Hot Topics
- In Memoriam: Barbara Chaffee, MD, MPH
- PEPline: 1-888-448-4911
- Health Advisory: Expanded Outbreak Response Meningococcal Vaccine Recommendations for MSM
- Health Advisory: Cephalosporin-Resistant Gonococcal Infections
- Updated Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents Released
- OMD Screenshot: May 8, 2013
- Dear Colleague Letter for HIV Quality of Care Program Annual Data Report Based on 2011 Performance Data
- New Phone App to Facilitate HIV Screening, Counseling, and Linkage to Care
- New York State Medicaid Update: April 2013
- eHIVQUAL Indicator Comparison
- HIV/AIDS Clinical Education Initiative: April 2013
- NQC 2013 Quality of Care Awards Application Period Open
- U.S. Preventive Services Task Force (USPSTF) Recommendations on Screening for HIV
- FDA Updates Efavirenz Labeling with Expanded Pediatric Indication Information
- FDA approves Prezista (darunavir) labeling changes
- FDA Updates Atripla Labeling
- Email Announcement Archives
- Hot Topics Archive
In Memoriam: Barbara Chaffee, MD, MPH
Posted March 2013
Barbara Hunter Chaffee, MD, MPH, deeply respected internist, colleague, and advocate, passed away on March 5th, 2013, ending a long battle with breast cancer. As a physician practicing in Binghamton, Dr. Chaffee was profoundly connected to the Binghamton community and Southern Tier of New York State.
She worked as Medical Director, Alcoholism Services, United Health Services, then for the Broome County Health Service in various capacities, including Medical Director. In 1989, she co-found an HIV clinic at the health department. Until her retirement in 2010, she served as Medical Director of Binghamton Family Care Center Internal Medicine Office at UHS and Medical Director of its HIV Team.
She dedicated her professional life to providing care for the underserved, including those suffering from addictions. She was a certified substance use practitioner, which gave way to the beginning of her work with HIV/AIDS in the 1980s. Being more compassionate than fearful, she was one of the only physicians in the area willing to treat patients with HIV.
Dr. Chaffee served the New York State Department of Health AIDS Institute memorably in many initiatives, including the Quality of Care Program, the HIV Clinical Guidelines Program, and Clinical Education Initiative. She served as Chair of the HIV Quality of Care Advisory Committee from 1997 until 2008. Among many awards received by Dr. Chaffee, she was the recipient of both the Linda Laubenstein Award and the Outstanding Service Award for exceptional accomplishments in HIV/AIDS service delivery from The New York State Department of Health.
Dr. Chaffee was an invaluable contributor to the HIV Clinical Guidelines Program. She was an active member of the Medical Care Criteria Committee since 1997, and also served on the Physicians’ Prevention Advisory Committee, and Committee for the Care of Substance Users With HIV Infection.
Dr. Chaffee vibrantly contributed to committee discussions, always steering the group back to important core values, often with a poignant anecdote to underscore her view. A fellow committee member captured her perfectly with the following description: “Barb Chaffee was the most inspirational person, portrait of courage, humor, humility, and intelligence with a fierce sense of what is just and right.”
Dr. Chaffee had a gift for expression through the written word, translating consensus from committee discussion into crisp, clear writing that would be easily digestible to the intended audience. This is exemplified in two wonderful commentaries that she recently wrote on Medscape for the HIV Clinical Guidelines Program:
- Commentary on Prevention With Positives guideline
- Commentary on Screening and Ongoing Assessment for Substance Use in HIV Infection guideline
She was a principal contributor to the following guidelines: Screening and Ongoing Assessment for Substance Use, Care of the Hospitalized HIV-Infected Substance User, and most recently recommendations on When to Initiate Antiretroviral Therapy. She also served as a reviewer for many guidelines, including Primary Care Approach to the HIV-Infected Patient, Prevention With Positives: Integrating HIV Prevention Into HIV Primary Care, and Kidney Disease in HIV-Infected Patients.
Barbara is survived by her husband, three sons, three grandsons, her parents, and a large extended family. Dr. Chaffee is credited with improving the lives of countless patients and for positively influencing colleagues through a devoted commitment to clinical education and by inspiring her colleagues to always do better and do what is right. A visit to Dr. Chaffee’s obituary guest book shows a glimpse of who Barb Chaffee was, how many she has touched, and the worthy way she led her life.
Donations can be made to the Barbara H. Chaffee, MD, MPH Educational Fund at the Community Foundation (donorswhocare.org/chaffee), which is dedicated to nurture and support of health care professionals caring for people with HIV/AIDS.
PEPline: 1-888-448-4911
Posted March 2007
PEPline: 1-888-448-4911
In collaboration with the National HIV/AIDS Clinicians’ Consultation Center (NCCC), the New York State Department of Health AIDS Institute offers the HIV Post-Exposure Prophylaxis Hotline (PEPline) for providers needing consultation with an HIV Specialist regarding the management of exposure to bloodborne pathogens. The PEPline operates 24 hours a day, 7 days a week. PEPline clinicians will assist callers in assessing of risk of the exposure, discuss the most recent New York State post-exposure prophylaxis guidelines, and review specific treatment and follow-up options.
PEPline: 1-888-448-4911
Hours: 24 hours/7 days a week
For more information about the National Clinicians’ Post-Exposure Prophylaxis Hotline, please visit the National HIV/AIDS Clinicians’ Consultation Center website at: http://www.nccc.ucsf.edu/about_nccc/pepline/
To order copies of this poster, please email Terri Wilder at: twilder@chpnet.org
Health Advisory: Expanded Outbreak Response Meningococcal Vaccine Recommendations for MSM
Posted September 2012; updated March 2013
March 21, 2013: NYS 2013 Health Advisory Update #1: Expanded Outbreak Response Meningococcal Vaccine Recommendations For Men Who Have Sex With Men (PDF)
Invasive Meningococcal Disease Cases Among Men Who Have Sex with Men
The New York State Department of Health is currently investigating a cluster of invasive meningococcal disease, commonly known as meningitis, among men who have sex with men. Invasive meningococcal disease is a severe bacterial infection that has a high fatality rate. New cases of invasive meningococcal infections among men who have sex with men continue to be reported.
The following groups are at highest risk for invasive meningococcal infections and should receive meningococcal vaccination:
- All HIV-infected men who have sex with men
- Men who have sex with men, regardless of HIV status, who regularly have close or intimate sexual contact with men met through an online website, digital application (“app”), or at a bar or party
NYS is extending this vaccination recommendation to persons residing in the rest of the state who traveled to NYC and engaged in the risk behaviors described above since September 1, 2012 and to anyone who wants to reduce their risk. (Previously, vaccination was recommended only for those with contact in certain high risk areas in New York City.)
New York City Department of Health and Mental Hygiene Health Alerts:
March 6, 2013: NYC 2013 Health Alert #5: UPDATE: Invasive Meningococcal Disease In Men Who Have Sex With Men, Expanded Vaccine Recommendations (PDF)
November 29, 2012: NYC 2012 Health Alert #36: UPDATE: Invasive Meningococcal Disease In Men Who Have Sex With Men (PDF)
October 22, 2012: NYC 2012 Health Alert #30: UPDATE: Invasive Meningococcal Disease In Men Who Have Sex With Men (PDF)
October 4, 2012: NYS 2012 Health Advisory/NYC 2012 Health Alert #28 UPDATE: Meningococcal Vaccine Recommendations For HIV-infected Men Who Have Sex With Men (PDF)
September 27, 2012: NYC 2012 Health Alert #27: Invasive Meningococcal Disease In Men Who Have Sex With Men (PDF)
More Information:
Health Department Clinic Locations
If you think you might be at risk, please read the patient fact sheet (PDF)
See the related Frequently Asked Questions on Invasive Meningococcal Disease (PDF)
Meningitis Information for Health Care Providers
March 22, 2013: Centers for Disease Control and Prevention. Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep 2013;62(RR-2):1-22.
January 4, 2013: Notes from the Field: Serogroup C Invasive Meningococcal Disease Among Men Who Have Sex With Men — New York City, 2010–2012, Morb Mortal Wkly Rep 2013;61(51);1048.
Health Advisory: Cephalosporin-Resistant Gonococcal Infections
Posted February 2012; updated March 2013
Recent alerts and updates have been published to increase awareness and prevent the emergence of cephalosporin-resistant gonococcal infections. These include an updated recommendation from the NYSDOH and Centers of Disease Control and Prevention (CDC) to treat uncomplicated gonorrhea with ceftriaxone 250 mg IM plus either a single 1-g dose of azithromycin or doxycycline 100 mg orally twice daily for 7 days. Exclusively oral regimens should not be used as first-line treatments for gonorrhea. However, if oral regimens are the only option, then a test of cure should be performed 1 week after treatment.
- For more information from the NYSDOH, refer to: NYS 2012 Health Advisory: Oral Cephalosporins No Longer Recommended For Treatment Of Gonococcal Infections In The United States (September 4, 2012)
- For the CDC’s update to the Sexually Transmitted Diseases Treatment Guidelines, 2010, refer to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm
Other published alerts include:
- March 19, 2013: NYC 2013 Health Alert #6: Gonorrhea With Reduced Susceptibility To Cephalosporins Isolated From New York City Residents
- February 13, 2012: NYC 2012 Health Alert #1: Neisseria Gonorrhoeae Isolates With Reduced Susceptibility To Cephalosporins
- CDC Grand Rounds: The Growing Threat of Multidrug-Resistant Gonorrhea. MMWR Wkly 2013;62(06):103-106. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6206a3.htm
- Centers for Disease Control and Prevention. Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates—United States, 2000–2010. MMWR Morbid Mortal Wkly Rep 2011;60:873-877. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6026a2.htm
- Bolan GA, Sparling PF, Wasserheit JN. The emerging threat of untreatable gonococcal infection. N Engl J Med 2012;366:485-487. [PubMed]
Media reports have highlighted a study that linked azithromycin with sudden death. However, the CDC is emphasizing that a 5-day regimen of azithromycin was studied, not a single-dose regimen, as is recommended for treatment of chlamydia or dual therapy for gonorrhea. Azithromycin regimens for treatment of chlamydia and gonorrhea should not be modified. See CDC Azithromycin Alert.
Updated Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents Released
Posted May 2013
The National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA) announce the release of the updated Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents.
Selected key updates to the guidelines include the following:
- New information on the diagnosis and management of immune reconstitution inflammatory syndrome (IRIS), particularly as it relates to tuberculosis and cryptococcosis.
- New guidance for managing IRIS related to each opportunistic infection (OI) is provided.
- Updated information on the management of hepatitis B and hepatitis C.
- Immunization strategies for preventing pneumococcal disease and human papillomavirus (HPV) have been updated to reflect the availability of new vaccines and new data.
- Drug interaction information has been updated, particularly as it relates to antiretroviral medications that have been approved since the last update of the guidelines in 2009.
In addition to information on the clinical manifestations, diagnosis, and prevention and treatment of each OI, the guidelines include tables at the end of each chapter and summary tables at the end of the document that list therapeutic options for preventing and treating OIs, adverse drug reactions, pharmacokinetic interactions, dosing recommendations in patients with renal insufficiencies, and therapeutic considerations in pregnancy.
To view or download the guidelines, go to the Adult and Adolescent OI Prevention and Treatment Guidelines section of AIDSinfo. Separate PDF files of the tables can also be downloaded from the page.
OMD Screenshot: May 8, 2013
Posted May 2013
Here is important information from the Office of the Medical Director (OMD) AIDS Institute:
- 2011 New York State eHIVQUAL Report Available – We are pleased to announce the release of the 2011 New York State eHIVQUAL report, available here.
- 2013 STD Clinical Update for New York Primary Care Providers – This one-day conference will be held in New York City on Wednesday, May 15th, and is aimed at improving provider knowledge about STD trends, screening recommendations, treatment guidelines, and prevention strategies. Please register here.
- Updated eHIVQUAL Indicator Comparison Document – This document, available here, summarizes the differences and/or similarities between eHIVQUAL performance measures and those developed by other agencies.
- March 14 NYS HIV Quality of Care Advisory Committee Summary – The OMD is pleased to share with you a summary of the meeting, available here.
Dear Colleague Letter for HIV Quality of Care Program Annual Data Report Based on 2011 Performance Data
Posted May 2013
New York State HIV Quality of Care Program Annual Data Report Based on 2011 Performance Data (PDF 2.52 MB)
New Phone App to Facilitate HIV Screening, Counseling, and Linkage to Care
Posted April 2013
NEW YORK, April 18, 2013 /PRNewswire-iReach/ — The Johns Hopkins University School of Medicine, in collaboration with the Institute for Johns Hopkins Nursing, the American Academy of HIV Medicine (AAHIVM), and DKBmed, LLC, has announced the creation of an application (app) that brings essential features of the SCALE HIV™ program to iPhone, iPad, and iPod Touch devices. The app can be found at www.dkbmed.com/scale. The goal of the app is to enhance the ability of healthcare professionals to screen their patients for HIV infection and to link those with positive test results to appropriate counseling and treatment. A key component of the app is direct access to the AAHIVM ReferralLink database.
(Photo: http://photos.prnewswire.com/prnh/20130418/CG97551)
The new SCALE HIV app provides key information, including current CDC recommendations, guidance for counseling HIV-positive patients/partner notification, and how to access expert care. In addition to providing information on screening patients and counseling, the app also includes access to the AAHIVM ReferalLink Database, an essential tool for all clinicians.
New York State Medicaid Update: April 2013
Posted April 2013
Dear Medicaid Provider,
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the April 2013 Medicaid Update (PDF 1.13 KB).
New York State Medicaid Updates Archives
eHIVQUAL Indicator Comparison
Posted April 2013
HIV/AIDS Clinical Education Initiative: April 2013
Posted April 2013
Provider Guide to HIV Testing
A new online HIV Testing simulation tool is available at: http://ceitraining.org/mobile-tools/simulation.cfm
New CME Courses
The Clinical Education Initiative is pleased to announce the availability of four new CME courses. All courses are free and can be taken online at any time.
- HIV Immune Reconstitution Inflammatory Syndrome (IRIS): pathogenesis and pearls for clinical management *
- HIV-1 Pathogenesis and the GI Tract: The Effects of Colorectal Immune Deficiency & Reconstitution *
- Preventing and Managing Kidney Disease in HIV-Infected Patients *
- What Do We Really Know About Cardiovascular Disease in the HIV-infected Population? *
* PRN (Physicians’ Research Network) Course
Please visit http://www.ceitraining.org/cme/ today to sign-up for this training opportunity.
New Learning Modules
The Clinical Education Initiative is pleased to announce the availability of six new learning modules. Learning modules are free and available online at any time:
- Update from the 2013 Conference on Retroviruses and Opportunistic Infections (20th CROI)
- Clinical Manifestations of the Most Common STDs
- Ethical and Policy Implications of HIV Treatment as Prevention
- Government Policy Perspectives
- Research Update on HIV Treatment as Prevention
- Treatment as Prevention for the Uninfected
- Treatment as Prevention with People Living with HIV
Please visit http://www.ceitraining.org/resources/audio-video.cfm to view all of our learning modules.
For more information, please visit http://www.ceitraining.org/index.cfm
NQC 2013 Quality of Care Awards Application Period Open
Posted March 2013
The National Quality Center is pleased to announce that the application period for the NQC 2013 Quality Of Care Awards is here!
For the past five years, it has been our pleasure to recognize the work of colleagues across the Ryan White Program continuum as they pursue excellence in providing care to HIV-infected individuals. Although the Awards only recognize one or two winners in each category, every application we receive shows us how hard all of you work to achieve your missions. NQC is honored to recognize you for your efforts.
This year we are also excited to offer a new Award – the Award for Retention in Care. This Award will recognize an organization that has made strides in retaining clients in care and has produced exceptional work through participating in the in+care Campaign.
NQC encourages you to apply. You can access the online Award Application Package by going to:
http://www.nationalqualitycenter.org/qualityawards
U.S. Preventive Services Task Force (USPSTF) Recommendations on Screening for HIV
Posted April 2013
- April 30, 2013: U.S. Preventive Services Task Force Issues Final Recommendation Statement on Screening for HIV
“The U.S. Preventive Services Task Force (Task Force) released its final recommendation statement on screening for HIV. The Task Force recommends that clinicians screen all people aged 15 to 65, as well as younger adolescents and older adults who are at an increased risk for HIV infection.”
Read the AIDS.gov blog post.
FDA Updates Efavirenz Labeling with Expanded Pediatric Indication Information
Posted May 2013
“On May 2, 2013, the FDA expanded the indication for Sustiva (efavirenz) to include pediatric patients at least three months old and weighing at least 3.5 kg. For pediatric patients who cannot swallow capsules, the capsule contents can be administered with a small amount of food or infant formula using the capsule sprinkle method of administration.
“The updated labeling includes a table for dosing along with the corresponding number of capsules or tablets and strength to administer.”
Other sections of the label that have been updated include the following: Warnings and Precautions, Adverse Reactions, Pediatric Use, Pharmacokinetics, and Clinical Studies.
The updated labeling will be available at the FDA website.
More information is available:
- FDA: Press release
- AIDSinfo: patientEfavirenz (Sustiva) patient drug summary
FDA approves Prezista (darunavir) labeling changes
Posted April 2013
- April 25, 2013: Prezista (Darunavir) Labeling Changes
“On April 24, 2013, FDA approved revisions to the Prezista (darunavir) tablet and oral suspension label to update labeling with 48 week data from study TMC114-C228 for HIV-1 treatment experienced pediatric patients three to less than 6 years of age.”
Read the FDA announcement.
FDA Updates Atripla Labeling
Posted April 2013
“FDA recently approved updates to the Atripla (efavirenz/emtricitabine/tenofovir disoproxil fumarate) tablet label to include the following changes:
- Lists Stribild as one of the drugs that should not be coadministered with Atripla
- Adds drug interaction information for raltegravir, boceprevir and telaprevir
- Strengthens Warnings and Precautions: Rash section
- Updates the Use in Specific Populations: Nursing Mothers section
- Updates Tables 7 and 8 with didanosine drug interaction data based upon recent changes to the prescribing information for Sustiva, Truvada and Viread.”
The updated labeling will be available at the FDA website.
More information is available:
- FDA: Press release
- AIDSinfo: Atripla patient drug summary
Email Announcement Archives
Posted December 2009
The HIV Clinical Guidelines Program provides subscribers with email announcements of when new guidelines are posted and existing guidelines are updated.
hivguidelines email announcement archives
Subscribe to hivguidelines email announcements
Hot Topics Archive
Please visit the Hot Topics Archive page.
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