<figure><img src="image_1.png" /></figure>

# CPD QUESTIONNAIRE

Vol. 14, No. 4

Five CPD points are awarded for the correct completion and submission of the questions below.

CPD questionnaires must be completed online via www.cpdjournals.co.za. After submission, you can check the answers and print your certificate.

This programme is available free of charge to members of the SA HIV Clinicians Society and SAMA only.

## Regarding the effect of antiretroviral therapy (ART) on pregnancy outcomes:

1. Studies from Europe and North America have suggested that *in utero* exposure to ART may be associated with prematurity, and this association appears particularly likely with nucleoside reverse transcriptase inhibitors (NRTIs).

2. Women initiating ART during pregnancy consistently appear to have lower birth weight infants than women who conceive after ART initiation.

## Regarding patients failing second-line ART:

3. For ART to be effective, adherence rates must be at least 70%.

4. Studies show that the vast majority of cases of confirmed viraemia on second-line ART regimens are the result of antiretroviral resistance.

5. For patients receiving second-line regimens who have evidence of viraemia, further adherence counselling is unlikely to be helpful, and referral for genotypic testing and/or third-line ART is the only option.

6. A targeted adherence counselling intervention can lead to resuppression in individuals who appear to be failing second-line regimens.

## Regarding human papillomavirus (HPV) infection in men:

7. HIV is a strong risk factor for HPV acquisition in men.

8. Anogenital HPV in men is not associated with significant pathology.

9. Compared with women, men have shorter-term persistence of infection and lower rates of re-infection of HPV.

10. The new HPV vaccine being rolled out in South Africa (SA) is not necessary for HIV-positive men.

## Regarding queries from nurses working in ART services:

11. In many parts of SA, nurse-initiated management of antiretroviral therapy (NIMART) underpins public sector ART services.

12. The interpretation of laboratory results before initiating patients on ART is a common knowledge gap among NIMART nurses.

## Regarding HIV self-testing in children:

13. Self-testing for HIV infection is being seen as a new way of reaching under-tested populations.

14. In line with key legal norms, children above the age of 12 years could consent to such a self-test.

15. There are already relatively high rates of health-facility-based HIV testing among children.

## Regarding mental illness in HIV-positive individuals:

16. 'Common' mental disorders such as depression or anxiety occur less commonly in HIV-positive individuals than in the general population.

17. A primary care practitioner can often identify significant mental illness with a few simple screening questions.

18. In starting antidepressants, the governing principle is to start at low doses and escalate dosing gradually over time.

19. Efavirenz has psychotropic properties and is absolutely contraindicated in individuals with serious mental disorders such as schizophrenia.

20. The approach to medication to treat anxiety disorders (such as post-traumatic stress disorder) parallels that of depressive disorders, and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine are the first-line treatment in most circumstances.

## INSTRUCTIONS

1. Read the journal. All the answers will be found there.

2. Go to www.cpdjournals.co.za to answer the questions.

Accreditation number: MDB001/011/01/2013 (Clinical)

<figure><img src="image_2.png" /></figure>