189    SAJHIVMED  DECEMBER 2013, Vol. 14, No. 4  

C
P

D
 Q

U
E

S
T

IO
N

A
IR

E

CPD QUESTIONNAIRE
Vol. 14, No. 4

Regarding the effect of antiretroviral therapy (ART) on preg­
nancy 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 second­line 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 self­testing 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 HIV­positive 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 
men   tal 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 
contra indicated 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.

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.

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)

http://www.cpdjournals.co.za
http://www.cpdjournals.co.za