Explore every episode of the podcast Conversations with CEI
| Title | Pub. Date | Duration | |
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| Anabolic Androgenic Steroids: Is “The Cycle” Addictive? | 24 sept. 2026 | 00:21:45 | |
Anabolic androgenic steroids (AAS) are synthetic versions of testosterone, and like naturally produced testosterone, they can increase male sex characteristics and help build muscle. They are prescribed for low testosterone, delayed puberty and muscle loss from severe illness, among other things. But AAS are also used regularly – particularly among gay, bisexual and queer men – without a prescription to gain muscle and improve physical appearance. The health impact of use varies from injection-site infection to sexual dysfunction and high blood pressure, and many people who use AAS have developed creative ways to mitigate risk. Today’s episode will introduce AAS as performance enhancing drugs and provide harm reduction strategies that clinicians can employ to mitigate risks associated with their use. Related content:
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| AIDS 2026 in Rio: What Came Out of the 26th International AIDS Conference | 10 sept. 2026 | 00:17:05 | |
AIDS 2026, the 26th International AIDS Conference, was held on July 26-31 in Rio. In this episode, Dr. Antonio E. Urbina, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, summarizes the clinical highlights from AIDS 2026, focusing on new HIV treatments and prevention strategies. Related content:
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| Updates on HSV Infection | 27 août 2026 | 00:22:45 | |
Daniela DiMarco, MD, MPH is joined by guest speaker Valeria Cantos, MD for this episode of “Conversations with CEI.” Dr. Valeria Cantos is an Associate Professor at the Division of Infectious Diseases at Emory. She is an investigator at the Emory Ponce Clinical research site, where she leads HIV prevention and HIV vaccine clinical trials from the HPTN and HVTN networks. Herpes simplex virus (HSV) infection is one of the most common STIs worldwide. This episode covers a brief overview of herpes simplex virus (HSV) mucocutaneous infections including current recommendations for testing, diagnosis, treatment, and preventing perinatal HSV transmission. They also discuss managing more challenging scenarios to provide practical guidance and address common clinical questions. Related Content:
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| Beyond the Script: Applying Harm Reduction Principles in Practice | 13 août 2026 | 00:46:51 | |
Communication and relationship building are key approaches to harm reduction that focus on meeting people where they are. Both rely on shifting away from stigma and bias to create a safe, open dialogue between patient and provider that builds trust and autonomy while prioritizing safety and dignity. Clinical guidelines on how to effectively implement these principles of harm reduction to affect incremental, positive change exist, but can be difficult to translate into practice. This episode features two New York City-based nurses who are passionate about harm reduction and strive to bring its principles to all care settings. In partnership with another colleague, they developed a harm reduction tool to help providers navigate the sometimes opaque work of harm reduction in clinical spaces. Guests will introduce the tool, discuss the complexities of practicing harm reduction medicine and provide concrete strategies to integrate harm reduction into every clinical encounter. Related Content:
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| Cardiovascular Risk in People with HIV: New Risk Equations, New Guidelines, and Who Gets a Statin | 23 juil. 2026 | 00:17:26 | |
The 2026 ACC/AHA/Multisociety Dyslipidemia Guideline recommends statin therapy for primary prevention of ASCVD for all people living with HIV (PLHIV) aged 40 to 75 years, independently of their traditional ASCVD risk score. This replaces previous calculator-based thresholds. On this episode, Antonio Urbina, MD, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, outlines the latest cardiovascular health guidelines for persons living with HIV. Related Content: | |||
| Best of the Best: Practice-Changing Papers in STI Care from 2025 | 09 juil. 2026 | 00:21:00 | |
Hosts Margie Urban, MD, and Daniela DiMarco, MD, MPH, are joined by Jason Zucker, MD. Dr. Zucker is an Assistant Professor of Medicine at the Columbia University Irving Medical Center and is also the Principal Investigator (PI) and Co-Medical Director of the New York City STD and HIV Prevention Training Center. This podcast gives a snapshot of Dr. Zucker’s review of the most influential STI-related publications of 2025. Dr. Zucker will be giving a presentation, titled STI Management: Top Papers of 2025 That Will Impact Your Management Today or Tomorrow, taking place on July 13, 2026. Additional information can be found at the link below. Related content:
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| Compassion, Choice and Curiosity: Harm Reduction in Practice | 25 juin 2026 | 00:20:06 | |
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. Although harm reduction was introduced as a U.S. Federal Drug Policy Priority in 2022, it’s currently facing funding cuts that threaten life-saving resources and services. In this episode, we’ll hear from harm reductionist Giorgio Handman who has over 15 years’ experience advocating for and implementing harm reduction to support New Yorkers. He will share his personal experience with harm reduction and talk about the evolution and future of harm reduction. Related Content:
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| Closer to a Cure? New HIV Cure Research from Stem Cell Transplants to CAR-T Cell Therapy | 11 juin 2026 | 00:10:24 | |
Two recent studies have shown remarkable advances in HIV cure research: (1) a Norwegian man who achieved long-term HIV remission after a stem cell transplant from his brother and (2) a Phase 1 trial testing CAR-T cell therapy. On this episode, Antonio Urbina, MD, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, dives into these studies and puts them into clinical context, including how to discuss cure research with patients. Related Content:
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| ASSETS-NY – Anal Dysplasia Screening, Surveillance, Education and Treatment Services of NY | 28 mai 2026 | 00:22:37 | |
Host Marguerite Urban, MD is joined by William DeWitt, MD, Clinical Director of Anal Health in Primary Care at Northwell Health, to discuss a new coalition forming in New York City about anal dysplasia. ASSETS-NY aims to bring together people in this field and harness momentum to drive further research and implementation of anal dysplasia and cancer screening, surveillance, education and treatment in New York State. Be sure to check out the coalition’s website at https://www.screenyourbutt.org/nyc/. Related Content:
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| Introducing Point-of-Care Testing for Hepatitis C | 14 mai 2026 | 00:21:35 | |
New York State’s Hepatitis C Dashboard shows that in 2023, 4,783 people were newly diagnosed with HCV in the state, an 8% decrease from 2022. Incidence also decreased, with the rate of new HCV infections dropping from 4.0 to 3.6 per 100,000 population among adult New Yorkers. Despite these gains, progress towards elimination has been stalled by reliance on a multi-step diagnostic algorithm to confirm viremia. In populations with the highest risk of infection – including people who inject drugs – testing and treatment are often inaccessible due to barriers along the care cascade. On June 27, 2024, the U.S. Food and Drug Administration authorized the first point-of-care (POC) HCV RNA test that can be performed where a person receives care, like an outpatient clinic or mobile unit. The availability of a POC HCV RNA testing, which can provide a qualitative results in 60 minutes, unlocks New York’s ability to integrate a test-and-treat approach where a person can be tested for HCV, and if positive for HCV RNA, be linked to care and potentially receive treatment during the same health care visit. To achieve elimination goals, simplified care that engaged people who inject drugs is essential, and single encounter testing and treatment offers a new tool to significantly expand access, decrease time from diagnosis to treatment and increase the number of New Yorkers who are treated for HCV. Today’s episode will focus on this new diagnostic tool and its potential impact on HCV elimination across New York. Related Content:
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| Cannabis and Pregnancy | 20 avr. 2026 | 00:22:41 | |
Based on data from 2023-24, roughly 23% of New Yorkers aged 21 or older reported cannabis use in the past 12 months. Although men generally have a higher prevalence of use than women, recent studies show a narrowing gap as female consumption rises. Despite this trend, research is sorely lacking on the impact of cannabis use on pregnancy, birth outcomes and overall health. Many advisory panels and organizations advise against the use of cannabis during pregnancy, but there are numerous reasons pregnant people choose to use. On today’s episode, we’ll talk through the evidence and provide best practices for caring for pregnant persons who use cannabis. Related Content:
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| CROI 2026 – Live from Denver: What You Need to Know | 07 avr. 2026 | 00:15:13 | |
Conference on Retroviruses and Opportunistic Infections (CROI) 2026 took place from February 22 to 25 in Denver, Colorado. CROI is an annual scientific meeting devoted to the understanding, prevention, and treatment of HIV/AIDS and the opportunistic infections associated with AIDS. Thousands of leading researchers and clinicians from around the world convene in each year for the Conference. On this episode, Antonio Urbina, MD, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, reflects on this year’s conference and shares his highlights about exciting developments in the world of HIV prevention and treatment. Related Content:
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| Misconceptions about Contraception | 12 mars 2026 | 00:33:32 | |
Host Dr. Erica Bostick from the University of Rochester Medical Center Division of Adolescent Medicine chats with Dr. Stacy Sun, a double board-certified physician in obstetrics and gynecology and complex family planning at the University of Rochester, about misconceptions they hear from patients about contraception. Should patients get their hormone levels checked before starting a birth control method? What is emergency contraception and how does it work? Is it safe to use contraception to suppress the menstrual cycle? What do recent studies show about the Depo-Provera shot and the risk of meningioma? Listen to this episode to hear all about these common questions and more, and to get real examples of counseling tips from Dr. Bostick and Dr. Sun! Related Content:
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| What “The 72-Hour Rule” Update Means for New York State | 17 févr. 2026 | 00:19:33 | |
Effective February 19, 2026, New York State law permits clinicians to dispense up to 72 hours (equivalent to a 3-day supply) of controlled substances, such as methadone and buprenorphine, for the management of opioid withdrawal while arranging referral and linkage to care for persons with opioid use disorder, as authorized by federal regulations (specifically, the Code of Federal Regulations or CFR number 1306.07). The federal regulations were updated in August 2023, and New York State law is just now catching up. We informally refer to the update as “The 72-Hour Rule.” Featuring Dr. Linda Wang, this episode reviews what this update means for New York State and how clinicians and healthcare administrators can think about its implementation. Are you implementing “The 72-Hour Rule” in clinical practice in New York State? We want to hear from you! Please reach out to share your experience: Lauren.walker3@mountsinai.org. Related Content:
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| Two New Treatments for Gonorrhea; one is available now! | 12 janv. 2026 | 00:15:20 | |
In this episode of the Conversations with CEI, infectious disease specialist Dr. Steven Fine delves into groundbreaking advancements in the treatment of urogenital gonorrhea. The episode highlights the FDA's December 2025 approval of two innovative oral therapies that mark a significant step forward in combating this prevalent sexually transmitted infection. Dr. Fine discusses the first of these treatments, Zoliflodacin (Nuzolvence), a novel medication specifically developed for urogenital gonorrhea. Administered as a single oral dose, it offers patients a convenient and effective option. The second treatment, Gepotidacin (Blujepa), is a versatile drug initially approved in March 2025 for urinary tract infections (UTIs). Now, it has been authorized for urogenital gonorrhea treatment, requiring two oral doses for optimal efficacy. Throughout the episode, Dr. Fine provides insights into the clinical trials, mechanisms of action, and potential impact of these therapies on public health. He also emphasizes the importance of addressing antibiotic resistance in gonorrhea and how these new treatments may help mitigate this growing concern. For more information, listeners can refer to the FDA's official announcement and other resources provided below. Tune in to this episode to learn more about these exciting developments and their implications for the future of infectious disease treatment. Related Content:
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| PrEParing for Lenacapavir Implementation in Your Clinic: Early Lessons Learned | 20 nov. 2025 | 00:28:23 | |
On June 18, 2025, the FDA approved Yeztugo, the brand name for subcutaneous lenacapavir, a prescription medication used for the pre-exposure prophylaxis of HIV. Subcutaneous lenacapavir is administered twice a year (every six months) to reduce the risk of sexually acquired HIV-1 infection in adults and adolescents at risk. With patients only needing lenacapavir twice a year for HIV prevention, the field has been optimistic about the potential for lenacapavir to reduce barriers and improve access to PrEP. Since we are still early in the rollout subcutaneous lenacapavir, many providers have questions about how to offer it to their patients—from workflow to billing to managing potential side effects and drug-drug interactions. On this episode, Antonio Urbina, MD, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, speaks with Alex Danforth, PharmD. Alex Danforth is a clinical pharmacist in Rochester, NY. She practices at Trillium Health, a federally qualified health center, where she works with patients and providers to help manage medications and optimize care. Alex currently provides clinical leadership for HIV treatment and prevention programs. Drs. Urbina and Danforth talk about the latest New York State Clinical Guidelines for PrEP, which were updated on October 16th. The new guidelines provide important updates, including subcutaneous lenacapavir. They discuss important considerations for initiating patients on lenacapavir as well as some early lessons learned from implementing lenacapavir in their Rochester- and New York City-based clinics. Related Content:
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| Keeping an Eye on STIs – Have You Heard of TMVII? | 13 nov. 2025 | 00:18:04 | |
This month, host Dr. Marguerite Urban chats with Dr. Jason Zucker, an adult and pediatric infectious diseases physician at Columbia University and the assistant medical director of the New York City HIV/STI Prevention Training Center, about an emerging fungal infection, Trichophyton mentagrophytes Genotype VII, also known as TMVII. Curious about what clinicians should know about TMVII? Listen now to learn more! Related Content:
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| Recap of the 2025 Annual New York State Hepatitis C and Drug User Health Conference | 09 oct. 2025 | 00:27:28 | |
On September 9th, CEI hosted its first in-person conference dedicated to hepatitis C and drug user health. A group of New York State-based clinicians met in Catskill for a full day agenda focused on (1) integrating wellness into clinical practice as a way to improve patient care and outcomes, and (2) innovative decision-making frameworks to help clinicians navigate complex scenarios in the absence of strong formal evidence, like clinical guidelines and peer reviewed studies. This episode of “Conversations with CEI” features conference planner and facilitator Taylor Edelmann – an educator and consultant working at the intersection of LGBTQIA+ health, drug user health and harm reduction – sharing his experience and insights about the day. Taylor currently oversees the Lighthouse Learning Collective at the National Harm Reduction Coalition, a program focused on supporting LGBTQIA+ harm reductionists and people who use drugs and engage in sex work. As one of the first openly transgender NCAA athletes, Taylor brings a deeply personal lens to his work advocating for gender-affirming care. He regularly provides clinical education and technical assistance to providers across the country, including Yale University and one of Connecticut’s largest federally qualified health centers, and recently presented at the 2025 Harm Reduction International Conference in Bogotá, Colombia. Taylor is also the co-creator of ChemSex Awareness Week, and the lead author of Gender Affirming Harm Reduction: A Toolkit for Syringe Service Programs, the first resource of its kind developed specifically for social service providers in harm reduction settings. Related Content:
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| Insights from the 13th International AIDS Society Conference on HIV Science | 09 sept. 2025 | 00:16:30 | |
In this episode of Conversations with CEI, Dr. Steven Fine unpacks some of the latest developments and research presented at the 2025 International AIDS Society (IAS) Conference on HIV Science, held in Kigali, Rwanda. From innovative treatment strategies to advancements in prevention and global health equity, Dr. Fine highlights the pivotal discussions and groundbreaking studies that are shaping the future of HIV care. Tune in to gain a deeper understanding of the strides being made in the fight against HIV and the collaborative efforts driving progress on a global scale. Related Content:
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| Evolving Landscape of Geriatric HIV Care | 11 août 2025 | 00:27:19 | |
The demographics of HIV care are rapidly changing, and with them, the clinical needs of patients aging with HIV. In this episode, host Dr. Tony Urbina, Medical Director for CEI's HIV Primary Care and Prevention Center of Excellence, sits down with geriatrician Dr. Angela Condo to explore the unique intersection of geriatric medicine and HIV care.
Dr. Angela Condo is a board-certified internist and geriatrician at Mount Sinai's Icahn School of Medicine, where she established the Comprehensive Program of Integrated Care for Older Adults with HIV at the Peter Krueger Clinic. With initial support from the Keith Herring Foundation and additional HRSA funding through the Aging with HIV initiative, her interdisciplinary program has been serving patients for five years using an innovative embedded consultation model. Related Content:
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| Highlights and Perspectives from the 11th Annual NYS Sexual Health Conference | 10 juil. 2025 | 00:16:36 | |
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:
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| Xylazine & Medetomidine & Nitazines, Oh My! An Update on New York State’s Drug Supply | 12 juin 2025 | 00:29:38 | |
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:
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| CEI…we got you! Evolving with the Science | 16 mai 2025 | 00:38:16 | |
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:
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| Navigating Measles Vaccine Recommendations for Patients with HIV | 08 mai 2025 | 00:20:06 | |
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:
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| The Invisible Latino HIV Crisis | 10 avr. 2025 | 00:21:40 | |
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:
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| Updates in Syphilis: Looking Back to Look Forward | 13 mars 2025 | 00:34:19 | |
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:
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| The Role of Opioid Treatment Programs in Hepatitis C Care: A Path to Elimination | 13 févr. 2025 | 00:20:58 | |
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:
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| Use of Injectable Cabotegravir for HIV PrEP in Pregnancy | 09 janv. 2025 | 00:09:28 | |
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:
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| Compassionate Care for LGBTQ+ Individuals Struggling with Substance Use Disorder | 12 déc. 2024 | 00:28:22 | |
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:
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| Reflections from the 2024 CDC STI Prevention Conference | 07 nov. 2024 | 00:22:11 | |
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:
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| The Case for Chronic Pain Management among People Who Use Opioids | 10 oct. 2024 | 00:46:50 | |
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:
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| An Exciting New Twice-yearly Option for HIV PrEP | 10 sept. 2024 | 00:13:35 | |
“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:
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| When HIV Tests Perplex: Expert Insights on Ambiguous and Discordant Results | 08 août 2024 | 00:29:08 | |
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:
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| It’s Complicated…but Necessary! Navigating Confidential Sexual Healthcare for Adolescents | 11 juil. 2024 | 00:22:05 | |
“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:
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| Special Conversations with CEI: Best Practices for Hepatitis C and Pregnancy Screening: Advice from a Fellow Clinician | 13 juin 2024 | 00:34:45 | |
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:
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| Special Conversations with CEI: Best Practices for Working with People Who Use Substances | 06 juin 2024 | 00:30:04 | |
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:
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| Special Conversations with CEI: The Impact of Hepatitis C Screening during Pregnancy: A Client’s Story | 30 mai 2024 | 00:36:45 | |
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:
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| Would you consider Injectable ART for those unable to suppress with oral HIV treatment? | 07 mai 2024 | 00:14:49 | |
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:
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| HIV Prevention Research in the Kink-Involved Population | 11 avr. 2024 | 00:23:43 | |
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:
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| Doxy-PEP Part II: Where Are We Now? | 14 mars 2024 | 00:17:25 | |
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:
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| Tackling Stigma with Compassion: Harm Reduction in Clinical Practice | 08 févr. 2024 | 00:28:35 | |
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:
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| RSV Vaccination in HIV Positive Adults | 11 janv. 2024 | 00:11:53 | |
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:
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| We can do it! Improving access to care for transgender and gender diverse patients | 14 déc. 2023 | 00:17:39 | |
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:
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| What is Doxy-PEP? A Conversation about the Use of Doxycycline Post Exposure Prophylaxis to Prevent STIs | 09 nov. 2023 | 00:15:44 | |
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:
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| Safe and Safer Supply for People Who Use Drugs | 12 oct. 2023 | 00:32:30 | |
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:
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| REPRIEVE: Pitavastatin to Prevent Cardiovascular Disease in HIV | 14 sept. 2023 | 00:12:51 | |
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:
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| Making a SPLASH! Long-acting Injectables for vulnerable populations with HIV | 10 août 2023 | 00:18:34 | |
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:
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| Tackling Syphilis: A Conversation with the New York State Department of Health AIDS Institute Office of Sexual Health and Epidemiology | 13 juil. 2023 | 00:30:57 | |
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:
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| Integrating Hepatitis C Treatment into Opioid Treatment Programs: The Greenwich House Story | 08 juin 2023 | 00:31:40 | |
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:
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| Talking to patients about Lenacapavir (Sunlenca); the new long-acting injectable medication for HIV | 11 mai 2023 | 00:16:11 | |
In this episode, Dr. Steven Fine, an infectious disease specialist affiliated with the University of Rochester and Anthony Jordan Health Center explains the pros and cons behind the newly approved Lenacapavir (Sunlenca) injectable for HIV. Dr. Fine receives a lot of questions about the medication in his practice. Many patients have heard good things about the new treatment for HIV that is given as a subcutaneous injection once every 6 months. Dr. Fine discusses the current indication in combination with other agents for “treatment-experienced” HIV patients and possible future uses. You’ll hear about Lenacapavir, the data that led to approval, and how it may be used in the future - including possibly for Pre-Exposure Prophylaxis (PrEP). Related Content:
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