New PrEP & PEP Detailing Kit to Reach 600 Practices Citywide

Health Department Issues Health Alert to Providers Showing Benefits and Guidelines of PEP

The Health Department today launched a new outreach campaign, PrEP & PEP: New Ways to Prevent HIV, at The Oval Center at Montefiore Medical Center to provide primary care and infectious disease practices with resources to support pre-exposure and post-exposure prophylaxis (PrEP and PEP). Each year, approximately 3,000 New Yorkers are newly diagnosed with HIV. PrEP and PEP are highly effective in preventing HIV when taken as directed. PrEP is a pill taken daily to prevent HIV infection when used in combination with other risk reduction strategies, while PEP is a combination of pills taken daily for 28 days to prevent HIV infection immediately after a high-risk exposure to HIV.

In spring 2014, the Health Department conducted surveys with more than 500 NYC men who have sex with men (MSM) aged 18-40. Results indicate that awareness of PrEP and PEP among this population is still relatively low. Among MSM respondents with HIV-negative or unknown status, up to 59 percent were unaware of PrEP and up to 51 percent of respondents were unaware of PEP. Less than five percent of respondents reported using PrEP or PEP within the past six months. New Yorkers at an increased risk for HIV infection include MSM, transgender individuals, serodifferent couples (couples where only one partner is HIV-positive), and injection drug users. In NYC, HIV prevalence and incidence is greatest among MSM and transgender women.

“Too many New Yorkers continue to be diagnosed with HIV every year, and too few clinicians are prescribing PrEP and PEP,” said Health Commissioner Dr. Mary Bassett. “With the Health Department’s new detailing campaign and targeted messaging, approximately 600 primary care and infectious disease practices will be armed with these life-saving tools.”

“Increasing prescriptions of PrEP and PEP is a critical step in interrupting the chain of transmission of HIV in NYC,” said Dr. Demetre Daskalakis, Assistant Commissioner for the Health Department’s Bureau of HIV. “We are excited to give our clinical colleagues more tools to prevent their patients from contracting HIV. Educated clinicians lead to educated patients.”

“As the director of the largest multidisciplinary and multispecialty adult HIV/AIDS program in New York State, I am proud to support the Health Department’s new efforts to raise awareness around the benefits of PrEP and PEP – two biomedical interventions that Montefiore supports,” said Dr. Barry S. Zingman, Medical Director of the AIDS Center at Montefiore. “For decades, Montefiore has been a leader in providing comprehensive care to patients and state-of-the-art training to health care providers caring for individuals with, or at risk for, HIV. The Health Department’s new detailing kit is a welcome addition to our arsenal of HIV treatment and prevention tools.”

“I am delighted to see DOHMH showing great leadership in fighting HIV/AIDS in The Bronx,” said Bronx Borough President Ruben Diaz, Jr. “My office has been actively engaging community based and health organizations in our borough to promote HIV testing (including our new initiative, Bronx Realness After Dark – where we have been testing people where they are during the overnight hours). I convened an HIV Roundtable to advise me and my staff last year, and recently released a survey to query medical facilities and CBOs on their knowledge of, and ability to connect clients to, PEP and PrEP and will be sharing the results in late February. We will continue to partner with DOHMH and Bronx providers to combat HIV and reduce HIV transmissions.”

“We have reached a watershed moment in the fight against HIV/AIDS,” said NYC Council Member Corey Johnson, Chair of the Council’s Health Committee and New York State’s only HIV-positive elected official. “We have the opportunity to end this epidemic, but only if we utilize every tool at our disposal, including PrEP and PEP. Make no mistake; these treatments will save lives. Unfortunately, awareness of PrEP and PEP among health care providers and the general public is still far too low.  I thank Dr. Mary Bassett and the Health Department for undertaking this outreach campaign and I look forward to partnering with them to ensure its success.”

Through the Health Department’s new PrEP and PEP awareness campaign, trained Health Department representatives will make visits to present targeted messages to the entire clinical care team using the PrEP and PEP Action Kit for Health Care Providers. Kit resources promote the following evidence-based best practices:

  • Taking a thorough sexual history from all patients as a part of routine medical care
  • Screening sexually active patients for STIs based on sexual history and clinical guidelines
  • Discussing PrEP and PEP with HIV-negative patients with ongoing risk of exposure and with HIV-positive patients who may have HIV-negative partners
  • Prescribing PrEP and PEP according to clinical guidelines, or referring patients to clinical sites that provide PrEP and PEP

The following patient and provider resources are included in each action kit:

  • PEP FAQs
  • PrEP FAQs
  • PEP Triage Protocol Card
  • List of PrEP/PEP Trainings
  • PrEP-Related Billing Codes
  • Taking a Sexual History Card
  • STI Screening Guidelines Card
  • STD Treatment Guidelines Card
  • PrEP Medication Assistance Application
  • English and Spanish PrEP/PEP booklets for patients
  • English/Spanish PrEP Poster for patient waiting rooms
  • 2012 HIV Annual Surveillance Report for New York City
  • Preventing Sexually Transmitted Infections City Health Information
  • Easel and Waiting Room Self-Assessment PrEP Tear Off Pad for patients

During follow-up visits, representatives from the Health Department will provide each practice with a newly developed City Health Information bulletin, Providing Comprehensive Health Care to Men Who Have Sex With Men (MSM), that encourages healthcare providers to address the specific health needs of their male patients who have sex with men and create a welcoming environment for those patients by:

  • Taking a sexual history as a routine part of primary care and remembering that MSM may not identify as gay
  • Displaying posters and/or pamphlets with gay-friendly or gay-positive messages
  • Ensuring that patient intake forms use inclusive language
  • Providing patients with a list of community resources
  • Posting nondiscrimination statements inclusive of sexual orientation
  • Subscribing to gay-oriented news or entertainment magazines
  • Acknowledging relevant observances, such as World AIDS Day or LGBT Pride

In conjunction with the campaign launch, the Health Department today released a health alert notification(HAN) to medical providers across the city to increase awareness on the benefits and guidelines to prescribing PEP. The HAN shares data that show more New Yorkers are seeking care after possible exposure to HIV, with the proportion of visits to NYC hospital emergency departments related to HIV exposure increasing three-fold in the past decade. Awareness of PEP remains relatively low, even among groups with high incidence of HIV, such as gay men and other MSM. In issuing the HAN, the Health Department requests that providers know the basics of PEP, prescribe it in a timely manner, and inform their patients about this emergency HIV prevention method.

Several clinics across the city have experience providing PrEP and PEP, and some offer free three-day PEP starter packs. View the full list of the Health Department’s partners and their services.

About The Oval Center at Montefiore: Opened in 2014, The Oval Center is a new care, teaching and research site of the Montefiore/Einstein AIDS Center and Division of Infectious Diseases. Located near the main hospital on Montefiore’s Moses campus at 3230 Bainbridge Ave., The Oval Center offers:

  • STI screening and treatment by expert staff
  • The latest HIV biomedical prevention interventions, including PrEP to high risk individuals and PEP after sexual encounters
  • Rapid HIV testing and vaccinations against Hepatitis, HPV and other infections
  • Other aspects of sexual healthcare to LGBTQ individuals
  • Hepatitis C screening and treatment using the newest treatments
  • Training for healthcare workers in these areas

The Oval Center is open Monday-Friday (except holidays) for scheduled and walk-in appointments.  The Center can accommodate walk-ins until 4:30 PM Mon-Thurs, until 11:30AM on Fridays. Most insurance plans are accepted. Sliding scale fee and help obtaining insurance is available for individuals in need. To schedule an appointment or learn more, please call (718) 882-5482.