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Research suggests that LGBTQ adults have higher rates of substance use and mental health issues, compared to their heterosexual cisgender peers. These health disparities are often related to minority stress—the chronic psychological and emotional strain that people experience due to being part of a marginalized social group. For example, some LGBTQ folks may use alcohol and drugs to cope with internalized homophobia or to self-medicate for anxiety and depression. On the other hand, some people use drugs in the context of social settings and connecting with others in their community. Since not all substance use is unhealthy, how do providers know how to identify when substance use is problematic? And what can physicians do to best support their patients who may be at greater risk for harm or even overdose?
On this episode, Antonio Urbina, MD, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, speaks with Eric Kutscher, MD, MSc. Dr. Eric Kutscher is an Assistant Professor of Medicine at the Icahn School of Medicine, where he practices as a primary care and addiction medicine physician at Mount Sinai's Internal Medicine Associates and REACH Program. He currently serves as the Medical Director of the Mount Sinai Hospital Opioid Overdose Prevention Program and Primary Care Lead for the Mount Sinai Center for Transgender Medicine and Surgery. His clinical work and research focus on harm reduction techniques for patients with substance use disorders, particularly within the LGBTQ+ community. Drs. Urbina and Kutscher talk about how providers can identify when substance use is a problem and how to help patients manage substance use disorder, including treatment options and harm reduction strategies. Related Content:
2021-2022 Lesbian, Gay, And Bisexual Behavioral HealthA Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, & Transgender (LGBT) IndividualsCEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
For the first time since 2018 and since the COVID-19 pandemic, the Centers for Disease Control and Prevention hostedtheir biennial STI Prevention Conference in-person in Atlanta, GA from September 16 – 19, 2024. This event broughttogether international leading researchers with government experts, clinical sexual healthcare providers, and state andlocal public health administrators for four days of scientific updates and sessions on science, programs, and policiesrelated to STI care.Dr. Marguerite Urban and Dr. Daniela DiMarco from the CEI Sexual Health Center of Excellence attended the conferenceand are back to bring you insights about their experience at the event. They chat about the different sessions theyattended and share personal thoughts and summaries of the cutting-edge research presented at the conference,focusing on syphilis, Doxy-PEP, gonococcal resistance, and the syndemic of substance use and STIs.Were you unable to attend the conference yourself? Were you there and want to hear our CEI experts’ perspectivesabout some of the sessions? Listen now and let us know what you think by leaving a comment! Related Content:
CDC STI Prevention Conference 2024 website: https://stipreventionconference.org/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
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Are current guidelines failing chronic pain patients with a history of substance-use disorders? Find out why Dr. Wang and Dr. Kelly are calling for urgent policy changes and how updated guidelines can support effective pain management.
Join us for a compelling discussion on the intersection of chronic pain and substance use disorders with insights from Dr. Linda Wang, Medical Director of CEI's Hepatitis C and Drug User Health Center, and Dr. Lauren Kelly, a geriatrician and palliative care provider at Mount Sinai. We explore the complex case of a 62-year-old woman who, after decades of sobriety, began experiencing severe, undiagnosed pain. Despite numerous consultations and non-opioid treatments, her pain remained unmanaged, leading her to self-medicate with heroin. We discuss the significant barriers she faced in seeking appropriate care, including the reluctance of prescribers to provide methadone due to her history of opioid use disorder.
Dr. Wang and Dr. Kelly discuss the importance of understanding patients' substance use patterns and the benefits of treatments like methadone and buprenorphine for stability and safety. We also cover non-opioid treatments such as physical therapy, acupuncture, and emerging modalities like scrambler therapy. The conversation emphasizes addressing the psychological aspects of pain and tackling the pervasive issue of stigma that impacts patients' access to necessary treatments. Finally, we delve into the critical issue of prescribing controlled substances to individuals with a history of addiction, shedding light on the gaps in current guidelines and the stigma within the healthcare system. Dr. Wang and Dr. Kelly stress the need for updated guidance to support chronic pain patients with substance use disorder, advocating for compassionate, individualized care. Related Content:
Rules and Regulations on Controlled Substances in NYS
CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
“This podcast discusses the recent presentation of data for lenacapavir, a potent capsid inhibitor for HIV that was 100% effective in preventing HIV infection in cis-gender woman at risk for HIV. If approved, it will offer an exciting new option to prevent HIV which should dramatically improve our chances of reaching the goal of totally eliminating new HIV infections. The trial compared twice yearly injections of lenacapavir to both F/TAF and F/TDF in cis-gender woman and found similar effectiveness for F/TAF compared to F/TDF but there were zero new HIV infections in participants on lenacapavir.”. Related Content:
The New England Journal of Medicine. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women. Authors: Linda-Gail Bekker, M.B., Ch.B, Ph.D. https://orcid.org/0000-0002-0755-4386, Moupali Das, M.D., M.P.H., Quarraisha Abdool Karim, Ph.D. https://orcid.org/0000-0002-0985-477X, Khatija Ahmed, M.B., B.Ch., Joanne Batting, M.B., Ch.B., D.F.S.R.H., D.R.C.O.G., Dip. HIV Man., William Brumskine, M.B., Ch.B., Dip. HIV Man., Katherine Gill, M.B., Ch.B., M.P.H., +33, for the PURPOSE 1 Study Team*Author Info & Affiliations. Published July 24, 2024. DOI: 10.1056/NEJMoa2407001CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
Providers calling into our CEI hotline often ask me what to do when their patient's HIV test results are unclear. These ambiguous or discordant test results can be a source of anxiety and confusion for both patients and healthcare providers alike.
To provide additional insight into this complex issue, Dr. Tony Urbina, Professor of Medicine from Mt. Sinai Health System and Medical Director of the New York State CEI HIV Primary Care and Prevention Center of Excellence, speaks with Dr. Lucia Torian, a distinguished epidemiologist who has dedicated over three decades of her career to the New York City Department of Health. As the Deputy Director of the HIV Epidemiology Program, she brings a wealth of expertise in HIV diagnostic testing and case surveillance.
In our conversation, we dive into real-world scenarios that illustrate the challenges of interpreting HIV test results. We explore real-world cases involving early exposure, false positives, and the added complications of testing migrant populations. The discussion includes practical advice on managing patient anxiety, effective communication strategies, and navigating ambiguous results. Listeners will gain insights into testing acute infections, how to handle PrEP ambiguity, and the role of advanced diagnostic techniques like Western blot tests. Additionally, Dr. Torian shares her thoughts on whether ambiguous results are becoming more prevalent in NYC and provides recommendations for follow-up procedures and timing. Tune in for a comprehensive look at improving HIV testing accuracy and patient care. Related Content:
CDC HIV Nexus -- https://www.cdc.gov/hivnexus/hcp/prep/index.html#:~:text=If%20results%20are%20discordant%20or,until%20HIV%20status%20is%20confirmed. AIDS Institute PrEP guidance including diagnostic testing -- https://www.hivguidelines.org/guideline/hiv-prep/ NY State Wadsworth Center -- https://www.aphl.org/conferences/proceedings/Documents/2018/43_Gaynor_Parker.pdf APHL -- https://www.aphl.org/aboutAPHL/publications/Documents/ID-2019Jan-HIV-Lab-Test-Suggested-Reporting-Language.pdf CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
“Nobody goes into adolescent medicine or into a field of medicine that serves adolescent patients because it’s simple and straightforward, right?”
In May 2024, the New York State Department of Health AIDS Institute Clinical Guidelines Program published an update to the guidelines, “Guidance: Adolescent Consent to HIV and STI Treatment and Prevention.” These guidelines serve to inform New York State clinicians who provide primary care to adolescents about existing regulations that allow minors to consent for and receive confidential HIV and STI screening, treatment, and prevention.
In this episode, Dr. Erica Bostick chats with Dr. Uri Belkind, Associate Medical Director for Adolescent Medicine and Clinical Director of the Health Outreach to Teens (HOTT) program at Callen-Lorde Community Health Center in New York City, and original lead author of these guidelines. Drs. Bostick and Belkind discuss the intricacies of providing confidential HIV and STI care to adolescents, perspectives on how to navigate sexual health conversations with patients and a trusted adult, resources on confidential adolescent healthcare for general providers, and more! Related Content:
Guidance: Adolescent Consent to HIV and STI Treatment and Prevention: https://www.hivguidelines.org/guideline/adolescent-consent/?mycollection=hiv-treatment NYCLU – Teenagers, Health Care, and the Law: https://www.nyclu.org/uploads/2018/10/thl.pdf Guidance for Local Health Departments (LHD) and Health Care Providers on STI Billing and Minor's Consent to Prevention Services and. HIV-related Services: https://www.health.ny.gov/diseases/communicable/std/docs/faq_billing_consent.pdf “Effect of Mandatory Parental Notification on Adolescent Girls' Use of Sexual Health Care Services” - https://jamanetwork.com/journals/jama/fullarticle/195185 CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
Hepatitis C virus (HCV) is a pathogen spread by contact with blood from a person with HCV infection. Prevalence among the US obstetric population rose nearly 10-fold over the past 20 years and approximately 6% of infants born to people with HCV become infected during pregnancy or delivery. The New York State Hepatitis C Elimination Plan outlines over 30 recommendations to eliminate HCV in the state by 2030, including implementation of universal screening for all adults. And in 2023, state legislators approved expanding the existing hepatitis C virus (HCV) testing law to include screening during each pregnancy; changes will go into effect on May 3rd, 2024.
This special edition of “Conversations with CEI” describes best practices for screening and identifying hepatitis C and substance use in pregnant persons and linking people to care and treatment. The conversation identifies key steps clinicians can take to support pregnant persons in their care, including ways to operationalize critical health systems for universal hepatitis C screening among pregnant persons. Related Content:
New York State Hepatitis C Screening during Pregnancy, Digital Provider Toolkit: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdfNew York State Department of Health AIDS Institute guideline for treatment of chronic HCV with direct-acting antivirals, Pregnancy and HCV: https://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4New York State Department of Health AIDS Institute guideline for substance use disorder treatment in pregnant adults: https://www.suguidelinesnys.org/guideline/substance-use-disorder-treatment-in-pregnant-adults/National Harm Reduction Coalition “Pregnancy and Substance Use: A Harm Reduction Toolkit” https://harmreduction.org/issues/pregnancy-and-substance-use-a-harm-reduction-toolkit/Ramsey KS, Cunningham CO, Stancliff S, et al.; Substance Use Guidelines Committee. Substance Use Disorder Treatment in Pregnant Adults [Internet]. Baltimore (MD): Johns Hopkins University; 2021 Jul. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572854/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
Hepatitis C virus (HCV) is a pathogen spread by contact with blood from a person with HCV infection.Prevalence among the US obstetric population rose nearly 10-fold over the past 20 years and approximately6% of infants born to people with HCV become infected during pregnancy or delivery. The New York StateHepatitis C Elimination Plan outlines over 30 recommendations to eliminate HCV in the state by 2030,including implementation of universal screening for all adults. And in 2023, state legislators approvedexpanding the existing hepatitis C virus (HCV) testing law to include screening during each pregnancy;changes will go into effect on May 3rd, 2024.
This special edition of “Conversations with CEI” describes common barriers people who use substances facewhen seeking health care services, particularly HCV screening during pregnancy. The conversation alsoidentifies best practices clinicians can implement in practice to provide responsive care for people who usedrugs, including pregnant persons. Related Content:
New York State Hepatitis C Screening during Pregnancy, Digital Provider Toolkit: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdfNew York State Department of Health AIDS Institute guideline for treatment of chronic HCV with direct-acting antivirals, Pregnancy and HCV: https://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4New York State Department of Health AIDS Institute guideline for substance use disorder treatment in pregnant adults: https://www.hivguidelines.org/substance-use/sud-treatment-pregnancy/National Harm Reduction Coalition “Pregnancy and Substance Use: A Harm Reduction Toolkit” https://harmreduction.org/issues/pregnancy-and-substance-use-a-harm-reduction-toolkit/Ramsey KS, Cunningham CO, Stancliff S, et al.; Substance Use Guidelines Committee. Substance Use Disorder Treatment in Pregnant Adults [Internet]. Baltimore (MD): Johns Hopkins University; 2021 Jul. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572854/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
Hepatitis C virus (HCV) is a pathogen spread by contact with blood from a person with HCV infection. Prevalence among the US obstetric population rose nearly 10-fold over the past 20 years and approximately 6% of infants born to people with HCV become infected during pregnancy or delivery. The New York State Hepatitis C Elimination Plan outlines over 30 recommendations to eliminate HCV in the state by 2030, including implementation of universal screening for all adults. And in 2023, state legislators approved expanding the existing hepatitis C virus (HCV) testing law to include screening during each pregnancy; changes will go into effect on May 3rd, 2024.
This special edition of “Conversations with CEI” will provide important information about pregnancy, HCV and substance use from the perspective of a client with lived experience, with a focus on providing affirming services for all pregnant persons and their infants. Related Content:
New York State Hepatitis C Screening during Pregnancy, Digital Provider Toolkit: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdfNew York State Department of Health AIDS Institute guideline for treatment of chronic HCV with direct-acting antivirals, Pregnancy and HCV: https://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4New York State Department of Health AIDS Institute guideline for substance use disorder treatment in pregnant adults: https://www.hivguidelines.org/substance-use/sud-treatment-pregnancy/American Association for The Study of Liver Diseases (AASLD)/Infectious Diseases Society of America (IDSA) Recommendations for Testing, Managing and Treating Hepatitis C: https://www.hcvguidelines.org/The American College of Obstetricians and Gynecologists Clinical Practice Guidelines for Viral Hepatitis in Pregnancy: https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/09/viral-hepatitis-in-pregnancyUS Centers for Disease Control and Prevention (CDC) Recommendations for Hepatitis C Testing among Perinatally Exposed Infants and Children (2023): https://www.cdc.gov/mmwr/volumes/72/rr/rr7204a1.htm?s_cid=rr7204a1_e&ACSTrackingID=USCDC_921-DM116215&ACSTrackingLabel=MMWR%20Recommendations%20and%20Reports%20%E2%80%93%20Vol.%2072%2C%20November%203%2C%202023&deliveryName=USCDC_921-DM116215Ramsey KS, Cunningham CO, Stancliff S, et al.; Substance Use Guidelines Committee. Substance Use Disorder Treatment in Pregnant Adults [Internet]. Baltimore (MD): Johns Hopkins University; 2021 Jul. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572854/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode, Dr. Steven Fine discusses some of the latest data that might be used to support startingpatients who are unable to take oral antiretroviral medications on long acting, injectable ARV. Patients whoconsider this off label use because their HIV viral load was not suppressed on oral treatment would have to becarefully selected and well supported. Related Content:
Long-acting Injectable Cabotegravir/Rilpivirine Effective in a Small Patient Cohort With Virologic Failure on Oral Antiretroviral Therapy. James B. Brock, Peyton Herrington, Melissa Hickman, and Aubri Hickman. Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center. Jackson, Mississippi, USA. Clinical Infectious Diseases, Volume 78, Issue 1, 15 January 2024, Pages 122–124, https://doi.org/10.1093/cid/ciad511CROI 2024: Abstract number 628 24 Week Viral Suppression in Patients Starting Long-Acting CAB/RPV Without HIV Viral Suppression. Matthew D Hickey, Janet Grochowski, Francis Mayorga-Munoz, Elizabeth Imbert, John D. Szumowski, Jon Oskarsson, Mary Shiels, Samantha Dilworth, Ayesha Appa, Diane V Havlir, Monica Gandhi, Katerina Christopoulos. Division of HIV, Infectious Disease, & Global Medicine, University of California, San Francisco, CA, United States.CROI 2024: ABSTRACT NUMBER 212. SESSION TITLE. Special Session. Clinical Late-Breaking Oral Abstracts. SESSION NUMBER Oral Session-14. Long-Acting Injectable CAB/RPV is Superior to Oral ART in PWH With Adherence Challenges: ACTG A5359. Aadia I. Rana, Yajing Bao, Lu Zheng, Sara Sieczkarski, Jordan E. Lake, Carl J. Fichtenbaum, Tia Morton, Lawrence Fox, Paul Wannamaker, Jose R. Castillo-Mancilla, Kati Vandermeulen, Chanelle Wimbish, Karen T. Tashima, Raphael J. LandovitzCEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
Cultural humility in healthcare, especially for those involved in kink, requires going beyond basic competence. Clinicians must provide respectful care, acknowledging patients' diverse backgrounds and beliefs about kink as part of their identity. This necessitates self-reflection, ongoing learning, and awareness of the doctor-patient power dynamic. Healthcare professionals still hold unfounded biases, highlighting the need for further education and combating the stigma surrounding healthy expressions of sexuality. Related Content:
CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode, Dr. Marguerite Urban and Dr. Daniela DiMarco pick up from the November 2023 episode of Conversations with CEI, where they talked about Doxy-PEP for the prevention of sexually transmitted infections (STIs) covering updates on doxy-PEP since the last episode, and delving deeper into some unique aspects. Drs. Urban and DiMarco are infectious disease faculty members at the University of Rochester, specializing in sexual health care. They were part of the team who authored the recently released New York State (NYS) Department of Health (DOH) AIDS Institute’s guidelines regarding Doxy-PEP. This episode is a “part two” of Doxy-PEP. Drs. Urban and DiMarco review the results of a recently published trial from Kenya, and discuss common questions related to Doxy-PEP. Related Content:
“Doxycycline Prophylaxis to Prevent Sexually Transmitted Infections in Women” - https://www.nejm.org/doi/full/10.1056/NEJMoa2304007?query=featured_homehttps://www.hivguidelines.org/guideline/sti-doxy-pep/?mycollection=sexual-healthhttps://www.cdc.gov/nchhstp/newsroom/2022/Doxy-PEP-clinical-data-presented-at-2022-AIDS-Conference.htmlCEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It is also a movement for social justice build on a belief in, and respect for, the rights of people who use drugs. With its introduction as a U.S. Federal Drug Policy Priority in 2022, harm reduction has been in the news a lot lately.This episode will build on the momentum by discussing action steps that clinicians can take to address stigma and promote compassionate, non-judgmental interactions with people who use drugs. Dr. Linda Wang will use a clinical vignette to describe the impact of stigma on access to and engagement in healthcare services. She will continue by outlining commonly-used stigmatizing language associated with drug use, and providing practical replacements that promote engagement and trust. Related Content:
National Harm Reduction Coalition: https://harmreduction.org/New York State Office for Addiction Services and Supports (OASAS) Harm Reduction: https://oasas.ny.gov/harm-reductionHawk, M., Coulter, R.W.S., Egan, J.E., et al. (2017). Harm reduction principles for healthcare settings. Harm Reduct J. 14(70). doi: https://doi.org/10.1186/s12954-017-0196-4Zwick, J., Appleseth, H., and Arndt, S. (2020). Stigma: How it affects the substance use disorder patient. Subst Abuse Treat Prev Policy. 15(50). doi: https://doi.org/10.1186/s13011-020-00288-0Logan, D.E., and Marlatt, G.A. (2014). Harm reduction therapy: A practice-friendly review of research. J Clin Psychol. 66(2): 201-214. doi: https://doi.org/10.1002%2Fjclp.20669Milaney, K., Haines-Saah, R., Farkas, B., et al. (2022). A scoping review of opioid harm reduction interventions for equity-deserving populations. The Lancet. 12(100271). doi: https://doi.org/10.1016/j.lana.2022.1002712022 National Survey on Drug Use and Health: https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-main-highlights.pdfKelly, F., and Westerhoff, C.M. (2010). Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. Int J Drug Policy. 21(3): 202-207. doi: https://doi.org/10.1016/j.drugpo.2009.10.010CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
RSV vaccine for adults has recently become available and can protect against severe disease or death from one of the main causes of upper respiratory infections. HIV patients are asking if they should receive the vaccine. This question is discussed by Dr. Steven Fine. Related Content:
Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting: DOI: https://doi.org/10.1016/j.jinf.2017.06.007Immunizations for Adults with HIV: https://www.hivguidelines.org/guideline/hiv-immunizations/?mycollection=hiv-care.CDC: Respiratory Syncytial Virus (RSV) Vaccine VIS: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/rsv.html#:~:text=CDC%20recommends%20a%20single%20dose,most%20of%20the%20United%20States.Respiratory Syncytial Virus Infection (RSV) in Older aAdults and Adults with Chronic Medical Conditions: https://www.cdc.gov/rsv/high-risk/older-adults.htmlAdult Immunization Schedule by Age: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.htmlCEI Clinician toll free line for NYS providers: 866- 637-2342https://ceitraining.org/ -
Compared with the general population, transgender and gender diverse people are more likely to experience poor health outcomes, such as chronic health conditions, HIV, substance use, and mental illness. We know these disparities are due structural factors, such as political and economic policies, and interpersonal factors, such as discrimination, stigma, and violence. Transgender people are also more likely to encounter barriers to accessing health insurance and health care. When transgender people do access health care, nearly half report being mistreated by medical providers.
In this episode, Dr. Antonio E. Urbina, Medical Director of CEI’s HIV Primary Care and Prevention Center of Excellence, speaks with Dr. Joshua D. Safer, Executive Director of Mount Sinai’s Center for Transgender Medicine (CTMS) and Professor at the Icahn School of Medicine. While gender wellness clinics like CTMS are so important, there is a need to expand the health care workforce of providers treating transgender patients. For example, transgender patients report barriers to accessing inclusive primary care providers and specialists who can treat them outside of their gender-affirming interventions. Drs. Urbina and Safer unpack common misconceptions and discuss how providers can improve access to inclusive care for transgender and gender diverse patients. Related Content:
Center for Transgender Medicine and Surgery at Mount Sinai: https://www.mountsinai.org/locations/center-transgender-medicine-surgeryWPATH: https://www.wpath.org/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode, Dr. Marguerite Urban and Dr. Daniela DiMarco discuss Doxy-PEP, a new tool for the prevention of bacterial STIs. Drs. Urban and DiMarco are infectious disease faculty members at the University of Rochester, specializing in sexual health care. They were part of the team who authored the recently released New York State (NYS) Department of Health (DOH) AIDS Institute’s guidelines regarding Doxy-PEP.
This episode is an introduction to the use of doxycycline as post exposure prophylaxis for bacterial STIs. The hosts will briefly review results from recent clinical trials as well as discuss concerns about risks and side effects. They will also present how guidelines for implementation (who, when and how) of Doxy-PEP have varied thus far and review the current recommendations of the NYS DOH guidelines. Related Content:
Quick Survey: https://93dsff4pt87.typeform.com/to/ECrf0DTY https://www.hivguidelines.org/guideline/sti-doxy-pep/?mycollection=sexual-healthhttps://www.nejm.org/doi/full/10.1056/NEJMoa2211934https://www.cdc.gov/nchhstp/newsroom/2022/Doxy-PEP-clinical-data-presented-at-2022-AIDS-Conference.htmlNYSDOH STI Surveillance Report, 2021: https://www.health.ny.gov/statistics/diseases/communicable/std/docs/sti_surveillance_report_2021.pdfCDC STI Surveillance Report, 2021: https://www.cdc.gov/std/statistics/2021/default.htmCEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
The United States is in the midst of an overdose crisis that’s been exacerbated by the COVID-19 pandemic and increased toxicity of the drug supply, largely a result of adulterants like fentanyl and other synthetic opioids. In 2021, the number of deaths in New York State alone surged to more than 5,800 individuals – an average of nearly 16 people every day.
Scaling up harm reduction interventions has helped avert thousands of overdose-related deaths, but the persistent predominance of fentanyl continues to fuel mortality. To complement existing interventions, colleagues in Canada and elsewhere around the globe have pointed to providing “safer supply,” or an alternative to the unregulated, toxic drug supply as a potential solution to prevent overdose-related deaths and address the needs of people for whom current treatment models do not work or are not a good fit. Although not intended as a standalone treatment for substance use disorder, this novel approach is showing promise in addressing the growing morbidity and mortality surrounding the current drug supply.
This episode will introduce safer supply as a harm reduction approach to support and engage people who use drugs.
Disclaimer: Safer supply is not legal or authorized in the United States under current FDA and DEA regulations. Related Content:
New York State Office of Addiction Services and Supports Harm Reduction: https://oasas.ny.gov/harm-reductionGovernment of Canada Safer Supply: https://www.canada.ca/en/health-canada/services/opioids/responding-canada-opioid-crisis/safer-supply.htmlBritish Columbia Centre on Substance Use, Provincial Clinical Guidelines for Opioid Use Disorder:https://www.bccsu.ca/opioid-use-disorder/The National Harm Reduction Coalition: https://harmreduction.org/Haines M, O'Byrne P. Safer opioid supply: qualitative program evaluation. Harm Reduct J. 2023 Apr 20;20(1):53. doi: 10.1186/s12954-023-00776-z. PMID: 37081500; PMCID: PMC10117245Tyndall M. A safer drug supply: a pragmatic and ethical response to the overdose crisis. CMAJ. 2020 Aug 24;192(34):E986–7. doi: 10.1503/cmaj.201618. PMCID: PMC7840515McNeil R, Fleming T, Mayer S, Barker A, Mansoor M, Betsos A, Austin T, Parusel S, Ivsins A, & Boyd J. Implementation of safe supply alternatives during intersecting COVID-19 and overdose health emergencies in British Columbia, Canada 2021. Am J Public Health. 2022;112(S151_S158). doi: 10.2105/AJPH.2021.306692Dr. Eric Kutscher Mount Sinai profile: https://profiles.mountsinai.org/eric-kutscherCEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
HIV patients are known to have up to a two-fold increase in heart-related events, compared with the general population. Could treatment with statins reduce this risk?
Dr. Steven Fine, an infectious disease specialist affiliated with the University of Rochester, reviews the recently published results of the REPRIEVE trial. The big picture is a 35% reduction in heart-related events. Dr. Fine digs into the details and statistics of the trial, and the encouraging results of statin treatment, even in those deemed to be at lower risk. Related Content:
The Reprieve Trial The Results in NE Journal of MedicineCEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
The clinical innovation of antiretroviral treatment for HIV is a major public health victory that has transformed the shape of the epidemic. Healthcare professionals must remain committed to reaching every person with HIV, which means not only developing new clinical technologies, but also the strategies to implement them equitably. Long-acting injectable antiretroviral treatment (LAI-ART) is the newest clinical tool for ending the epidemic. How can we make sure that it reaches the people living with HIV who are not virally suppressed? In today’s episode, I speak with Dr. Monica Gandhi about her research increasing access to LAI-ART among vulnerable populations. Related Content:
Dr. Gandhi’s newest publication, “Demonstration Project of Long-Acting Antiretroviral Therapy in a DiversePopulation of People With HIV” https://www.acpjournals.org/doi/10.7326/M23-0788Dr. Gandhi’s faculty profile at UCSF: https://profiles.ucsf.edu/monica.gandhiNYS Injectable ART Guidelines: https://www.hivguidelines.org/antiretroviral-therapy/art-injectable/ CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode, Dr. Marguerite Urban chats with Drs. Rachel Hart-Malloy and Wilson Miranda from the New York State Department of Health AIDS Institute Office of Sexual Health and Epidemiology (OSHE) to discuss how clinicians and the Department of Health can collaborate to tackle the significant increases in cases of syphilis and congenital syphilis reported in New York State. What is the Office of Sexual Health and Epidemiology? Are we bending the curve in reducing syphilis? What are the trends in syphilis rates? What is the Department of Health and the Clinical Education Initiative doing to help reduce and prevent syphilis and congenital syphilis? Listen to this new episode to find out and learn more about what you can do to help! Related Content:
NYSDOH OSHE: https://www.health.ny.gov/diseases/aids/general/about/sexual_health_epi.htmNYSDOH STI Surveillance Report, 2021: https://www.health.ny.gov/statistics/diseases/communicable/std/docs/sti_surveillance_report_2021.pdfCDC STI Surveillance Report, 2021CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ - もっと表示する
