 1, patient Molly from Atlanta discusses her symptoms and frustrations since being first diagnosed with IBS-D ten years ago. Expert physician Dr. Gregory Sayuk introduces treatment options.. US-VBZ-220064 09/22 This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.

IBS-D was once a diagnosis of exclusion. If a patient didn’t test positive for other gastrointestinal conditions, IBS-D was considered possible. On this episode of IBS-D(ecoded), experts who have been involved in both the research and treatment of IBS-D discuss the symptoms that may help health care providers make an efficient, reliable diagnosis. US-VBZ-220064 09/22 This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.

IBS-D can affect people of all ages, from all walks of life. On this third and final episode of IBS-D(ecoded), we meet two more patients. Nico is a young man who was first diagnosed with IBS-D while in college. Christine is in her 60s and has lived with abdominal pain and diarrhea for decades. Our expert gastroenterologists discuss these patients’ symptoms and treatment options. Then patient Molly, whom we met in Episode 1, returns with some important advice for both health care providers and patients. US-VBZ-220064 09/22 This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.