Headlines:Clinical Education Initiative

Steps to Further Reduce Mother to Child HIV Transmission

The Bureau of HIV Ambulatory Care Services released a health alert
yesterday related to prevention of mother-to-child HIV transmission (MTCT).
The purpose of the alert, entitled "Health Alert: Steps to Further Reduce
Mother-to-Child HIV Transmission", is to highlight important strategies to
continue reducing MTCT with the goal of eliminating perinatal HIV
transmission. The four strategies highlighted in the Alert are: identifying
acute HIV infection during pregnancy, HIV testing in the third trimester
(routinely recommending a second test later in pregnancy), point-of-care
rapid testing in delivery settings and assuring access to care and
supportive services.

The alert has been posted on the Department's HIV/AIDS website as well as
on the HPN, HIN and HAN. Copies are being mailed in the next week to
approximately 14,000 targeted providers (OB/GYNs, pediatricians, family
practice physicians, midwives, staff at birth facilities, Designated AIDS
Centers, etc).

Please share the alert with individuals/agencies that serve women and their
families. If you have questions about the alert or distribution, please
call the Bureau of HIV Ambulatory care at 518.486.6048.

The link to the alert is:
http://nyhealth.gov/diseases/aids/testing/healthalert.htm

2. HIV Testing in the Third Trimester

In concert with the Centers for Disease Control and Prevention (CDC), the
Department recommends that prenatal providers routinely recommend repeat
HIV testing, preferably at 34-36 weeks, for all women who test negative
early in prenatal care (See MMWR 2006; 55[RR-14]: 1-17.) The second test
ideally should be at least three months after the initial test. Repeat
testing will identify women who become infected with HIV during pregnancy,
a group which accounts for an increasing proportion of MTCT. The Informed
Consent to Perform HIV Testing form allows pregnant women to have repeat
HIV testing during pregnancy without signing another consent form. (Consent
Forms DOH-2556 and 2556i)

A Leadership Forum on HIV and Tobacco

The New York State Department of Health Presents:
Light Up Your Life
A Leadership Forum on HIV and Tobacco
Tuesday May 22, 2007
8:30am - 4:30pm
Conference Center at Driver's Village
5885 East Circle Drive, Second Floor
Cicero, NY 13039

Morning Plenary Session Topics include Overview of Tobacco Use and Health, HIV and Tobacco: Time for Action, What We Know About HIV+ Smokers and Implications for Treatment and a Video: Fumigation - Tobacco and the HIV Consumer.
Lunch is provided.
Afternoon Concurrent Session Topics include How TO Design a Smoking Cessation Program for HIV+ Clients, How to Promote a Smoke-Free Workplace among HIV Provders, and Creating an Assessment and Motivating HIV+ Smokers to Quit.
Pre-registration is required and must be received by May 8, 2007.
To register send e-mail with date of event, your name, agency name, agency address and the 2 workshops of choice to :clinicaleducation@health.state.ny.us or call Anna Harris at 315.477.8166

For more information regarding the workshops please download the program brochure by visiting www.upstate.edu/cei/conf.shtml

Occupational & Non-Occupational PEP

Occupational & Non-Occupational Post Exposure Prophylaxis for HIV, HBV, and HCV
National Satellite Videoconference

Wednesday, April 11, 2007
12:30-2:30 p.m. EST
SUNY Upstate Medical University
Weiskotten Hall, Alumni Auditorium
766 Irving Ave
Syracuse, NY 13210

Agenda
• Noon - Registration
• 12:30 pm - Welcoming Remarks
Douglas Fish, MD & Lester Wright, MD, MPH
• 12:35 pm - Occupational Post Exposure Prophlaxis
Todd Ellerin, MD
• 1:10 pm - Live Q & A call in session with speakers
1:20 pm - Break
• 1:30 pm - Non-Occupational Post Exposure Prophylaxis
Harish Moorjani, MD
• 2:05 pm - Live Q & A call in session with speakers
• 2:15 pm - Discussion of case by panel
• 2:30 pm - Adjourn

Who Should Attend?
Physicians, physician assistants, nurse practitioners, nurses, dentists, dental hygienists, and other interested providers.

Videoconference Viewing Sites
All sites will broadcast the program on the same date and time. To arrange a downlink site in your area, please use the menu above. If you have any questions, contact Jim Ybarra at (518) 262-4674 or ybarraj@mail.amc.edu.

CME Accreditation

Albany Medical College is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Albany Medical College designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nursing Accreditation

The Albany Medical Center Hospital is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center ’s Commission on Accreditation.

This learning activity will be awarded a maximum of 2.0 nursing contact hours.

For more information please visit www.upstate.edu/cei/savethedate.shtml or contact Melissa at (315) 464-7313 or napierkm@upstate.edu

NYS DOH Update of the Key to Methamphetamine-Related Literature

January 9, 2007

The New York State Department of Health has posted an updated release of A
Key to Methamphetamine-Related Literature on its web site at the following
address:

http://www.nyhealth.gov/diseases/aids/harm_reduction/crystalmeth/docs/meth_literature_index.pdf

This resource, now in Version 1.0.1 (January 2007), is a comprehensive
thematic index of research articles which pertain to methamphetamine. The
cited articles are drawn principally from peer-reviewed journals.

The citations in "A Key to Methamphetamine-Related Literature" are organized
under approximately 500 subject headings, known in the document as Indexed
Terms. To facilitate navigation, most of the Indexed Terms are further
organized under two distinct sets of Grouped Themes, one for human and the
other for non-human studies. The Grouped Themes are as follows:

Human Studies
Behavioral Correlates
Biological Influences
Brain
Community
HIV
Legal Issues
Medical Issues
Neurological, Cognitive and Psychological Issues
Neurotransmitters and Their Metabolism
Other Substances
Populations
Populations--Geography-Based (United States)
Populations--Geography-Based (Outside of United States)
Treatment
Usage

Non-Human Studies
Behavioral and Cognitive Responses
Biological Influences
Brain
Dependency
Dosing and Routes of Administration
External Influences
Human Diseases (animal models)
Metabolic, Hormonal and Immune Functions
Neurotransmitters and Their Metabolism
Organ Systems and Structures
Other Substances
Physiological Responses
Treatment

The Grouped Themes and the more detailed Indexed Terms are conveniently
accessible via PDF bookmarks. There are also extensive hyperlinked
cross-references throughout the document to aid the reader.

For all cited articles which are part of the National Library of Medicine’s
PubMed database, the citations are hyperlinked to the corresponding PubMed
web page on which the abstract appears. It is frequently possible to link
from the PubMed page to the full text of an article if the user has online
access rights to the journal (generally through an institutional
subscription) or if the journal’s contents are not restricted to
subscribers.

This version of A Key to Methamphetamine-Related Literature is substanially
more detailed and more comprehensive than its predecessors. Neuroscience,
behavioral science, medicine, treatment, pharmacological interventions and
sociology are among the areas in which these enhancements are most
apparent.

Because of the length of this document, users are encourged to download it
from the Department’s web site and to store it on their computers, rather
than repeatedly accessing the large file

Please share this information with others who might benefit from a
convenient bridge to methamphetamine-related research.

Thank You.

Revised CDC Recommendations for HIV Testing

A new HIV/AIDS recommendation was published in the most recent issue of the Morbidity and Mortality Weekly Report (MMWR) Reports and Recommendations series, September 22, 2006.

Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings, can be viewed on-line or downloaded at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm.

This report is also available in the Adobe Acrobat PDF file format at http://www.cdc.gov/mmwr/PDF/rr/rr5514.pdf. The PDF file is a true representation of the hard copy MMWR. The Adobe Acrobat format requires the free Adobe Acrobat Reader.

Visit the CDC HIV/AIDS Web site at http://www.cdc.gov/hiv.

2005 Guidance for HIV Counseling & Testing

In an April 2005 letter the New York State Department of Health announced the 2005 Guidance for HIV Counseling and Testing and New Laboratory Reporting Requirements. This guidance addresses changes made to reduce barriers to HIV counseling and testing and entry into care, as well as provide important information to better monitor the effectiveness of HIV treatment and the development of HIV antiviral resistance in persons with HIV.

To access the information please visit the New York State Department of Health website at:

http://www.health.state.ny.us/diseases/aids/regulations/2005_guidance/index.htm

Updates from NYSDOH AIDS Institute

The Office of the Medical Director, New York State Department of Health AIDS Institute is pleased to announce that

February 8, 2007
"Prevention of Secondary Disease: Preventive Medicine"

Dear Colleague,

The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that Prevention of Secondary Disease: Preventive Medicine guidelines are now available on the web. These guidelines include medical screening recommendations to maintain physical and emotional health and to prevent disease progression in HIV-infected individuals. The following sections are currently available on the website:

-Immunizations
-Opportunistic Infections
-Mental Health Care

Forthcoming sections of this chapter will also address prevention of viral hepatitis, cancer, diabetes, dyslipidemia and cardiovascular risk, gynecologic care, and oral health care.

How to access Prevention of Secondary Disease: Preventive Medicine:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for preventing secondary disease can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "New Publications" section on the page. You can also access all HIV clinical guidelines pertaining to Prevention by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/Content.aspx?pageID=260

January 16, 2007
"Suicidality and Violence in Patients with HIV/AIDS"

Dear Colleague,

The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Mental Health Guidelines Committee has updated Suicidality and Violence in Patients With HIV/AIDS, which is now available on the web.

This publication includes the following:

-Expanded discussion regarding the detection of and estimation of risk for suicide and violence
-New algorithm for screening and managing suicidal or violent patients (see Figure 1)
-Comprehensive descriptions of the risk factors associated with suicide and violence (see Tables 1 and 2)
-Expanded discussion of management and referral strategies for suicidal and violent patients

How to access Suicidality and Violence in Patients With HIV/AIDS:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for suicidality and violence in HIV-infected patients can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "New Publications" section on the page. You can also access all HIV clinical guidelines pertaining to Mental Health by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/Content.aspx?PageID=261

October 17, 2006
"Working with the Active User"

Dear Colleague,

The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Substance Use Guidelines Committee has published Working With the Active User, which is now available on the web.

This publication includes the following:

-Treatment models and coordination of multidisciplinary care for HIV-infected patients actively using substances
-Relapse-prevention strategies for patients who are in early recovery from substance use
-Strategies to enhance effective patient-provider communication, including motivational interviewing and brief interventions
-Harm-reduction techniques, including safer injection practices, access to clean needles, safe storage of sharps (see Table 5), and overdose prevention (see Table 7)

How to access Working With the Active User:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for Working With the Active User can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "New Publications" section on the page. You can also access all HIV clinical guidelines pertaining to Substance Use by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/Content.aspx?PageID=262

September 25, 2006
"Adherence to Antiretroviral Therapy Among HIV-Infected Patients with Mental Health Disorders"

Dear Colleague,
The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Mental Health Guidelines Committee has published Adherence to Antiretroviral Therapy Among HIV-Infected Patients With Mental Health Disorders, which is now available on the web.

This publication includes the following:

Encouraging ARV adherence through coordination of care among medical and mental health providers
Discussion of predictors of and barriers to ARV treatment adherence
Strategies to address potential barriers to adherence before initiating HAART (see Table 1)
Information on initiation, measurement, and monitoring of adherence to ARV therapy
Strategies to improve adherence, including interactions between patient and provider, health education, and motivational and cognitive-behavioral techniques
How to access Adherence to Antiretroviral Therapy Among HIV-Infected Patients With Mental Health Disorders:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for adherence in HIV-infected patients with mental health disorders can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "New Publications" section on the page. You can also access all HIV clinical guidelines pertaining to Mental Health by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/Content.aspx?pageID=261

September 7, 2006
"New HIV Clinical Resource Website"

Dear Colleague,
The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce the launch of a new HIV Clinical Resource website.

In addition to a fresh new look, the site has been redesigned to be more user-friendly and easier to navigate. New drop-down menus will allow users to quickly view the contents of the entire site and locate pertinent information. The new site also features clinical guidelines available in several file formats, including HTML, PDF, and PDA for use with handheld devices.

If you have any feedback that you would like to share with us, please contact the webmaster via the information below or the Contact Us link on the website.

Contact Information:
email: webmaster@hivguidelines.org
voice: 410-502-7911
web: http://www.hivguidelines.org

May 10, 2006
"Personality Disorders in Patients With HIV/AIDS"

Dear Colleague,

The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Mental Health Guidelines Committee has updated "Personality Disorders in Patients With HIV/AIDS," which is now available on the web.

This update includes the following:

A new explanation of categories, or "clusters," of personality disorders (see Table 1)
Comprehensive descriptions of and recommendations for managing patients with specific personality disorders (see Table 4)
Discussion of effective approaches for providers treating patients with personality disorders
Listings of grant-funded HIV/AIDS-related mental health programs (see Appendices A and B)
How to access "Personality Disorders In Patients With HIV/AIDS":
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for personality disorders in HIV-infected patients can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "Recent Publications" section to the right of the page. You can also access all HIV clinical guidelines pertaining to Mental Health by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/public_html/center/clinical-guidelines/mental_health_guidelines/mental_health_intro.htm

March 27, 2006
"Mental Health Screening: Anxiety Disorders In Patients With HIV/AIDS"

Dear Colleague,

The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Mental Health Guidelines Committee has updated "Anxiety Disorders in Patients With HIV/AIDS," which is now available on the web.

This update includes the following:

A revised algorithm for screening patients with anxiety symptoms (see Figure 1)
A revised listing of medications for treating specific anxiety disorders (see Table 3)
Comprehensive descriptions of specific anxiety disorders and their symptoms
How to access "Anxiety Disorders in Patients With HIV/AIDS":
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for anxiety disorders in HIV-infected patients can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "Recent Publications" section to the right of the page. You can also access all HIV clinical guidelines pertaining to Mental Health by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/public_html/center/clinical-guidelines/mental_health_guidelines/mental_health_intro.htm

January 24, 2006
"Mental Health Screening: A Quick Reference Guide for HIV Primary Care Clinicians"

Dear Colleague,

The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Mental Health Guidelines Committee has updated "Mental Health Screening: A Quick Reference Guide for HIV Primary Care Clinicians," which is now available on the web.

This update includes the following:

-a new algorithm for screening and managing suicidal or violent patients
-new questions to identify cognitive impairment
-addition of questions to identify sleep and appetite problems
-addition of questions to determine psychosocial status
-addition of a description of past psychiatric history
a-n updated list of resources for mental health and substance use disorders
How to access "Mental Health Screening: A Quick Reference Guide for HIV Primary Care Clinicians":
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The reference guide for mental health screening in HIV-infected patients can be accessed when you log on to the HIV Clinical Resource home page, www.hivguidelines.org, and visit the "Recent Publications" section to the right of the page. You can also access all HIV clinical guidelines pertaining to Mental Health by clicking on the link below, or by going to the Clinical Guidelines section of the HIV Clinical Resource site.

http://www.hivguidelines.org/public_html/center/clinical-guidelines/mental_health_guidelines/mental_health_intro.htm

January 11, 2006
"Pharmacists: Partners in Health Care for HIV-Infected Patients"

Dear Colleague,

The Office of the Medical Director, New York State Department of
Health AIDS Institute, is pleased to announce that "Pharmacists:
Partners in Health Care for HIV-Infected Patients" is now available on
the web. This chapter was developed by the Pharmacy Advisory
Committee for People With HIV Infection.

This chapter includes the following:

the importance of education for the pharmacist and an extensive
list of resource materials
key points that pharmacists should discuss with patients and
prescribers
types of HIV-specific medication prescribing errors and how to
prevent medication errors
a table of drugs associated with ARV-related side effects and
complications
an algorithm to assist pharmacists in evaluating adherence to ARV
therapy
advantages and disadvantages to specific adherence measures

How to access "Pharmacists: Partners in Health Care for HIV-Infected
Patients":
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The guidelines for pharmacists can be accessed when you log on to the
HIV Clinical Resource home page, www.hivguidelines.org, and visit the
"Recent Publications" section to the right of the page. You can also
access all HIV Clinical Guidelines pertaining to Pharmacy by clicking
on the link below, or by going to the Clinical Guidelines section of
the HIV Clinical Resource site.

http://hivguidelines.org/public_html/center/clinical-guidelines/ph/ph.htm

January 9, 2006

The New York State Department of Health has posted a new version of A Key
to Methamphetamine-Related Literature on its web site at the following
address:
http://www.nyhealth.gov/diseases/aids/harm_reduction/crystalmeth/docs/meth_literature_index.pdf

This comprehensive bibliography of research articles has over 5,000
entries, each of which is hypertext linked to the PubMed abstract. The
citations in A Key to Methamphetamine-Related Literature are organized
under approximately 300 indexed terms. The citations may also be accessed
via broader grouped themes, which include Animal Studies; Behavioral
Correlates; Geography; HIV and STDs; Legal Issues; Medical Issues,
Neurological, Cognitive and Psychological Issues; Populations; and
Treatment. The current version’s improvements include expanded
international coverage and a new section cataloging review articles.