Special Conversations with CEI: Best Practices for Working with People Who Use Substances

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: 

• New York State Hepatitis C Screening during Pregnancy, Digital Provider Toolkit: https://ceitraining.org/documents/HCV%20Screening%20for%20Pregnant%20People%20-%20Provider%20Toolkit%20MARCH%202024%20for%20Posting.pdf
• New York State Department of Health AIDS Institute guideline for treatment of chronic HCV with direct-acting antivirals, Pregnancy and HCV: https://www.hivguidelines.org/hepatitis-care/treatment-with-daa/#tab_4
• New York State Department of Health AIDS Institute guideline for substance use disorder treatment in pregnant adults: https://www.hivguidelines.org/substance-use/sud-treatment-pregnancy/
• National Harm Reduction Coalition “Pregnancy and Substance Use: A Harm Reduction Toolkit” https://harmreduction.org/issues/pregnancy-and-substance-use-a-harm-reduction-toolkit/
• Ramsey KS, Cunningham CO, Stancliff S, et al.; Substance Use Guidelines Committee. Substance Use Disorder Treatment in Pregnant Adults [Internet]. Baltimore (MD): Johns Hopkins University; 2021 Jul. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572854/
• CEI toll free line for NYS providers: 866-637-2342
• https://ceitraining.org/