Conversations with CEI

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: CEI Line: 1-866-637-2342 www.ceitraining.org www.hivguidelines.org ASSETS-NY Website: https://www.screenyourbutt.org/nyc/ NYS DOH AIDS Institute, “Screening for Anal Dysplasia and Cancer in Adults With HIV” guidelines: https://www.hivguidelines.org/guideline/hiv-anal-cancer/#toc_wurop7uf International Anal Neoplasia Society (IANS): https://www.iansoc.org/

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: New York State Department of Health Clinical Guidelines Program Therapeutic Use of Medical Cannabis in New York State (October 2025): https://www.suguidelinesnys.org/guideline/med-cannabis/?mytab=tab_6/#pregnancy New York State Department of Health Office of Cannabis Management Cannabis Considerations for Pregnant and Breastfeeding/Chest Feeding Individuals (2022): https://cannabis.ny.gov/system/files/documents/2022/07/cannabis-considerations-for-pregnant-and-breastfeeding-chestfeeding-individuals-fact-sheet_v2.pdf New York State Behavioral Risk Factor Surveillance System Brief (November 2024-05): https://www.health.ny.gov/statistics/brfss/reports/docs/2024-05_brfss_cannabis_use.pdf New York State Office of Cannabis Management Cannabis Education Library: https://cannabis.ny.gov/education Zolotov Y, Mendoza Temple L, Isralowitz R, et al. Developing Medical Cannabis Competencies: A Consensus Statement. JAMA Netw Open. 2025;8(10):e2535049. doi:10.1001/jamanetworkopen.2025.35049 Raz M, Gupta-Kagan J, & Asnes A. THC Ingestions and Child Protective Services: Guidelines for Practitioners. J Addict Med. 2025 July-Aug;19(4):350-52. doi:10/1097/ADM.0000000000001441 Data to Action: Cannabis consumption during the perinatal period and clinicians’ screening and advising, New York State outside of New York City, 2017-2018 and 2021-2022: https://apps.health.ny.gov/public/tabvis/PHIG_Public/prams/publications/Cannabis_consumption_during_the_perinatal_period.pdf Project CBD: http://projectcbd.com/ American College of Gynecologists and Obstetrics Clinical Consensus on Cannabis Use during Pregnancy and Lactation (October 2025): https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2025/10/cannabis-use-during-pregnancy-and-lactation CEI Training, Clinical Approaches to Medical Cannabis: https://ceitraining.org/courses/1589 CEI Clinical Consultation Line1-866-637-2342 A toll-free service for NYS clinicians offering real-time clinical consultations with specialists on HIV, sexual health, hepatitis C, and drug user health. https://ceitraining.org/

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: CEI Line: 1-866-637-2342 https://ceitraining.org/ www.hivguidelines.org Curtis KM, Nguyen AT, Tepper NK, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2024.MMWR Recomm Rep 2024;73(No. RR-3):1–77. DOI: http://dx.doi.org/10.15585/mmwr.rr7303a1 Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWRRecomm Rep 2024;73(No. RR-4):1–126. DOI: http://dx.doi.org/10.15585/mmwr.rr7304a1 Xiao T, Kumar P, Lobbous M, Yogi-Morren D, Soni P, Recinos PF, Kshettry VR. Depot Medroxyprogesterone Acetate and Risk of Meningioma in the US. JAMA Neurology. 2025;82(11):1094-1102. doi:10.1001/jamaneurol.2025.3011. Roland N, Neumann A, Hoisnard L, Duranteau L, Froelich S, Zureik M, Weill A. Use of progestogens and the risk of intracranial meningioma: national case-control study. BMJ. 2024;384:e078078. doi:10.1136/bmj-2023-078078

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: FDA Approves Two Oral Therapies to Treat Gonorrheahttps://www.fda.gov/news-events/press-announcements/fda-approves-two-oral-therapies-treat-gonorrhea CEI Clinical Consultation Line1-866-637-2342 A toll-free service for NYS clinicians offering real-time clinical consultations with specialists on HIV, sexual health, hepatitis C, and drug user health. https://ceitraining.org/

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: CEI Line: 1-866-637-2342 www.ceitraining.org www.hivguidelines.org “Notes from the Field: Trichophyton mentagrophytes Genotype VII – New York City, April – July 2024” - https://www.cdc.gov/mmwr/volumes/73/wr/mm7343a5.htm Emerging Sexual Transmission of Trichophyton mentagrophytes Genotype VII Infections, United States - https://wwwnc.cdc.gov/eid/article/31/10/25-1056_article Information for Healthcare Providers: Emerging Ringworm - https://www.cdc.gov/ringworm/hcp/clinician-brief-resistant-infections/index.html

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: The International AIDS Society (IAS) https://www.iasociety.org/conferences/ias2025 Official site for the IAS 2025, 13th IAS Conference on HIV Science, held in Kigali, Rwanda, from July 14-17, 2025. https://www.iasociety.org/blog/takeaways-ias-2025 Takaways from the IAS 2025 Conference CEI Clinical Consultation Line 1-866-637-2342 A toll-free service for NYS clinicians offering real-time clinical consultations with specialists on HIV, sexual health, hepatitis C, and drug user health. www.ceitraining.org

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: STI Dashboard New York: https://www.stidashboardny.org/ Chemsex: Questions and Answers: https://www.suguidelinesnys.org/guideline/chemsex/ New York State Department of Health, Healthy Sex campaign: https://campaigns.health.ny.gov/SexualHealth University of Rochester Center for Community Practice: www.urccp.org CEI Clinical Consultation Line 1-866-637-2342 A toll-free service for NYS clinicians offering real-time clinical consultations with specialists on HIV, sexual health, hepatitis C, and drug user health. ceitraining.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: CEI Clinical Consultation Line 1-866-637-2342 A toll-free service for NYS clinicians offering real-time clinical consultations with specialists on HIV, sexual health, hepatitis C, and drug user health. 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: CEI Line: 1-866-637-2342 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: CEI Training “Hepatitis C and Injection Drug Use” - https://ceitraining.org/courses/1148 VOCAL-NY: https://www.vocal-ny.org/ Respectful, Equitable Access to Comprehensive Healthcare (REACH) Program at Mount Sinai: https://www.mountsinai.org/care/primary-care/upper-east-side/ima/reach New York State Department of Health AIDS Institute guideline for the treatment of chronic hepatitis C virus infection in Adults: https://www.hivguidelines.org/hepatitis-care/hcv-treatment/ 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.921 Addiction 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.pdf New York State Hepatitis C Elimination Plan: https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/docs/hepatitis_c_elimination_plan.pdf New York State Hepatitis C Dashboard: https://hcvdashboardny.org/ 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 Health A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, & Transgender (LGBT) Individuals CEI toll free line for NYS providers: 866-637-2342 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 CEI toll free line for NYS providers: 866-637-2342 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: CDC HIV Nexus -- https://www.cdc.gov/hivnexus/hcp/prep/index.html#:~:text=If%20results%20are%20discordant%20or,until%20HIV%20status%20is%20confirmed. AIDS Institute PrEP guidance including diagnostic testing -- https://www.hivguidelines.org/guideline/hiv-prep/ NY State Wadsworth Center -- https://www.aphl.org/conferences/proceedings/Documents/2018/43_Gaynor_Parker.pdf APHL -- https://www.aphl.org/aboutAPHL/publications/Documents/ID-2019Jan-HIV-Lab-Test-Suggested-Reporting-Language.pdf CEI toll free line for NYS providers: 866-637-2342 https://ceitraining.org/