Afleveringen
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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/ -
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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/ -
Hepatitis C virus (HCV) infection is a major public health problem responsible for substantial morbidity, including cirrhosis and liver cancer, and mortality. In 2021, over 6,500 new cases were reported in New York State, many of which occurred in younger people as a result of injection drug use. Although we have highly effective treatments available for HCV, many people face numerous barriers to accessing them. With the ongoing opioid epidemic fueling new cases, innovative ways of reaching people who inject drugs to ensure they have access to treatment are more essential than ever. Furthermore, people who use drugs and substance use disorder treatment programs were identified in the New York State HCV Elimination Plan as priority populations and settings to focus HCV elimination efforts.Opioid Treatment Programs, or OTPs for short, are uniquely poised to engage people who inject drugs and integrate HCV treatment into their services and help expand access to those most in need. This episode, featuring Dr. Sara Lorenz Taki from New York City’s Greenwich House, will discuss evidence for and best practices to integrate hepatitis C treatment into an OTP setting. Related Content:
New York State Hepatitis C Elimination Plan: https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/docs/hepatitis_c_elimination_plan.pdfNew York State Hepatitis C Dashboard: https://hcvdashboardny.org/New York State Hepatitis C Guidelines and Recommendations: https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/providers/index.htmAmerican Association for the Study of Liver Diseases Hepatitis C Guidelines: https://www.hcvguidelines.org/Taylor, LE. (2020), Colocalization in Hepatitis C Virus Infection Care: The Role of Opioid Agonist Therapy Clinics. Clinical Liver Disease, 16:12-15. https://doi.org/10.1002/cld.921Empire Liver Foundation (2020), Building Capacity for Hepatitis C Treatment at Opioid Treatment Programs On-site and via Telemedicine, New York City: https://empireliverfoundation.org/wp-content/uploads/2020/10/Building-Capacity-for-Hepatitis-C-Treatment-at-Opiod-Treatment-Programs-On-site-and-via-Telemedicine-in-New-York_slides.pdfAddiction Technology Transfer Center Guide to Integrating HCV Services into Opioid Treatment Programs: https://attcnetwork.org/sites/default/files/2020-07/Guide%20to%20Integrating%20HCV%20Services%20into%20Opioid%20Treatment%20-%20July%2024-1.pdfGreenwich House: https://www.greenwichhouse.org/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode, Dr. Steven Fine, an infectious disease specialist affiliated with the University ofRochester and Anthony Jordan Health Center explains the pros and cons behind the newlyapproved Lenacapavir (Sunlenca) injectable for HIV.Dr. Fine receives a lot of questions about the medication in his practice. Many patients haveheard good things about the new treatment for HIV that is given as a subcutaneous injectiononce every 6 months. Dr. Fine discusses the current indication in combination with other agentsfor “treatment-experienced” HIV patients and possible future uses. You’ll hear aboutLenacapavir, the data that led to approval, and how it may be used in the future - includingpossibly for Pre-Exposure Prophylaxis (PrEP).
Related Content:
The Capella Trial for Lenocapavir CROI 2023FDA Approves New HIV Drug for Adults with Limited Treatment OptionsCEI toll free line for NYS providers: 866-637-2342Visit us at https://ceitraining.org/ -
One recent study shows that only 4% of trans youth with supportive parents attempted suicide, while 57% with unsupportive parents committed suicide…
In the current political landscape, transgender healthcare and rights have been used to stoke political divisiveness, creating confusion and perpetuating misinformation. As healthcare providers, it is important to focus on the facts and how to provide inclusive care and support the health and well-being of the transgender community, especially during these tumultuous times.
In this episode, 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 Carolyn Wolf-Gould, MD, founder of the Gender Wellness Center in Susquehanna, New York.
Dr. Wolf-Gould began practicing transgender medicine in 2007, when her first trans patient begged her to get educated on transgender care so she could provide treatment. She is a member of the World Professional Association for Transgender Health (WPATH), and trains healthcare professionals on how to include transgender health services within a primary care setting. Dr. Wolf-Gould and The Gender Wellness Center clinicians provide a broad range of patient care services- from medical and mental health care to research and legal advocacy. They provide care for all who consider themselves “under the transgender umbrella,” including individuals who identify as transgender, gender-expansive, or non-binary. Related Content:
The Gender Wellness CenterArticle about Dr. Wolf-Gould and the Gender Wellness CenterDr. Antonio Urbina LinkedIn CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode host Melinda Godfrey, a Nurse Practitioner at the University of Rochester, and Program Manager of the Congenital Syphilis Prevention Project, (part of the NYS CEI Sexual Health Center of Excellence) speaks with special guest Dr. Geoffrey Weinberg, Professor of Pediatrics at the University of Rochester School of Medicine and Dentistry. Dr. Weinberg is the Clinical Director of the Pediatric Infectious Diseases and Pediatric HIV Program. He is the co-attending at the Pediatric Primary Immune Deficiency Disorders Clinic at the University of Rochester Golisano Children’s Hospital, and consults with the NYSDOH AIDS Institute.
Dr. Weinberg gives us a brief history of syphilis (“The Great Pox”) all the way back to the 1400s. Through the years, medicine began to understand how the disease was transmitted, and in the 1940s, with the advent of penicillin, syphilis was all but eliminated. The disease resurfaced in the 1980s with other STDs and chronic drug use. Again, it was all but eliminated by the year 2000. Alarmingly, in 2021 there were 2700 known cases in newborns, and this has led to today’s discussion about what clinicians can do to help reduce the number of babies born with syphilis today, and preventing transmission in the future. Related Content:
CDC - syphilis InformaionClinical Education Initiative; Sexual Health Learning Pathways - Mastering syphilisTampa M, Sarbu I, Matei C, Benea V, Georgescu SR. Brief history of syphilis. J Med Life. 2014 Mar 15;7(1):4-10. Epub 2014 Mar 25. PMID: 24653750; PMCID: PMC3956094. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956094/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
In this episode host Lauren Walker, Program Director for the Hep C and Drug User Health Center of Excellence at CEI, speaks with special guests Dr. Sharon Stancliff and NYSDOH’s Lisa Skill about the increasing health threat posed by Xylazine.
Dr. Stancliff is Associate Medical Director of Harm Reduction in Healthcare and Medical Director of Harm Reduction in Healthcare, AIDS Institute, NYSDOH. She has been working with people who use drugs since 1990, and currently focuses on opioid overdose prevention. Lisa Skill is a Health Program Coordinator at the NYSDOH AIDS Institute Office of Drug User Health.
Xylazine, often called “tranq” or “tranq dope” on the street, is being used to amplify and extend the effects of other drugs such as stimulants, opioids, and other sedatives. The drug was designed for veterinary use in animals as a sedative and muscle relaxant and is not approved for human consumption. Human use of Xylazine was first noted in Puerto Rico in the early 2000s, and has since spread across the U.S. into local drug supplies. In November 2022, the FDA issued a national warning to healthcare professionals to be cautious of the potential for xylazine inclusion in fentanyl, heroin and other illicit drug overdoses.
This episode will describe xylazine trends and use over time, and provide clinicians with an understanding of the physiologic effects of xylazine intoxication. Dr. Sharon Stancliff and Lisa Skill will also share their clinical and harm reduction recommendations for xylazine intoxication, overdose and withdrawal. Related Content:
NYSDOH Naloxone Availability without a prescriptionSafer Consumption Spaces - End Overdose NY Fiorentin TR, Logan BK. Analytical findings in used syringes from a syringe exchange program. Int J Drug Policy. 2022, 81:102770. doi: 10.1016/j.drugpo.2020.102770Friedman J, Montero F, Bourgois P, Wahbi R, Dye D, Goodman-Meza D, Shover C. Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis. Drug Alcohol Depend. 2022, 233:109380. doi: 10.1016/j.drugalcdep.2022.109380Johnson J, Pizzicato L, Johnson C, Viner K. Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010-2019. Injury Prevention. 2021, 24:395-398. doi: 10.1136/injuryprev-2020-043968Kariisa M, Patel P, Smith H, Bitting J. Notes from the field: Xylazine detection and involvement in drug overdose deaths – United States, 2019. MMWR Morb Mortal Wkly Rep. 2021, 70(37):1300-1302. doi: 10.15585/mmwr.mm7037a4 National Institute of Drug Abuse. Xylazine.Ruiz-Colón K, Chavez-Arias C, Díaz-Alcalá JE, Martínez MA. Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: A comprehensive review of the literature. Forensic Sci Int. 2014, 240:1-8. doi: 10.1016/j.forsciint.2014.03.015United States Department of Justice, Drug Enforcement Administration. Xylazine. November 2022.United States Food and Drug Administration. FDA alerts health care professionals of risks to patients exposed to xylazine in illicit drugs. November 2022.CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ -
This podcast is about a long term follow up to the START trial which originally showed that startingantiretroviral therapy even at high CD4 counts (above 500) was better than waiting until CD4 counts drop to
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Preventing perinatal HIV transmission is an important strategy for eliminating HIV. Historically, rates of perinatal HIV transmission were 25-40% without interventions, but advances in HIV research, prevention, and treatment have made it possible to reduce that risk to less than 1%. Despite this progress, many myths and misconceptions about HIV and pregnancy remain. In this episode, Dr. Antonio E. Urbina, Medical Director of CEI’s HIV Primary Care and Prevention Center of Excellence, speaks with Dr. Andrés Ramírez Zamudio, Assistant Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Medicine, Division of Infectious Diseases, at the Icahn School of Medicine at Mount Sinai. Drs. Urbina and Ramírez Zamudio discuss strategies for preventing perinatal HIV transmission more broadly. As well, they unpack some of the common myths and misconceptions to help destigmatize HIV in pregnancy. Related Content:
CEI line for NYS providers: 866-637-2342 (press 2 for questions about perinatal HIV transmission)National hotline: (888) 448-8765The Well Project: https://www.thewellproject.org/International Workshop on HIV and Women: https://virology.eventsair.com/international-workshop-on-hiv-women-2023/registration/Site/RegisterInfectious Diseases Society for Obstetrics and Gynecology (IDSOG): https://www.idsog.org/NYS Perinatal HIV Care Guidelines: https://www.hivguidelines.org/perinatal-hiv-care/https://ceitraining.org/ -
Reproductive healthcare is a critical part of healthcare overall. Yet components of this care, including abortion, are becoming more and more inaccessible to certain parts of the population, worsened by the overturning of Roe vs. Wade. The implications of this decision on access to care, marginalization and inequity are already being seen and causing substantial concern within the medical community.
In this episode, Dr. Erica Bostick chats with Dr. Rachael Phelps, a nationally recognized family planning expert, about the impact of this decision on New York State clinicians and patients. Dr. Phelps offers her expertise and insights into what encompasses reproductive healthcare, and how clinicians can “take the next step” in offering comprehensive, preventative reproductive health services to patients of all ages. Related Content:
CDC Medical Eligibility Criteria website: https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.htmlCDC Medical Eligibility Criteria, PDF Chart: https://www.cdc.gov/reproductivehealth/contraception/pdf/summary-chart-us-medical-eligibility-criteria_508tagged.pdfCDC Selected Practice Recommendations website: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.htmlCDC MEC & SPR App: https://www.cdc.gov/reproductivehealth/contraception/contraception-app.htmlbedsider.orgSociety of Family Planning: https://societyfp.org/https://abortionpillcme.teachtraining.org/The Turnaway Study: https://www.ansirh.org/research/ongoing/turnaway-studyHey Jane Medical Abortion in NY https://www.heyjane.co/home-bPlan C Abortion Resource https://www.plancpills.org/CEI toll free line for NYS providers: 866-637-2342https://ceitraining.org/ - Laat meer zien
