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In Memoriam: Kathleen Cavolo

Posted October 2014
Kathleen Cavolo

Kathleen Cavolo, deeply respected Project Director of the New York State HIV Clinical Guidelines Program, passed away on September 29, 2014 following a battle with cancer.

We often talk about unsung heroes in the fight against HIV, and among those was Kathleen. For nearly 15 years, Kathleen was the anchor of the New York State HIV Clinical Guidelines Program, where she provided editorial expertise, research, and leadership to oversee the development of a robust package of guidelines and associated activities.

Kathleen had a sparkle—a way of making every activity she was part of seem lighter and manageable. She had an unusual gift for understanding medical information without any medical training and a similar gift for working with a wide array of situations that emerged in our various committees and interactions. She handled situations with ease, a laugh, and a sense that things would get done no matter how complex the process. She mastered guidelines methodology and understood how guidelines play a key role in shaping the way that care is delivered—why they had to be so clear. It is astonishing to think that she wasn’t even 25 when she started this work and seemed to dive right into it with a natural ability.

Her colleagues will keep Kathleen’s laugh in our heads, her smile in our hearts, and her model of professionalism as a way to guide us. Her contribution to the guidelines program has been enormous. As a member of her staff observed:

She was one in a million. A rare combination of beauty, grace, brains, and strength who could not only get along with everyone and keep a sense of humor while doing it, but someone who could break out with a most hardy, happy, and infectious laugh. I just wish I had heard more of it.

Those who worked closely with Kathleen deeply appreciated her skill, her warmth, and her sense of humor. As another colleague put it:

She also knew how to make work fun, and I, personally, was always relieved that I had a very grounded colleague in the room who could spring into action to help resolve a difficult situation to keep us moving forward whether parking a matter or defining a process to tackle a complex problem.

Kathleen leaves behind her husband and three young children, siblings, and her mother and father.

Dr Bruce Agins, Medical Director of the AIDS Institute



A fund has been established for the children’s education expenses. Checks should be made payable: Kathleen Cavolo Giese Memorial Fund

Please write the a/c number on the check’s memo line: A/C # 5329481324

They can be mailed directly to:

PNC Bank
1 East Pratt Street
Suite 100
Baltimore, MD 21202

 

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CEI PEP/PrEP Line: 1-866-637-2342

Posted September 2014

CEI PEP/PrEP Line: 1-866-637-2342

The New York State Department of Health AIDS Institute in collaboration with the CEI program at Mt. Sinai Institute for Advanced Medicine offers this hotline for providers needing consultation with an HIV Specialist regarding the pre-exposure and post-exposure management of HIV. The CEI PEP/PrEP Line operates 24 hours a day, 7 days a week. Clinicians will assist callers in assessing of risk of the exposure, discuss the most recent New York State pre- and post-exposure prophylaxis guidelines, and review specific treatment and follow-up options.

CEI PEP/PrEP Line:    1-866-637-2342
Hours:                            24 hours/7 days a week

For more information about CEI and the other disease specific services of the CEI Line, please visit www.ceitraining.org.

CEI PEP/PrEP Line Poster

To order copies of this poster, please email Terri Wilder at: twilder@chpnet.org

 

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New York City Health Alert: Update on Invasive Meningococcal Disease in Men Who Have Sex With Men

Posted September 2012; updated September 2014

September 5, 2014: NYC 2014 Health Alert #28: Update on Invasive Meningococcal Disease in Men Who Have Sex With Men (PDF 78.1 KB)

Since August 24, 2014, the New York City Department of Health and Mental Hygiene (NYC DOHMH) has identified three cases of invasive meningococcal disease (IMD) requiring hospitalization in intensive care units. A fourth case of IMD was identified in late June 2004. None of the patients has died.

All four cases were HIV-infected men who have sex with men (MSM), and the infections represent an apparent reemergence of IMD from the 2010-2013 outbreak that killed seven people.

As part of the ongoing effort to prevent further emergence of IMD, the New York State Department of Health and NYC DOHMH continue to recommend meningococcal vaccination for the following groups at highest risk for IMD:

  • All HIV-infected MSM who reside in New York City
  • MSM, regardless of HIV status, who reside outside of New York City but have engaged in the following risk behaviors when traveling to New York City: having regular close or intimate sexual contact with men met through an online website, digital application (“app”), or at a bar or party

Although a large number of people have received one dose of meningococcal vaccine, some HIV-infected persons have not received their second dose. HIV-infected patients who have not received their second dose should be contacted to return to the office for completion of vaccination. HIV-infected men who have sex with men should receive two doses of meningococcal conjugate vaccine, administered at least 8 weeks apart and no less than 6 weeks.

Providers should be aware of early clinical and laboratory findings that might indicate meningococcal septicemia, particularly in HIV-infected men MSM. Of the four cases among MSM that occurred in 2014, two of the individuals received two doses of meningococcal vaccine.

Previous IMD-Related Health Advisories and Alerts:

July 18, 2014: NYC 2014 Health Alert #15: Update on Invasive Meningococcal Disease in Men Who Have Sex With Men (PDF 52.5 KB)

August 14, 2013: NYC 2013 Health Alert #31: Update on Invasive Meningococcal Disease in Men Who Have Sex With Men (PDF 82.1 KB)

March 21, 2013: NYS 2013 Health Advisory Update #1: Expanded Outbreak Response Meningococcal Vaccine Recommendations for Men Who Have Sex With Men (PDF 126 KB)

March 6, 2013: NYC 2013 Health Alert #5: UPDATE: Invasive Meningococcal Disease in Men Who Have Sex With Men, Expanded Vaccine Recommendations (PDF 83.9 KB)

November 29, 2012: NYC 2012 Health Alert #36: UPDATE: Invasive Meningococcal Disease in Men Who Have Sex With Men (PDF 162 KB)

October 22, 2012: NYC 2012 Health Alert #30: UPDATE: Invasive Meningococcal Disease in Men Who Have Sex With Men (PDF 75.5 KB)

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 107 KB)

September 27, 2012: NYC 2012 Health Alert #27: Invasive Meningococcal Disease in Men Who Have Sex With Men (PDF 134 KB)

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.

 

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NYS Clinical Education: STD Resources, ACTHIV CME/CNE Courses

Posted October 2014

STD Resources

CEI’s STD Center of Excellence offers a variety of STD resources for clinicians including:

New CME/CNE Courses – 2014 ACTHIV Conference

The Clinical Education Initiative is pleased to announce the availability of six new CME/CNE courses from the 2014 ACTHIV Conference. After viewing a course, follow the link in the course instructions to receive CME/CNE credit.* Courses are free and available online at any time:

* CME/CNE credit is offered through the joint sponsorship/co-providership of the William Beaumont Hospital, American Academy of CME, Inc., and the American Conference for the Treatment of HIV (ACTHIV).

Get Free Online CE

For more information, please visit http://www.ceitraining.org/

 

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Medicaid Update: September

Posted October 2014

Dear Medicaid Provider,

The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the September 2014 Medicaid Update.

Please click the link below to download the current edition.
http://www.health.ny.gov/health_care/medicaid/program/update/2014/sept14_mu.pdf (PDF)

To see a list of all of the 2014 DOH Medicaid Updates, please visit http://www.health.ny.gov/health_care/medicaid/program/update/2014/index.htm/

 

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Multi-Part Blog Series About State Health Department PrEP Education and Access Initiatives

Posted September 2014

As part of the continued focus on “Raising the Bars,” NASTAD is launching a new multi-part blog series about state health department pre-exposure prophylaxis (PrEP) education and access initiatives. This blog series will examine three states’ models for expanding PrEP programming.

  • New York: highlights a six step plan for creating an innovative, yet aggressive harm-reduction plan to end the AIDS epidemic by 2020 focused on utilization of PrEP for non-condom users and promotion of Treatment as Prevention (TasP) for all infected individuals.
  • Massachusetts (October): will share their involvement with local community health centers (CHCs) and advocacy community to move clinical research into authentic program implementation by creating unique education and access programs for each CHC’s diverse populations.
  • Washington (November): will showcase their unique PrEP medication access program modeled after the state’s AIDS Drug Assistance Program (ADAP) using state funds, ensuring communities in need can get the medication for free.

Additional NASTAD Resources:

Please contact Christopher Cannon if you have PrEP questions or want technical assistance.

 

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NYSDOH Dear Colleague Letter: Opioid Overdose

Posted September 2014

Please click here to download and view a Dear Colleague Letter from the AIDS Institute regarding the New York State Opioid Overdose Prevention Program.

 

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Quick News Update from OMD AIDS Institute: September 9

Posted September 2014

OMD SCREENSHOT – September 9, 2014

Here is important information from the Office of the Medical Director (OMD) AIDS Institute:

  • NYC DOHMH Update on Invasive Meningococcal Disease in MSM
  • Multi-Speciality Maintenance of Certification (MOC) Portfolio Approval Program – Enrollment DEADLINE: Physicians engaged in QI through the NYS Quality of Care Program may earn 20 points of MOC Part IV practice credit from their specialty board(s). Eligible physicians seeking Part IV MOC credit in 2014 should contact Joshua Bardfield immediately. The Enrollment deadline has been extended to September 12.
  • Missed Clinic Visits Independently Associated with All-Cause Mortality
    • Mugavero, et al. (2014) “HIV/AIDS: Beyond Core Indicators of Retention in HIV Care: Missed Clinic Visits Are Independently Associated with All-Cause Mortality”. CID. [PubMed]
    • Armstrong and del Rio. (2014) “Falling Through the Cracks and Dying: Missed Clinic Visits and Mortality Among HIV-Infected Patients in Care.” CID. [PubMed]
  • Free HIV,HCV,PEP and PrEP Clinical Consultation – CEI offers free clinical consultations with HIV/HCV specialists on topics such resistance testing, drug interactions and toxicity, and PrEP/PEP. Call 1-866-637-2342.
  • State Health Innovation Plan (SHIP)/State Innovation Models (SIM) Update – For more information on SHIP/SIM grant materials please click here.
  • Ongoing Sofosbuvir Based Hepatitis C Clinical Trials are listed here.
  • June 12 NYS HIV Quality of Care Advisory Committee Summary – The OMD is pleased to share a summary from the June 12th meeting, available here.

 

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2014 New Developments in HIV Clinical Guidelines: What Non-Clinicians Should Know to Improve Patient Care and Coordination

Posted August 2014

2014 New Developments in HIV Clinical Guidelines: What Non-Clinicians Should Know to Improve Patient Care and Coordination

This series of one-hour webinars explores the latest HIV clinical guidelines with an emphasis on the specific knowledge that non-clinical providers should have and the actions they can take to support positive health outcomes for clients. Each monthly webinar features an engaging discussion with a leading physician who served on the NYSDOH AIDS Institute Clinical Guidelines Committee that developed the respective guideline.

September’s Topic: Acute HIV Infection

September 23, 2014
10:00 am – 11:00 am ET
Webinar

Guest Presenter: Samuel T Merrick, MD, Associate Professor of Clinical Medicine, New York Presbyterian Hospital and Weill Cornell Medical Center; Medical Director, Center for Special Studies, Glenn Bernbaum Unit, NY Presbyterian Hospital Weill Cornell Medical Center; Medical Director, David E Rogers Unit, Judith Peabody Wellness Center

Register Here: http://hivtrainingny.org/Account/LogOn?crs=1046

Click here, to download a promotional flyer with details.

You can also access an archived clinical guideline webinar (May 2014) — Pre-Exposure Prophylaxis (PrEP) Guidance — to view at your convenience. Guest Presenter: Demetre C Daskalakis, MD, Medical Director of Ambulatory HIV Services, Mount Sinai Comprehensive Health Program-Downtown.

Register Here: http://hivtrainingny.org/Account/LogOn?crs=1042

For more information, please visit: http://www.hivtrainingny.org/

 

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New York State HIV/AIDS Surveillance Annual Report

Posted August 2014

“The New York State HIV/AIDS Surveillance Annual Report” for Cases Diagnosed Through December 2012 has now been posted to the NYSDOH web site at the link below.

http://www.health.ny.gov/diseases/aids/general/statistics/

 

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Cases on the Web: Drug Interactions with HCV DAAS

Posted August 2014

Drug Interactions With Hepatitis C Virus Direct-Acting Antivirals
John J. Faragon, PharmD, BCPS

The availability of direct-acting antiviral (DAA) drugs simeprevir, a nonstructural protein 4/5A (NS4/5A) hepatitis C virus (HCV) protease inhibitor, and sofosbuvir, a nonstructural protein 5B (NS5B) polymerase inhibitor in the management of HCV infection has led to dramatic increases in sustained virologic response (SVR) among patients receiving treatment with these drugs. Although these new HCV DAAs have improved response rates, their use may result in unexpected drug interactions with primary care medications and many HIV antiretroviral drugs. However, the risk of drug interactions with the new DAAs is likely to be lower than with earlier DAAs boceprevir and telaprevir.

On completion of this activity, the learner will be able to:

  • Describe the effects of HCV DAAs on cytochrome P450 and other systems involved with drug metabolism
  • Using patient cases, delineate strategies for preventing and managing interactions between HCV DAAs, primary care medications, and HIV medications
  • Identify reputable sources of information about drug interactions between HCV DAAs, HIV antiretroviral drugs, and common primary care medications

Visit www.iasusa.org/content/drug-interactions-hepatitis-c-virus-direct-acting-antivirals to start learning from this new COW activity!

 

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hivguidelines and Medscape: HIV/HBV Coinfection: Guideline and Commentary

Updated August 2014

Every few months Medscape features a New York State Department of Health AIDS Institute guideline along with commentary written by clinicians who work with the HIV Clinical Guidelines Program.

The most recent featured guideline is Hepatitis B Virus with commentary written by Dr Steven M Fine.

To view the commentary and guideline on Medscape, please click on the following link: http://www.medscape.com/viewarticle/830053

To see the full series of hivguidelines that have posted on Medscape so far, please visit the Medscape website at: http://www.medscape.com/index/section_10155_0

hivguidelines and Medscape Archives

 

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Dear Colleague Letter: Role of pre-exposure prophylaxis (PrEP) to prevent new HIV cases

Posted July 2014

Dear Colleague Letter Outlines Role of PrEP for HIV-Negative Individuals to Prevent New HIV Cases

Attached please find a Letter from Dan O’Connell, Director, AIDS Institute, that describes the role that pre-exposure prophylaxis for HIV (or PrEP) plays in the Governor’s three point plan to “bend the curve” on the AIDS epidemic. The letter outlines actions that can be taken by clinical and non-clinical providers to expand access to this important HIV prevention intervention.

Please feel free to share this letter with others in your organization and community.

 

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Governor Cuomo Announces Plan to End the AIDS Epidemic in New York State

Posted June 2014; updated July 2014

Three-pronged Plan Focuses on Improved HIV Testing, Preventing the Spread of the Disease, and Better Treatment for People Who Have It

Governor Andrew M. Cuomo announced a three-point plan to “bend the curve” and decrease new HIV infections to the point where the number of people living with HIV in New York State is reduced for the first time. The end of the AIDS epidemic in New York will occur when the total number of new HIV infections has fallen below the number of HIV-related deaths.

The “Bending the Curve” three-point program includes:

  1. Identifying persons with HIV who remain undiagnosed and linking them to health care;
  2. Linking and retaining persons diagnosed with HIV to health care and getting them on anti-HIV therapy to maximize HIV virus suppression so they remain healthy and prevent further transmission; and
  3. Providing access to Pre-Exposure Prophylaxis (PrEP) for high-risk persons to keep them HIV negative.

To read the full announcement, please visit https://www.governor.ny.gov/press/06292014-end-aids-epidemic

Please click here to download a letter to Governor Cuomo from Michel Sidibe of UNAIDS expressing his support and interest in Governor Cuomo’s recent plan to end the AIDS epidemic in New York State by 2020.

 

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PrEP/PEP Voluntary Directory

Posted July 2014

PrEP/PEP Voluntary Directory

To increase access to PrEP and PEP, the AIDS Institute is compiling a list of providers who prescribe PrEP/PEP for a voluntary directory. Please click here to access eight short questions to register as a provider.

 

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CDC Recommendations: Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations

Posted June 2014

The CDC has released updated HIV testing recommendations. For resources for all FDA-approved diagnostic HIV tests for use in moderate and high complexity laboratories, please visit: http://www.cdc.gov/hiv/testing/lab/guidelines/index.html

 

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CDC Guidelines: PrEP Guidelines for the Prevention of HIV Infection

Posted May 2014

On Wednesday May 14, 2014, the Centers of Disease Control and Prevention (CDC) released guidelines to help providers identify potential candidates for the use of daily pre-exposure prophylaxis (PrEP) for the prevention of HIV infection. In January 2014, the New York State Department of Health AIDS Institute also released its own guidance document on PrEP.

For the CDC PrEP documents, see:

For the New York State Department of Health AIDS Institute PrEP guidance document, see Guidance for the Use of Pre-Exposure Prophylaxis (PrEP) to Prevent HIV Transmission.

 

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NYC Health: New Ways to Prevent HIV - PrEP and PEP

Posted June 2014

More than 3,000 New Yorkers are diagnosed with HIV each year. Fortunately, there are new options to prevent HIV infection: Pre- and post-exposure prophylaxis (PrEP and PEP).

PrEP is a pill taken daily to prevent HIV infection when used in combination with other risk reduction strategies. PEP is a combination of pills taken daily for 28 days to prevent HIV infection after a high-risk exposure to HIV. Both employ antiretroviral medications that are also used to treat HIV.

The New York City Health Department has developed public health education materials to promote awareness and use of PrEP and PEP among at-risk New Yorkers. “PrEP and PEP: New Ways to Prevent HIV” includes a pamphlet, postcards, posters and provider and consumer web tools. Your organization can order free pamphlets, postcards and posters by calling 311.

Please share and discuss these materials with clients who:

  • Receive a negative HIV test result
  • Report sexual or drug use behaviors that place them at high risk for HIV
  • Are seeking care for a sexually transmitted infection (STI) or report a recent STI
  • Express concern about HIV
  • Have a partner living with HIV

Please also encourage clients living with HIV to share materials with their HIV-negative partners.

As interest in PrEP and PEP grows, community organizations that serve people at risk of HIV throughout New York City should be ready to partner with clinical sites that accept referrals for PrEP and PEP. Clinicians should also become comfortable prescribing PrEP and PEP to appropriate patients or be ready to refer them to experienced clinics. Clinicians can refer to recent clinical guidelines on the use of these strategies:

The New York State Clinical Education Initiative’s Line is available for consultation about PrEP and PEP (as well as HIV and STI care).

New York State CEI Line
1-866-637-2342 (24 hours/7 days per week)

For more information about PrEP and PEP in New York City, or to learn about becoming part of the New York City referral network, please contact the Health Department at PrEPandPEP@health.nyc.gov

We look forward to partnering with you to implement these new strategies for HIV prevention.

 

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What Support Services Providers Should Know About PrEP

Posted May 2014

From the New York State Department of Health AIDS Institute’s Improving Health Outcomes Series:

What Support Services Providers Should Know About PrEP (PDF 142 KB)


 

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amfAR Fact Sheet: WHO Guidelines for the Screening, Care, and Treatment of Persons with Hepatitis C Infection

Posted July 2014

An estimated 150–180 million people are infected with hepatitis C globally; however, available hepatitis C treatments are complex and/or expensive, and many governments currently do not cover the costs of treatment. In April 2014, the World Health Organization published its first guidelines on screening, care, and treatment of hepatitis C infection to help government officials and healthcare providers in resource-limited settings establish effective programs to care for individuals infected with the virus.

The following fact sheet briefly summarizes the guidelines’ major recommendations, including who should be offered screenings for hepatitis C infection, how to monitor and reduce liver damage in those who test positive, and how to treat patients co-infected with HIV.

Please click here to download the fact sheet.

 

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SAMHSA Update: 2 Publications To Help Clinicians Address Viral Hepatitis

Posted June 2014

Addressing Viral Hepatitis in People With Substance Use Disorders

Get an overview of viral hepatitis and information on screening, evaluation, treatment, side effects management, and potential interactions among medications used to treat chronic hepatitis, as well as medications used in the treatment of behavioral health disorders.

Get KAP Keys for Clinicians

Are You a Clinical Administrator?

Get succinct, easily accessible information that behavioral health clinicians can refer to when working with clients who have or may have hepatitis. The guide includes information on hepatitis prevention, screening, treatment, and coordination of client care. It also includes guidance for administrators on how to add or improve hepatitis services.

Get the Quick Guide for Clinicians and Administrators

 

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AIDS Institute Update: Two New Hepatitis C Educational Materials

Posted May 2014

In celebration of May Hepatitis Awareness Month and May 19 Hepatitis Testing Day, the AIDS Institute Viral Hepatitis Section is pleased to announce the availability of two new HCV education materials.

Hepatitis C Testing Card – This double sided card is aimed at increasing hepatitis C screening among persons at-risk for hepatitis C, including those born between 1945 and 1965. The card outlines who should be screened for hepatitis C and includes information on the hepatitis C screening methods and test result interpretations.

Hepatitis C Counseling Message Pads – This new counseling message material is designed for persons performing HCV screening and counseling and to ensure appropriate counseling messages are delivered based on the screening test result. This material was developed in collaboration with the New York City Department of Health and Mental Hygiene.

Both materials are available to be ordered in English and Spanish. All materials are available free-of-charge through the NYSDOH Distribution Center.

Click here to download a special order form.

 

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NYSDOH Update: Amended Health Law Related to HIV Testing

Updated May 2014

Amended Health Law related to HIV Testing – Please click here to download a letter from Dr. Nirav Shah, former NYS Commissioner of Health, describing changes to Public Health Law Section 2781 enacted to further increase HIV testing in the State and promote linkage and retention in care for HIV-positive persons.

For further information and guidance on HIV testing in New York State, including testing women in prenatal care, please see the New York State Department of Health website at: http://www.health.ny.gov/diseases/aids/providers/testing/index.htm

 

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NQC e-Newsletter: September

Posted September 2014

NQC e-Newsletter | Next TOT – November 11-13

We are pleased to announce a new training opportunity for Ryan White grantees; the Training-of-Trainers (TOT) session on November 11-13, 2014. This will be the 17th TOT session that NQC has provided and it is gratifying to know that over 500 individuals representing more than 44% of all currently funded Ryan White grantees have already attended this training. The interest in this training is as strong today as when we launched the first one in 2007. NQC encourages all individuals who seek to build their training skills to apply to this session and join us in Las Vegas, NV.

We are on the verge of launching an exciting new application for you to share your improvement stories. You can read more about it in the in+care Campaign update in this issue.

September NQC e-Newsletter

For more information, please visit http://www.nationalqualitycenter.org/

 

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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

 

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Hot Topics Archive

Please visit the Hot Topics Archive page.

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