Module Updates

INTRODUCTION

The STRIPE HIV team made several updates in response to feedback from STRIPE HIV partners following the launch of Version 1.0. Across all modules in Version 2.0, the importance of virial suppression has been underscored and facilitator instructions have been added to invite use of country-specific guidelines. Key updates are listed below, but the list is not exhaustive of all changes. For questions related to revisions made from v1.0 to v2.0, please email stripeHIV@ucsf.edu with attention to Shayanne Martin.

2.1 updates

New v2.1 Module 17 Objective Map: Duplicate objective removed.

New v2.1 Module 6 Facilitator Guide: Activity 4 has been updated so that the 4 questions match the Learner Guide.

Module 8 Update: Switched Hematologic and Gastrointestinal in the signs and symptoms table in Activity 2 (so that they correctly matched the signs and symptoms)

Summary of Changes:

Module 1

  1. 90-90-90 updated to 95-95-95 (Activity 1)
  2. Safety of DTG updated to reflect the most recent guidelines: https://www.who.int/news-room/detail/22-07-2019-who-recommends-dolutegravir-as-preferred-hiv-treatment-option-in-all-populations (Activity 4)
  3. Added partner disclosure (Activity 5)
  4. Added open-ended discussion opportunity at the end of the module to enable discussion about other needs that women with newly diagnosed HIV face (Activity 6)

Module 2

  1. Case vignette, history, and physical exam details updated (Introduction/Case)
  2. Page 3 of the WHO 2011 Global Atlas of CVD Prevention and Control is now included (Activity 1)
  3. Replaced pages 16-21 of the 2007 WHO Pocket Guidelines with pages 60-65 (Activity 3) and page 71 (Activity 2) of the 2016 WHO HEARTS Technical Package for Cardiovascular Disease Management in Primary Health Care. Answers for Activities 2 and 3 were updated to reflect these more recent guidelines.
  4. Added statement on empirical treatment when there is a lack of diagnostic supplies/equipment (Activity 3)
  5. Case evolution added (Activity 6) in the Facilitator Guide (was already in the Learner Guide)
  6. Deletion of misplaced TB activity; replaced with activity on recognizing the negative impact of CVD on long term outcomes of PWH (Activity 7)
  7. Added statement on importance of virologic suppression (Activity 7)
  8. Added objective 7, “Appreciate other NCDs experienced by PWH,” and added new activity on recognizing additional NCDs that develop in PWH (Activity 8)

Module 3

  1. Updated Answer Slides (ppt), including proposing to include an image of chest x-ray (Activity 1)
  2. Added AIDS Info tables 21c and 21d (Activity 2) to Additional Learner Materials
  3. Added assessing nutritional status (Activity 1)
  4. Added importance of other drug-drug interactions, including psychiatric medications and some forms of oral contraceptives (Activity 2)
  5. Added reflection on importance of virologic suppression at end of module (Conclusion)

Module 4

  1. In addition to covering ART options during pregnancy, added ART options during delivery and breastfeeding (Objective 2 and Activity 2)
  2. Updated # of antenatal care visits pregnant women should aim for from 4 to 8, per WHO recommendations (Activity 1)
  3. Updated breastfeeding recommendations (Activity 1)
  4. Added language re: woman-centered and rights-based approach to ART decision making (Activity 2)
  5. Added ART combinations to Answer Slides (Slide 3)
  6. Added importance of viral suppression during breastfeeding (Activity 4)

Module 5

  1. Added additional factors that increase adolescents’ risk of HIV acquisition (Activity 2)
  2. Added optional discussion on what to do in case of stockout of STI medication (Activity 1 and ppt slide 4)

Module 6

  1. Kissing and insect bites added to list of exposures that constitute “negligible risk” (Activity 3: ppt slide 2)
  2. Transmission risk activity simplified (Activity 3: table)
  3. Added counseling on need for PEP (Activity 4)
  4. Added roles of different health care professionals and management in preventing and handling needlestick injuries to strengthen IPE (Activity 5: Qs 3-4)

Module 7

  1. Added detail on differential diagnosis of AMS (Activity 1 and ppt slide 2)
  2. Added contraindications for lumbar puncture (Activity 2 and ppt slide 3)
  3. Added use of a manometer to check the opening pressure (Activity 2)
  4. Added India ink (Activity 5 and ppt slide 6)
  5. Clarified focus is on timing of ART initiation/re-initiation, not the selection of an ART regimen (Activity 8)
  6. Added discussion of prophylaxis of positive CrAg (Conclusion)

Module 8

  • Signs and symptoms corrected (Activity 2: table headings)
  • Added mention of SOFA score (Activity 3)

Module 9

  1. Minor changes made; no significant updates to report

Module 10

  1. Explanation of EOL care updated to reflect dying as a process that ideally begins preparing a person while they are still conscience (Introduction)
  2. IP component added to Objective 5 and Activity 6
  3. Added additional prompts to reflect on experiences of breaking bad news throughout module

Module 11

  1. Updated facilitator introduction to address importance of high quality, non-judgmental care for MSM even in countries where certain sexual practices are criminalized (Introduction)
  2. Updated language on number of sexual partners to be more objective and less stigmatizing; updated client to be HIV negative (Introduction/Case)
  3. Added way the provider in video Scenario B could have improved taking a sexual history (Activity 3)
  4. Scenario A and B videos are now provided as Additional Facilitator Materials (Activity 3)
  5. Added optional review of evidence for PrEP efficacy (Activity 4)

Module 12

  1. Updated age of client (John) to 17 years old (Case)
  2. Objective 2 updated to include retention
  3. Added mention of adolescent friendly services, including teen clubs (Activity 2)
  4. Added PHQ-2 (Activity 4, ppt slide 4)

Module 13

  1. Created Answer Slides
  2. Added urgency needed to address ARV stockouts (Activity 2, Conclusion)
  3. Substantial copyediting throughout

Module 14

  1. Updated health district and health worker schematics on Answer Slides (Activities 1 & 2)
  2. Objectives updated
  3. The HIV case manager and HIV nurse no longer have names. The introduction of the ART clients and flow of questions have been updated throughout the module.
  4. New conclusion
  5. Substantial copyediting throughout

Module 15

  1. End of 5 Ways activity updated to include a prompt for learners to think of solutions to the systems problem they’ve identified (Activity 6)

Module 16

  1. Role play facilitation updated (Activity 1)
  2. QI activity simplified (Activity 3 and Answer Slides)
  3. List of “What can Ministries of Health do?” updated (Activity 6)
  4. Additional reference added (#4)
  5. Role play cards updated (Additional Learner Materials)

Module 17

  1. Added link to growth chart for girls for optional practice (Activity 2 and Reference 12)
  2. Answer on page 6 on “Pneumocystis prophylaxis” updated to “Pneumocystis pneumonia” prophylaxis (Activity 4)
  3. Indications for cotrimoxazole prophylaxis updated to reflect the 2016 WHO guidelines (Activity 4)
  4. Added mention of following principles in integrated management of childhood illnesses (Activity 4)
  5. Added mention of social support for children, along with additional reference material (Activity 6)

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