SlideShare a Scribd company logo

Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Exposure Prophylaxis

•Download as PPT, PDF•
•
M
MedicineAndHealthUSA
Health & Medicine
1 of 46
Occupational Exposure Management of HIV Post-Exposure Prophylaxis Bruce D. Agins, MD MPH Medical Director, AIDS Institute New York State Department of Health
Overview ,[object Object],[object Object],[object Object]
RATIONALE ,[object Object],[object Object],[object Object]
Occupational HIV Infection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Occupational HIV Infection ,[object Object],[object Object],[object Object],[object Object]
U.S. Health-Care Workers with Documented Occupationally Acquired HIV Infection, by Occupation through June 1999 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Source Fluids for Exposures Resulting in Occupational HIV Transmission US HCW reported through 12/98
Risk Factors for HIV Transmission CDC Case Control Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exposure Risk ,[object Object],[object Object],[object Object]
Exposure Risk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rationale for PEP: The Science ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Outcomes of HIV Exposures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Animal Studies of PEP: Prevention of SIV in macaques with Tenofovir (PMPA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tsai et al, J Virol, 1998;72:4265
Animal Studies of PEP: Prevention of SIV in macaques with Tenofovir (PMPA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tsai et al, J Virol, 1998;72:4265
Animal Studies: Observed Outcomes ,[object Object],[object Object],[object Object],[object Object]
Animal Studies: Problems in Interpretation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Human Data ,[object Object],[object Object],[object Object]
PEP in Humans / HCW ,[object Object],[object Object],[object Object],[object Object],[object Object]
CDC Case Control Study ,[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors For HIV Transmission CDC Case Control Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Limitations of CDC Study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PEP in Humans ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Perinatal Transmission Prophylaxis Data ,[object Object],26.1 342 NO THERAPY 18.4 38 AFTER 48 hours POST-PARTUM 9.3 86 BEFORE 48 hours POST-PARTUM 10.0 50 INTRAPARTUM 6.1 423 PRENATAL Percent HIV-Infected Number Born Timing of Prophylaxis Initiation
Other Perinatal Transmission Prophylaxis Data ,[object Object],[object Object],[object Object],[object Object]
GUIDELINES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Guidelines: The Goal ,[object Object]
Indications for PEP NYSDOH CDC ,[object Object],[object Object],Recommendations are the same
Immediate Measures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antiretroviral Regimens NYSDOH CDC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(Combivir) (Combivir)
Alternative Regimens ,[object Object],[object Object],[object Object],[object Object],[object Object]
Initiation of PEP NYSDOH vs. CDC ,[object Object],[object Object],[object Object],[object Object]
Duration of Therapy ,[object Object],[object Object]
NYSDOH vs. CDC
ZDV PEP Treatment Failures in HCWs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Implementation of PEP Programs
Designing a PEP Program ,[object Object],[object Object],[object Object],[object Object]
Institutional Procedures ,[object Object],[object Object],[object Object],[object Object]
Institutional Procedures: Counseling ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Institutional Procedures: Counseling ,[object Object],[object Object],[object Object]
Procedures: Access to Therapy ,[object Object],[object Object],[object Object],[object Object]
Occupational Exposure & PEP: The Central Issues ,[object Object],[object Object]
Reality of PEP ,[object Object],[object Object],[object Object],[object Object]
Acknowledgments ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendations Hepatitis B ,[object Object],[object Object],[object Object]
Recommendations Hepatitis C ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended

Nosocomial infections prevention
Nosocomial infections preventionNosocomial infections prevention
Nosocomial infections preventionSubraham Pany
 
VAP Bundle
VAP BundleVAP Bundle
VAP BundleApollo Hospitals
 
Surgical Site Infection (SSI)
Surgical Site Infection (SSI)Surgical Site Infection (SSI)
Surgical Site Infection (SSI)Philippine Hospital Infection Contol Nurses Associaton (PHICNA) Inc.
 
Hospital Acquired Infection (HAI)
Hospital Acquired Infection (HAI)Hospital Acquired Infection (HAI)
Hospital Acquired Infection (HAI)Zulfiquer Ahmed Amin
 
Catheter Associated Urinary Tract Infection (CAUTI)
Catheter Associated Urinary Tract Infection (CAUTI)Catheter Associated Urinary Tract Infection (CAUTI)
Catheter Associated Urinary Tract Infection (CAUTI)Philippine Hospital Infection Contol Nurses Associaton (PHICNA) Inc.
 
Hospital infection control(Indicators)
Hospital infection control(Indicators)Hospital infection control(Indicators)
Hospital infection control(Indicators)Jayant Balani
 
Post exposure prophylaxis of hiv
Post exposure prophylaxis of hivPost exposure prophylaxis of hiv
Post exposure prophylaxis of hivNiranjan Chavan
 
District health planning
District health planningDistrict health planning
District health planningvishal soyam
 

Recommended

Nosocomial infections prevention
Nosocomial infections preventionNosocomial infections prevention
Nosocomial infections preventionSubraham Pany
 
VAP Bundle
VAP BundleVAP Bundle
VAP BundleApollo Hospitals
 
Surgical Site Infection (SSI)
Surgical Site Infection (SSI)Surgical Site Infection (SSI)
Surgical Site Infection (SSI)Philippine Hospital Infection Contol Nurses Associaton (PHICNA) Inc.
 
Hospital Acquired Infection (HAI)
Hospital Acquired Infection (HAI)Hospital Acquired Infection (HAI)
Hospital Acquired Infection (HAI)Zulfiquer Ahmed Amin
 
Catheter Associated Urinary Tract Infection (CAUTI)
Catheter Associated Urinary Tract Infection (CAUTI)Catheter Associated Urinary Tract Infection (CAUTI)
Catheter Associated Urinary Tract Infection (CAUTI)Philippine Hospital Infection Contol Nurses Associaton (PHICNA) Inc.
 
Hospital infection control(Indicators)
Hospital infection control(Indicators)Hospital infection control(Indicators)
Hospital infection control(Indicators)Jayant Balani
 
Post exposure prophylaxis of hiv
Post exposure prophylaxis of hivPost exposure prophylaxis of hiv
Post exposure prophylaxis of hivNiranjan Chavan
 
District health planning
District health planningDistrict health planning
District health planningvishal soyam
 
Outbreak investigation steps
Outbreak investigation stepsOutbreak investigation steps
Outbreak investigation stepsAbdiwali Abdullahi Abdiwali
 
Antibiotic policy
Antibiotic policyAntibiotic policy
Antibiotic policyDr. Md Ashraf Ali Namaji
 
WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...
WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...
WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...Philippine Hospital Infection Contol Nurses Associaton (PHICNA) Inc.
 
Surveillance of HAI
Surveillance of HAISurveillance of HAI
Surveillance of HAIApollo Hospitals
 
Needle stick Injuries concerns and prevention
Needle stick Injuries concerns and prevention Needle stick Injuries concerns and prevention
Needle stick Injuries concerns and prevention Society for Microbiology and Infection care
 
Surgical site infection
Surgical site infectionSurgical site infection
Surgical site infectionOsama Warda
 
Needle Stick Injury Presentation
Needle Stick Injury PresentationNeedle Stick Injury Presentation
Needle Stick Injury Presentationdrabushafi
 
CLABSI
CLABSICLABSI
CLABSIMary Mwinga
 
Health care associated infections
Health care associated infectionsHealth care associated infections
Health care associated infectionsDr.Hemant Kumar
 
Prevention of nosocomial infections
Prevention of nosocomial infectionsPrevention of nosocomial infections
Prevention of nosocomial infectionsSachin Verma
 
SURGICAL SITE INFECTIONS PREVENTION AND CARE
SURGICAL SITE INFECTIONS PREVENTION AND CARESURGICAL SITE INFECTIONS PREVENTION AND CARE
SURGICAL SITE INFECTIONS PREVENTION AND CARESociety for Microbiology and Infection care
 
Surveillance
SurveillanceSurveillance
SurveillanceDr. Anees Alyafei
 
Needle stick injury management
Needle stick injury managementNeedle stick injury management
Needle stick injury managementCHANDANMISHRA141
 
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACP
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACPPost exposure prophylaxis (pep) -by Dr Munawar Khan SACP
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACPDr Munawar Khan
 
Needle stick and sharp injuries
Needle stick and sharp injuriesNeedle stick and sharp injuries
Needle stick and sharp injuriesLee Oi Wah
 
Seven strategies to prevent hospital associated infections improved.pptx
Seven strategies to prevent hospital associated infections improved.pptxSeven strategies to prevent hospital associated infections improved.pptx
Seven strategies to prevent hospital associated infections improved.pptxPathKind Labs
 
Infection Prevention and Control in Hospitals by Dr Dele
Infection Prevention and Control in Hospitals by Dr DeleInfection Prevention and Control in Hospitals by Dr Dele
Infection Prevention and Control in Hospitals by Dr DeleKemi Dele-Ijagbulu
 
Cauti ppt
Cauti pptCauti ppt
Cauti pptDeboraJasmin S
 
Infection prevention & control general orientation [compatibility mode]
Infection prevention & control general orientation [compatibility mode]Infection prevention & control general orientation [compatibility mode]
Infection prevention & control general orientation [compatibility mode]drnahla
 
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSESCLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSESDEEPARANI
 
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and... Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...hivlifeinfo
 
Family Planning for Persons Living with HIVAIDS_2015 AR and MS
Family Planning for Persons Living with HIVAIDS_2015 AR and MSFamily Planning for Persons Living with HIVAIDS_2015 AR and MS
Family Planning for Persons Living with HIVAIDS_2015 AR and MSNikole Gettings
 

More Related Content

What's hot

Surgical site infection
Surgical site infectionSurgical site infection
Surgical site infectionOsama Warda
 
Needle Stick Injury Presentation
Needle Stick Injury PresentationNeedle Stick Injury Presentation
Needle Stick Injury Presentationdrabushafi
 
Health care associated infections
Health care associated infectionsHealth care associated infections
Health care associated infectionsDr.Hemant Kumar
 
Prevention of nosocomial infections
Prevention of nosocomial infectionsPrevention of nosocomial infections
Prevention of nosocomial infectionsSachin Verma
 
Needle stick injury management
Needle stick injury managementNeedle stick injury management
Needle stick injury managementCHANDANMISHRA141
 
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACP
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACPPost exposure prophylaxis (pep) -by Dr Munawar Khan SACP
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACPDr Munawar Khan
 
Needle stick and sharp injuries
Needle stick and sharp injuriesNeedle stick and sharp injuries
Needle stick and sharp injuriesLee Oi Wah
 
Seven strategies to prevent hospital associated infections improved.pptx
Seven strategies to prevent hospital associated infections improved.pptxSeven strategies to prevent hospital associated infections improved.pptx
Seven strategies to prevent hospital associated infections improved.pptxPathKind Labs
 
Infection Prevention and Control in Hospitals by Dr Dele
Infection Prevention and Control in Hospitals by Dr DeleInfection Prevention and Control in Hospitals by Dr Dele
Infection Prevention and Control in Hospitals by Dr DeleKemi Dele-Ijagbulu
 
Infection prevention & control general orientation [compatibility mode]
Infection prevention & control general orientation [compatibility mode]Infection prevention & control general orientation [compatibility mode]
Infection prevention & control general orientation [compatibility mode]drnahla
 
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSESCLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSESDEEPARANI
 

What's hot (20)

Outbreak investigation steps
Outbreak investigation stepsOutbreak investigation steps
Outbreak investigation steps
 
Antibiotic policy
Antibiotic policyAntibiotic policy
Antibiotic policy
 
WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...
WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...
WHO Guidelines on Core Components of Infection Prevention and Control (IPC) P...
 
Surveillance of HAI
Surveillance of HAISurveillance of HAI
Surveillance of HAI
 
Needle stick Injuries concerns and prevention
Needle stick Injuries concerns and prevention Needle stick Injuries concerns and prevention
Needle stick Injuries concerns and prevention
 
Surgical site infection
Surgical site infectionSurgical site infection
Surgical site infection
 
Needle Stick Injury Presentation
Needle Stick Injury PresentationNeedle Stick Injury Presentation
Needle Stick Injury Presentation
 
CLABSI
CLABSICLABSI
CLABSI
 
Health care associated infections
Health care associated infectionsHealth care associated infections
Health care associated infections
 
Prevention of nosocomial infections
Prevention of nosocomial infectionsPrevention of nosocomial infections
Prevention of nosocomial infections
 
SURGICAL SITE INFECTIONS PREVENTION AND CARE
SURGICAL SITE INFECTIONS PREVENTION AND CARESURGICAL SITE INFECTIONS PREVENTION AND CARE
SURGICAL SITE INFECTIONS PREVENTION AND CARE
 
Surveillance
SurveillanceSurveillance
Surveillance
 
Needle stick injury management
Needle stick injury managementNeedle stick injury management
Needle stick injury management
 
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACP
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACPPost exposure prophylaxis (pep) -by Dr Munawar Khan SACP
Post exposure prophylaxis (pep) -by Dr Munawar Khan SACP
 
Needle stick and sharp injuries
Needle stick and sharp injuriesNeedle stick and sharp injuries
Needle stick and sharp injuries
 
Seven strategies to prevent hospital associated infections improved.pptx
Seven strategies to prevent hospital associated infections improved.pptxSeven strategies to prevent hospital associated infections improved.pptx
Seven strategies to prevent hospital associated infections improved.pptx
 
Infection Prevention and Control in Hospitals by Dr Dele
Infection Prevention and Control in Hospitals by Dr DeleInfection Prevention and Control in Hospitals by Dr Dele
Infection Prevention and Control in Hospitals by Dr Dele
 
Cauti ppt
Cauti pptCauti ppt
Cauti ppt
 
Infection prevention & control general orientation [compatibility mode]
Infection prevention & control general orientation [compatibility mode]Infection prevention & control general orientation [compatibility mode]
Infection prevention & control general orientation [compatibility mode]
 
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSESCLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
CLABSI/CRBSI PREVENTION BUNDLE CARE FOR NURSES
 

Similar to Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Exposure Prophylaxis

Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and... Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...hivlifeinfo
 
Family Planning for Persons Living with HIVAIDS_2015 AR and MS
Family Planning for Persons Living with HIVAIDS_2015 AR and MSFamily Planning for Persons Living with HIVAIDS_2015 AR and MS
Family Planning for Persons Living with HIVAIDS_2015 AR and MSNikole Gettings
 
Presentation ipre xwebsite
Presentation ipre xwebsitePresentation ipre xwebsite
Presentation ipre xwebsiteJames Wilton
 
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...hivlifeinfo
 
HIV (Durgapur Steel Plant Hospital) 01 dec 09
HIV (Durgapur Steel Plant Hospital) 01 dec 09HIV (Durgapur Steel Plant Hospital) 01 dec 09
HIV (Durgapur Steel Plant Hospital) 01 dec 09Ratnadeep Ganguly
 
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...hivlifeinfo
 
A presentation on pep kie
A presentation on pep kieA presentation on pep kie
A presentation on pep kiebmetobo
 
Prophylaxis and HIV Prevention by Dr. Ken Mayer
Prophylaxis and HIV Prevention by Dr. Ken MayerProphylaxis and HIV Prevention by Dr. Ken Mayer
Prophylaxis and HIV Prevention by Dr. Ken MayerSearch For A Cure
 
Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...
Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...
Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...hivlifeinfo
 
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...hivlifeinfo
 
Drug Therapy For Prevention?
Drug Therapy For Prevention?Drug Therapy For Prevention?
Drug Therapy For Prevention?CHAMP Network
 
Early HIV Intervention by Dr. Rachel Baden
Early HIV Intervention by Dr. Rachel BadenEarly HIV Intervention by Dr. Rachel Baden
Early HIV Intervention by Dr. Rachel BadenSearch For A Cure
 
Contemporary Management of HIV. New Data From AIDS 2018
Contemporary Management of HIV. New Data From AIDS 2018Contemporary Management of HIV. New Data From AIDS 2018
Contemporary Management of HIV. New Data From AIDS 2018hivlifeinfo
 
High Sensitivity HIV Testing and Translational Science around PrEP
High Sensitivity HIV Testing and Translational Science around PrEPHigh Sensitivity HIV Testing and Translational Science around PrEP
High Sensitivity HIV Testing and Translational Science around PrEPHopkinsCFAR
 
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...hivlifeinfo
 
Clinical Impact of New HIV Data From CROI 2019
Clinical Impact of New HIV Data From CROI 2019Clinical Impact of New HIV Data From CROI 2019
Clinical Impact of New HIV Data From CROI 2019hivlifeinfo
 
Bbp 2014 15
Bbp 2014 15Bbp 2014 15
Bbp 2014 15gfd232
 
NationalLatest Updates to the Canadian VAP Guidelines - What's New?
NationalLatest Updates to the Canadian VAP Guidelines - What's New?NationalLatest Updates to the Canadian VAP Guidelines - What's New?
NationalLatest Updates to the Canadian VAP Guidelines - What's New?Canadian Patient Safety Institute
 

Similar to Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Exposure Prophylaxis (20)

Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and... Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...
 
Family Planning for Persons Living with HIVAIDS_2015 AR and MS
Family Planning for Persons Living with HIVAIDS_2015 AR and MSFamily Planning for Persons Living with HIVAIDS_2015 AR and MS
Family Planning for Persons Living with HIVAIDS_2015 AR and MS
 
Presentation ipre xwebsite
Presentation ipre xwebsitePresentation ipre xwebsite
Presentation ipre xwebsite
 
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...
Современное лечение ВИЧ: новые парадигмы в АРТ / Contemporary Management of H...
 
HIV (Durgapur Steel Plant Hospital) 01 dec 09
HIV (Durgapur Steel Plant Hospital) 01 dec 09HIV (Durgapur Steel Plant Hospital) 01 dec 09
HIV (Durgapur Steel Plant Hospital) 01 dec 09
 
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...
Новые данные с конференции по ВИЧ-инфекции CROI 2017/Clinical Impact of New D...
 
A presentation on pep kie
A presentation on pep kieA presentation on pep kie
A presentation on pep kie
 
Prophylaxis and HIV Prevention by Dr. Ken Mayer
Prophylaxis and HIV Prevention by Dr. Ken MayerProphylaxis and HIV Prevention by Dr. Ken Mayer
Prophylaxis and HIV Prevention by Dr. Ken Mayer
 
Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...
Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...
Современное лечение ВИЧ: когда начинать, чем начинать. Contemporary Managemen...
 
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...
Cовременное лечение ВИЧ : новые данные с конференции CROI 2017/ Contemporary...
 
Drug Therapy For Prevention?
Drug Therapy For Prevention?Drug Therapy For Prevention?
Drug Therapy For Prevention?
 
Early HIV Intervention by Dr. Rachel Baden
Early HIV Intervention by Dr. Rachel BadenEarly HIV Intervention by Dr. Rachel Baden
Early HIV Intervention by Dr. Rachel Baden
 
HIV Treatment and PrEP in 2015
HIV Treatment and PrEP in 2015HIV Treatment and PrEP in 2015
HIV Treatment and PrEP in 2015
 
Contemporary Management of HIV. New Data From AIDS 2018
Contemporary Management of HIV. New Data From AIDS 2018Contemporary Management of HIV. New Data From AIDS 2018
Contemporary Management of HIV. New Data From AIDS 2018
 
E R Pep Sept 2009
E R Pep Sept 2009E R Pep Sept 2009
E R Pep Sept 2009
 
High Sensitivity HIV Testing and Translational Science around PrEP
High Sensitivity HIV Testing and Translational Science around PrEPHigh Sensitivity HIV Testing and Translational Science around PrEP
High Sensitivity HIV Testing and Translational Science around PrEP
 
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...
Современное лечение ВИЧ: новые подходы к оптимизации АРТ/Contemporary Managem...
 
Clinical Impact of New HIV Data From CROI 2019
Clinical Impact of New HIV Data From CROI 2019Clinical Impact of New HIV Data From CROI 2019
Clinical Impact of New HIV Data From CROI 2019
 
Bbp 2014 15
Bbp 2014 15Bbp 2014 15
Bbp 2014 15
 
NationalLatest Updates to the Canadian VAP Guidelines - What's New?
NationalLatest Updates to the Canadian VAP Guidelines - What's New?NationalLatest Updates to the Canadian VAP Guidelines - What's New?
NationalLatest Updates to the Canadian VAP Guidelines - What's New?
 

More from MedicineAndHealthUSA

Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...MedicineAndHealthUSA
 
Hiv Infection And The Nervous System
Hiv Infection And The Nervous SystemHiv Infection And The Nervous System
Hiv Infection And The Nervous SystemMedicineAndHealthUSA
 
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...MedicineAndHealthUSA
 
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...MedicineAndHealthUSA
 
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...MedicineAndHealthUSA
 
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...MedicineAndHealthUSA
 
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...MedicineAndHealthUSA
 
Transforming the Office Management of Heart Failure using the Chronic Disease...
Transforming the Office Management of Heart Failure using the Chronic Disease...Transforming the Office Management of Heart Failure using the Chronic Disease...
Transforming the Office Management of Heart Failure using the Chronic Disease...MedicineAndHealthUSA
 

More from MedicineAndHealthUSA (20)

Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...Prospects for preventing bacterial meningitis Prospects for preventing bact...
Prospects for preventing bacterial meningitis Prospects for preventing bact...
 
After Fellowship
After FellowshipAfter Fellowship
After Fellowship
 
Salzer
SalzerSalzer
Salzer
 
Hiv Infection And The Nervous System
Hiv Infection And The Nervous SystemHiv Infection And The Nervous System
Hiv Infection And The Nervous System
 
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
HIV Vaccine Research and HIV drugs in the pipeline HIV Vaccine Research and...
 
Low Back Pain
Low Back PainLow Back Pain
Low Back Pain
 
Thyroid Benign Slides
Thyroid Benign SlidesThyroid Benign Slides
Thyroid Benign Slides
 
The Challenge Of Acute Back Pain
The Challenge Of Acute Back PainThe Challenge Of Acute Back Pain
The Challenge Of Acute Back Pain
 
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple My...
 
Hiv Vaccines Overview
Hiv Vaccines OverviewHiv Vaccines Overview
Hiv Vaccines Overview
 
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
Breast Cancer - Is there a link to endocrine disrupting chemicals? Breast C...
 
Low Back Pain
Low Back PainLow Back Pain
Low Back Pain
 
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
How Should One Decide Whom to Treat for Hypertension? How Should One Decide...
 
low Back pain
low Back painlow Back pain
low Back pain
 
Calcium disorder
Calcium disorderCalcium disorder
Calcium disorder
 
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
Hypertension and Diabetic Kidney Disease Progression Hypertension and Diabe...
 
Diabetes Care Alphabet Strategy
Diabetes Care Alphabet StrategyDiabetes Care Alphabet Strategy
Diabetes Care Alphabet Strategy
 
Diabetes
DiabetesDiabetes
Diabetes
 
Balasubramanian K5 Oct 21 230pm
Balasubramanian K5 Oct 21 230pmBalasubramanian K5 Oct 21 230pm
Balasubramanian K5 Oct 21 230pm
 
Transforming the Office Management of Heart Failure using the Chronic Disease...
Transforming the Office Management of Heart Failure using the Chronic Disease...Transforming the Office Management of Heart Failure using the Chronic Disease...
Transforming the Office Management of Heart Failure using the Chronic Disease...
 

Recently uploaded

Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000aliya bhat
 
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...narwatsonia7
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiNehru place Escorts
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girlsnehamumbai
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformKweku Zurek
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Miss joya
 
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original PhotosBook Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAAjennyeacort
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingNehru place Escorts
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service MumbaiLow Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbaisonalikaur4
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...narwatsonia7
 

Recently uploaded (20)

Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Marathahalli 📞 9907093804 High Profile Service 100% Safe
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
 
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
 
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
 
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original PhotosBook Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
 
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service MumbaiLow Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
 

Management of HIV - Post-Exposure Prophylaxis Management of HIV - Post-Exposure Prophylaxis

  • 1. Occupational Exposure Management of HIV Post-Exposure Prophylaxis Bruce D. Agins, MD MPH Medical Director, AIDS Institute New York State Department of Health
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Source Fluids for Exposures Resulting in Occupational HIV Transmission US HCW reported through 12/98
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.  
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 35.
  • 36. Implementation of PEP Programs
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.