Conversations with CEI

Despite the existence of medications that can control HIV and even reduce viral transmission, HIV is still a leading cause of death and a health threat to millions worldwide. The goal of this episode is to highlight where we are in the development of an HIV vaccine and cure which will improve the health and well-being of millions of people worldwide. Related Content:

• AIDS Vaccine Advocacy Coalition: https://www.avac.org/

The COVID-19 pandemic substantially impacted the capacity of sexual health clinics across the nation. It also provided insight into the availability and demand for at-home health testing.

The National Coalition of STD Directors (NCSD) and LetsGetChecked, a virtual care company and commercial lab, have partnered on the Check Yourself initiative –the first ever STI home testing solution that was developed by, for, and in partnership with public health departments. Check Yourself was designed to expand capacity for self-collected STI testing within state and local health departments.

In this episode, Dr. Daniela DiMarco chats with Jennifer Mahn, Director of Clinical and Sexual Health at NCSD, and RJ Asplund, Vice President of Business Development at LGC Labs, about the Check Yourself partnership and how NYS clinicians can participate. Related Content:

• www.NCSDDC.org/Check-Yourself 
  

The number of drug overdose deaths in the US more than quadrupled between 2000 and 2019, and opioid overdose was declared a national public health emergency in 2017. Nationally, overdose deaths were the highest on record in 2020 with over 91,000 drug-involved overdose deaths and over 68,000 opioid-involved overdose deaths reported. New York State is no exception to the trend –drug-involved overdose deaths increased by 37% between 2019 and 2020, and overdose deaths involving any opioid increased by 44% during the same period for an average of nearly 12 deaths every day.

In response to the growing crisis, New York State convened a Heroin and Opioid Task Force in May 2016and on November 30th, 2021 New York became the first US city to open officially authorized Overdose Prevention Centers. Overdose Prevention Centers are an evidence-based approach to preventing overdose deaths adopted by countries around the world, however they remain unsanctioned in the US. They offer supervised, hygienic spaces for people who use drugs to do so safely, and provide a connection to health promoting services, such as harm reduction, medical care, mental health therapy, drug treatment and social supports. In addition, Overdose Prevention Centers improve individual and community health, increase public safety and reduce the social consequences of drug use.

Opponents view the Centers as magnets for drug use, however the New York State Department of Health announced that in their first three months of operation, the Centers were used more than 9,500times and staff on-site averted more than 150overdoses to prevent injury and death. Related Content:

• New York Harm Reduction Educators: https://nyhre.org/ 

Access to PrEP is a pillar of the NYSDOH End the Epidemic initiative, that emphasizes the safety and effectiveness of PrEP as a method to prevent HIV infection. However, structural and individual barriers may result in PrEP being underutilized, particularly by the populations at the highest risk of acquiring HIV. In this episode, Dr. Steven Fine, an infectious disease specialist affiliated with the University of Rochester and Anthony Jordan Health Center, speaks about the injectable option for PrEP, as a suitable choice for those who would prefer an alternative to preventative daily oral therapy. Related Content:

• https://www.hivguidelines.org/antiretroviral-therapy/art-injectable/

As we enter year three of the COVID-19 pandemic, we would like to review the latest updates about HIV and COVID-19.

In the first segment we will speak with Dr. Robert Fullilove, EdD, about the social and historical factors which have led to racial health disparities for HIV and COVID-19. In the second segment we will speak with Dr. Keith Sigel, MD, PhD, MPH, who will unpack the latest research and data about COVID-19 outcomes for Persons Living with HIV (PLWH). The goal of this episode will be to provide information for providers about how to understand and meet their patients’ needs in relation to HIV and COVID-19. Related Content:

Part 1: Robert Fullilove, EdD,

• Robert Fullilove Columbia University Mailman School of Public Health https://www.publichealth.columbia.edu/people/our-faculty/ref5

Part 2: Keith Sigel, MD, PhD, MPH

• Braunstein, S. L., Lazar, R., Wahnich, A., Daskalakis, D. C., & Blackstock, O. J. (2021). Coronavirus disease 2019 (COVID-19) infection among people with human immunodeficiency virus in new york city: a population-level analysis of linked surveillance data. Clinical Infectious Diseases, 72(12), e1021-e1029.

In July 2021, the Centers for Disease Control and Prevention released new evidence-based guidelines for the prevention, diagnosis, and treatment of sexually transmitted infections. This is the first new issue since 2015. Listen to this episode for a discussion about how the guidelines are developed and some of the most important changes in the field. Related Content:

• 2021 CDC STI Treatment Guidelines: https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

Hepatitis C is a major public health issue responsible for more deaths in the US than all 60 reportable infectious diseases combined, including HIV and tuberculosis. It infects about 25,000 people each year, most of whom don’tknow they are infected and are at risk for developing chronic infection. In New York State alone, over 6,000cases of hepatitis C were reported in 2019.

On November 17, 2021 the New York State Department of Health released the New York State Hepatitis C Elimination Plan which outlines five key principles, including: (1) Prevention; (2) Access to Care and Treatment; (3) Testing and Linkage to Care; (4) Surveillance, Data and Metrics; and (5) Social Determinants of Health. The Plan further defines priority populations and settings to ensure those most at risk are placed at the front and center of elimination efforts to help achieve World Health Organization targets of reducing new chronic infections by 90% and mortality by 65% by 2030. Related Content:

• New York State Hepatitis C Elimination Plan

According to the updated HCV guidelines, initial treatment of HCV infection includes patients with chronic hepatitis C who have not been previously treated with interferon, peginterferon, ribavirin, or any HCV direct-acting antiviral (DAA) agent, whether investigational, or US Food and Drug Administration (FDA) approved. However, the simplification of the treatment regimen for HCV may expand the number of healthcare professionals who prescribe antiviral therapy and increase the number of persons treated. In this episode, Dr. Steven Fine, an infectious disease specialist affiliated with the University of Rochester and Anthony Jordan Health Center, speaks about simplified HCV treatment for treatment naïve patients. Related Content:

• HCV Guidelines: hcvguidelines.org

It has been 40 years since the first known case of HIV was documented and we have come a long way in the past 40 years. HIV is now a chronic disease, we have highly effective HIV prevention options like PEP and PrEP, and we are now able to offer long-acting injectables for HIV treatment and soon HIV prevention. While we can celebrate these achievements, HIV health disparities persist. We see that communities who experience multiple forms of oppression have not benefitted as much from medical advances in HIV treatment and prevention. In this episode, Dr. Antonio E. Urbina, Medical Director for CEI’s HIV Primary Care and Prevention Center of Excellence, speaks with two experts to learn more about these disparities and what providers can do to address them: Kenyon Farrow, a public health and infectious disease activist, writer, and editor, and Dr. Sabrina Gard, a primary care provider specializing in HIV. Related Content:

• PrEP4All: https://www.prep4all.org/

Join us for the fifth and final episode of Any Positive Change, a Drug User Health Podcast. Dr. Margie Urban from the University of Rochester and the Clinical Education Initiative’s Sexual Health Center of Excellence joins as a guest host for this episode. She met with Dr. Sandy Springer from Yale University for a wide ranging conversation about her experiences as a joint Infectious Diseases and Addiction Medicine specialist from the early in the HIV epidemic to the present day. Listen as they discuss the progress in the field and some future directions of research at the intersection of drug user health and infectious diseases.

Future podcasts can be found at ‘Conversations with CEI’ and will focus on drug user health, Hepatitis C, sexual health and HIV care and prevention. Come join us there. Related content: 

• CEI toll free line for NYS providers: 866-637-2342