Conversations with CEI

Live from Canandaigua…it’s the 11th Annual NYS Sexual Health Conference! The CEI Sexual Health Center of Excellence hosted the 11th Annual NYS Sexual Health Conference in-person on Friday May 2, 2025, in beautiful Canandaigua, NY. This was the Center’s second in-person conference since the COVID-19 pandemic and was the Center’s largest in-person event held to-date, bringing together over 225 clinicians and public health professionals from across NYS (and beyond!). In this episode, host Juhua Wu, Director of the University of Rochester Center for Community Practice and team member of the CEI Sexual Health Center of Excellence, checks in live from the conference with four presenters about their experience at the conference, perspectives on what they learned from other sessions, and “need to know” highlights from their own presentations. Join Juhua, along with Rachel Hart-Malloy, PhD, MPH, Brenda Tesini, MD, Michael Brennan, DNP, FNP, and Jeremy Kidd, MD, MPH, for a real-time review of the conference! Related Content: https://www.stidashboardny.org/https://www.suguidelinesnys.org/guideline/chemsex/https://campaigns.health.ny.gov/SexualHealthwww.urccp.orgceitraining.org

New York drug overdose deaths and death rates are on the decline, but with significant disparities and the current, toxic drug supply is partially to blame. Harmful additives like fentanyl analogues, xylazine and medetomidine, among others, have been found in cocaine, heroin, MDMA and pressed into pills. Additives are undetectable by sight, taste and smell which increases the risk of overdose for people who use and may not be aware of what’s in their drug supply. This episode features Drs. Sharon Stancliff and Jennifer Love discussing additives commonly found in the New York State supply, including BTMPS, fentanyl analogues, medetomidine, nitazenes and an updates on xylazine. Related Content: https://www.suguidelinesnys.org/https://www.health.ny.gov/diseases/aids/consumers/prevention/oduh/drug_checking.htmhttps://www.nyc.gov/site/doh/health/health-topics/alcohol-and-drug-use-services.pagehttps://www.nyc.gov/assets/doh/downloads/pdf/basas/drug-checking-program-implementation-guide.pdfhttps://legislativeanalysis.org/wp-content/uploads/2025/03/BTMPS-Fact-Sheet-FINAL.pdfhttps://www.cfsre.org/images/content/reports/public_alerts/Public_Alert_Medetomidine_052024.pdfhttps://mattersnetwork.org/request-test-strips/https://oasas.ny.gov/harm-reduction-deliveredhttps://docs.google.com/forms/d/e/1FAIpQLSe-q8tfEZXfdhbIF9DPpN9--BeEYoYdxU1Iw0x4BZBLIktGqQ/viewformceitraining.org

In this episode of Conversations with CEI, we engage with CEI’s clinicians, researchers, and public health experts to explore current and emerging issues in HIV primary care, sexual health, Hepatitis C, and drug user health. From the early days of the HIV epidemic to today’s complex syndemic approach, our experts share valuable insights and practical strategies for translating science into practice. We emphasize the importance of a syndemic approach to care, recognizing the overlapping health needs of patients, particularly in the marginalized population. Through a wide range of training and resources, CEI supports New York State clinicians in delivering comprehensive and inclusive care. Related Content: ceitraining.org

In light of the increase in measles cases within the United States, this episode features Dr. Steven Fine, an infectious disease expert, who offers a comprehensive exploration of the history and progress of measles eradication efforts. Dr. Fine delves into the factors contributing to the resurgence of measles, particularly the role of misinformation in undermining public trust and vaccination efforts. Additionally, Dr. Fine walks us through the latest vaccination recommendations for patients with HIV, addressing the unique considerations required to safeguard this vulnerable group. Tune in to gain valuable insights and practical guidance on current vaccination recommendations aimed at protecting patients with HIV from measles in today's healthcare environment. Related Content: ceitraining.org

In May 2024, the Centers for Disease Control and Prevention (CDC) released its annual HIV surveillance reports. The new data show a continuation of year-over-year reductions through 2022 in the estimated number of new HIV infections in the United States. But disconcerting trends among Latino people — the country’s second-largest racial or ethnic group after White, non-Latino people — reflect persistent failures in HIV prevention and treatment systems that this overall progress has overshadowed. Related Content: ceitraining.org

Let’s dive in! This month, we welcome new hosts Patrick Passarelli, MD, an infectious diseases fellow at the University of Rochester, and Nicholas Gerbino, a public health professional at the Monroe County Sexual Health Clinic, who take a deep dive into all things syphilis. Dr. Passarelli and Nick discuss history, epidemiological trends, updates and diagnostics, screening strategies, and new studies exploring additional treatment and preventative options for syphilis. Related Content: https://www.cdc.gov/sti-statistics/annual/index.htmlhttps://cei.podbean.com/e/the-resurgence-of-congenital-syphilis-in-nys-a-look-at-the-past-and-present-to-change-the-future/https://cei.podbean.com/e/reflections-from-the-2024-cdc-sti-prevention-conference/ceitraining.org

Between 2010 and 2022 (the latest year for which data are available), 194,375 New Yorkers were diagnosed with hepatitis C (HCV) and of those, 53% (103,213 individuals) are known to have cleared their infection either through treatment or spontaneously. This statistic is worth celebrating, but also highlights the ongoing need for action – the goal outlined in New York State’s Hepatitis C Elimination Plan is to reach 80% by 2030. Furthermore, people who inject drugs are disproportionally affected by HCV – in 2022, 48% of newly reported cases of acute HCV in New York indicated injection drug use as a risk factor. And, when analyzing cases with known risk factors, that figure rose to 81% of newly reported acute cases indicating injection drug use. Providing HCV treatment in opioid treatment program (OTP)s is an innovative and necessary strategy to curb the ongoing epidemic and achieve statewide goals for elimination. This episode features Abigail Hunter, MPH, MSN, FNP-BC, sharing her experience providing HCV treatment at an OTP and recommendations for listeners interested in integrating treatment into clinical services. Related Content: https://ceitraining.org/courses/1148https://www.vocal-ny.org/https://www.mountsinai.org/care/primary-care/upper-east-side/ima/reachhttps://www.hivguidelines.org/hepatitis-care/hcv-treatment/https://doi.org/10.1002/cld.921https://attcnetwork.org/sites/default/files/2020-07/Guide%20to%20Integrating%20HCV%20Services%20into%20Opioid%20Treatment%20-%20July%2024-1.pdfhttps://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/docs/hepatitis_c_elimination_plan.pdfhttps://hcvdashboardny.org/ CEI toll free line for NYS providers: 866-637-2342 https://ceitraining.org/

This podcast outlines some of the data presented at the 25th International AIDS Conference from HPTN 084 as it pertains to using injectable cabotegravir for HIV PrEP during pregnancy. Related Content: https://www.hptn.org/research/studies/hptn-084 https://programme.aids2024.org/Programme/Session/349 CEI toll free line for NYS providers: 866-637-2342 https://ceitraining.org/

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) Individualshttps://ceitraining.org/

For the first time since 2018 and since the COVID-19 pandemic, the Centers for Disease Control and Prevention hosted their biennial STI Prevention Conference in-person in Atlanta, GA from September 16 – 19, 2024. This event brought together international leading researchers with government experts, clinical sexual healthcare providers, and state and local public health administrators for four days of scientific updates and sessions on science, programs, and policies related to STI care. Dr. Marguerite Urban and Dr. Daniela DiMarco from the CEI Sexual Health Center of Excellence attended the conference and are back to bring you insights about their experience at the event. They chat about the different sessions they attended 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’ perspectives about some of the sessions? Listen now and let us know what you think by leaving a comment! Related Content: https://stipreventionconference.org/https://ceitraining.org/

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 https://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: https://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: https://www.cdc.gov/hivnexus/hcp/prep/index.html#:~:text=If%20results%20are%20discordant%20or,until%20HIV%20status%20is%20confirmed. https://www.hivguidelines.org/guideline/hiv-prep/ https://www.aphl.org/conferences/proceedings/Documents/2018/43_Gaynor_Parker.pdf https://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: https://www.hivguidelines.org/guideline/adolescent-consent/?mycollection=hiv-treatmenthttps://www.nyclu.org/uploads/2018/10/thl.pdfhttps://www.health.ny.gov/diseases/communicable/std/docs/faq_billing_consent.pdfhttps://jamanetwork.com/journals/jama/fullarticle/195185https://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: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdfhttps://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4https://www.suguidelinesnys.org/guideline/substance-use-disorder-treatment-in-pregnant-adults/https://harmreduction.org/issues/pregnancy-and-substance-use-a-harm-reduction-toolkit/https://www.ncbi.nlm.nih.gov/books/NBK572854/https://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 common barriers people who use substances face when seeking health care services, particularly HCV screening during pregnancy. The conversation also identifies best practices clinicians can implement in practice to provide responsive care for people who use drugs, including pregnant persons. Related Content: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdfhttps://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4https://www.hivguidelines.org/substance-use/sud-treatment-pregnancy/https://harmreduction.org/issues/pregnancy-and-substance-use-a-harm-reduction-toolkit/https://www.ncbi.nlm.nih.gov/books/NBK572854/https://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: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdfhttps://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4https://www.hivguidelines.org/substance-use/sud-treatment-pregnancy/https://www.hcvguidelines.org/https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/09/viral-hepatitis-in-pregnancyhttps://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-DM116215https://www.ncbi.nlm.nih.gov/books/NBK572854/https://ceitraining.org/

In this episode, Dr. Steven Fine discusses some of the latest data that might be used to support starting patients who are unable to take oral antiretroviral medications on long acting, injectable ARV. Patients who consider this off label use because their HIV viral load was not suppressed on oral treatment would have to be carefully selected and well supported. Related Content: https://doi.org/10.1093/cid/ciad511https://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: https://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: 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.htmlhttps://ceitraining.org/