HIV dilemmas day

Who is it for?

The HIV dilemmas day, run by the British Infection Association and Hartley Taylor Medical Communications, is designed for any trainees or specialists working in HIV medicine, including those from infectious diseases, genitourinary medicine, microbiology, virology, and pharmacology.

When did you do it?

I took the course in January 2010 while I was a third year specialist registrar in infectious diseases, and I attended again for the fifth version of the course in January 2012 in Manchester.

Why did you do it?

Although I regularly see complex HIV cases, the sheer breadth of these means I only see some of the conditions once or twice a year. This course allowed me to reacquaint myself with some important HIV related scenarios and update on the latest evidence and current best practice in their management.

What is the structure?

The workshop covers clinical scenarios that occur frequently enough to be important, but not so regularly that they don’t still present considerable dilemmas for the clinic team. It is in the format of a series of case vignettes, presented in real time, punctuated with audience participation using keypads at key decision points during the narrative. The day provides an opportunity to debate the clinical reasoning and management options, as each case is presented by national experts and unfolds in the context of the most up to date evidence base. This not only informs best practice but does so in a way that is thoroughly captivating and memorable.

Examples of cases presented in 2012 are HBV/HIV co-infection, tuberculosis and HIV co-infection (pharmacology), managing detectable HIV viral load in late pregnancy, LGV in HIV infection, central nervous system disease, respiratory disease cases, cryptococcal infection, perinatal toxoplasmosis, legal and ethical issues surrounding HIV disclosure, and contact tracing.

The speakers include practising virologists and HIV physicians from critical care, infectious diseases, tropical medicine, and genitourinary medicine who are leaders in their clinical and research fields, most of whom sit on national and international HIV guidelines committees.

Particular strengths of the course are the lighthearted and entertaining styles of the speakers, the use of real life cases, and encouraging the audience to ask questions and debate ideas. The relatively small size of the group (50-75 delegates) means the course feels informal and relaxed. As most of the speakers stay in the audience for the whole day, their views and expertise are often called upon when relevant to another speaker’s case. This provides considerable additional strength and depth to the discussion and learning experience.

How much effort did it entail?

This is a single day workshop of case presentations and open discussion. Plenty of refreshments and a very good lunch are included. The format of the day enables what feels like effortless learning, yet on the way home you realise your brain has had a good workout.

What’s the fee?

The fee for the day is £50. This price is kept low by support from the British Infection Association and unrestricted educational grants from several drug companies. £50 is a bargain and as well as all the useful learning, the day was highly entertaining and sociable.

Was it worth it?

The course was absolutely worth attending. It brought me up to date with the latest evidence for the management of the clinical conditions covered, and this will definitely impact on how I manage my next case. I was made aware of some aspects of HIV medicine I had not considered before—for example legal issues related to transmission of HIV and how to deal with approaches from lawyers and the police about one of your patients. A lot was covered in a single day.

On the other hand, there were no electronic or printed summaries of the course material to take away. Learning could be enhanced by multiple choice questions, or something similar, before and after the course to reiterate the main learning points (for example, these could be sent by email to delegates).

Top tips

• Think of any difficult cases you have had in the past, as you will be able to discuss them informally with the speakers

• Take notes and make time to go over the areas covered a few days later to cement what you have learnt