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.

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.

Part 1: Robert Fullilove, EdD,

  • Robert Fullilove Columbia University Mailman School of Public Health https://www.publichealth.columbia.edu/people/our-faculty/ref5
  • Burns, D Learning for Our Common Health Association of American Colleges and Universities Washington, DC 109-119 1999
  • Golembeski C, Fullilove R Criminal (in)justice in the City and Its Associated Health Consequences. American Journal of Public Health 95 1701-6 2005
  • Green LL, Fullilove MT, Fullilove, RE. Remembering the Lizard: Reconstructing Sexuality in the Rooms of Narcotics Anonymous. Journal of Sex Research 42 28-34 2005
  • Fullilove RE HIV Prevention in the African American Community: Why Isn't Anybody Talking about the Elephant in the Room? AIDScience 1 1-7 2001
  • Fullilove MT and Fullilove RE What's housing got to do with it? American Journal of Public Health 90 183-4 2000
  • Fullilove RE, Green LL, Fullilove MT The Family to Family Program: A Structural Intervention with Implications for the Prevention of HIV/AIDS and Other Community Epidemics. AIDS. Vol 14 (1S) 2000.63-67 14(1S) 63-67 2000
  • Levine RS, Foster JE, Fullilove RE et al. Black-White Inequalities in Mortality and Life Expectancy, 1993-1999 :Implications for Healthy People 2010. Public Health Reports 116 474-83 2001
  • Malebranch DJ, Peterson JL, Fullilove RE, Stackhouse RW. Race and Sexual Identity: Perceptions about Medical Culture and Healthcare among Black Men Who Have Sex with Men. Journal of the National Medical Association 96 97-107 2004
  • 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.
    • Centers of Disease Control and Prevention. (2021) COVID-19 and HIV. https://www.cdc.gov/hiv/covid-19/index.html
    • Cooper, T. J., Woodward, B. L., Alom, S., & Harky, A. (2020). Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review. HIV medicine, 21(9), 567-577.
    • Garret, N., Tapley, A., Andriesen, J., Seocharan, I., Fisher, L. H., Bunts, L., ... & Corey, L. (2021). High rate of asymptomatic carriage associated with variant strain Omicron. MedRxiv.
    • Sigel, K., Swartz, T., Golden, E., Paranjpe, I., Somani, S., Richter, F., ... & Glicksberg, B. S. (2020). Covid-19 and people with HIV infection: outcomes for hospitalized patients in New York City. Clinical Infectious Diseases.
    • Verity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., ... & Ferguson, N. M. (2020). Estimates of the severity of coronavirus disease 2019: a model-based analysis. The Lancet infectious diseases, 20(6), 669-677.

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.

2021 CDC STI Treatment Guidelines: https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020: https://www.cdc.gov/mmwr/volumes/68/rr/rr6805a1.htm?s_cid=rr6805a1_w
National Network of STD Clinical Prevention Training Centers: https://www.stdccn.org/render/Public
Visit www.ceitraining.org for the toll-free number for NYS clinicians to discuss HIV, PEP, PrEP, HCV, Drug User Health, and STI management with a specialist.

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.

New York State Hepatitis C Elimination Plan
New York State Hepatitis C Guidelines and Recommendations
New York State Hepatitis C Dashboard
World Health Organization Hepatitis Information
Treatment Action Group
Hep ElimiNATION Initiative
VOCAL New York
Annette Gaudino LinkedIn
Christine Kerr, MD LinkedIn
Lauren Walker LinkedIn
CEI on LinkedIn
CEI on Twitter
CEI on Instagram
CEI on Facebook
CEI on YouTube

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.

HCV Guidelines: hcvguidelines.org
https://www.hivguidelines.org/hepatitis-care/treatment-with-daa/recommended-regimens-adults/
https://www.hcvguidelines.org/Treatment-Naive
https://ceitraining.org/courses/
https://ceitraining.org/resources/hcv/
https://www.health.ny.gov/publications/1806.pdf

https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/providers/testing_law.htm

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.

PrEP4All: https://www.prep4all.org/
Not Just a Black Body: https://notjustablackbody.com

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.

[The following episode was initially recorded as part of "Any Positive Change", which has since merged with Conversations with CEI]

Pre-exposure prophylaxis, also known as PrEP, is a highly effective way to prevent HIV infection. While we are most familiar with the pill that is taken every day, there are new long acting injectables coming down the pipeline, with the potential to improve PrEP adherence. Roughly 1 in 5 people who use drugs are at very high risk of getting HIV. Despite this, very few of them are actually getting PrEP. To hear more about these new advancements in PrEP, and how we can close the treatment gap for people who use drugs, Dr. Linda Wang interviewed Dr. Tony Urbina, an infectious disease physician and Professor of Medicine at the Icahn School of Medicine. Dr. Urbina is also the Medical Director of the New York State Clinical Education Initiative HIV Primary Care and Prevention Center of Excellence.

[The following episode was initially recorded as part of "Any Positive Change", which has since merged with Conversations with CEI]

In this episode, Dr. Linda Wang interviews Dr. Margie Urban, an infectious disease physician and Professor of Medicine at the University of Rochester and the Medical Director of the New York State Clinical Education Initiative Sexual Health Center of Excellence. Listen as we discuss the rising number of sexually transmitted infections affecting communities across the country and in New York State, and how clinicians and the New York State Department of Health have been responding to this crisis in the middle of a pandemic.

[The following episode was initially recorded as part of "Any Positive Change", which has since merged with Conversations with CEI]

The medical clinic at New York Harm Reduction Educators (NYHRE) provides access to healthcare right in the middle of the drop-in center. Participants who come for sterile injection equipment can also receive treatment for hepatitis C and be prescribed buprenorphine, a medication for opioid use disorder, on-site at NYHRE. Perhaps more importantly, they receive all of this at a clinic that is loving, nurturing, and provides non-stigmatizing care to people who use drugs. Hear about how the NYHRE clinic operates and why it is so important to provide this low-barrier model of care to people who use drugs, from Brianna Norton, DO, Medical Director of the NYHRE medical clinic, and Christine Fitzsimmons, RN. Brianna and Christine also talk about the challenges faced during the pandemic, and how they are staying connected to their patients to keep them safe and healthy.

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