Conversations with CEI Clinical Education Initiative

“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: 
Guidance: Adolescent Consent to HIV and STI Treatment and Prevention: https://www.hivguidelines.org/guideline/adolescent-consent/?mycollection=hiv-treatment  
NYCLU – Teenagers, Health Care, and the Law: https://www.nyclu.org/uploads/2018/10/thl.pdf  
Guidance for Local Health Departments (LHD) and Health Care Providers on STI Billing and Minor's Consent to Prevention Services and. HIV-related Services: https://www.health.ny.gov/diseases/communicable/std/docs/faq_billing_consent.pdf 
“Effect of Mandatory Parental Notification on Adolescent Girls' Use of Sexual Health Care Services” - https://jamanetwork.com/journals/jama/fullarticle/195185  
CEI toll free line for NYS providers: 866-637-2342
https://ceitraining.org/

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: 
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.suguidelinesnys.org/guideline/substance-use-disorder-treatment-in-pregnant-adults/
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/

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 approximately6% of infants born to people with HCV become infected during pregnancy or delivery. The New York StateHepatitis 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 approvedexpanding 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 facewhen seeking health care services, particularly HCV screening during pregnancy. The conversation alsoidentifies best practices clinicians can implement in practice to provide responsive care for people who usedrugs, 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/

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: 
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/
American Association for The Study of Liver Diseases (AASLD)/Infectious Diseases Society of America (IDSA) Recommendations for Testing, Managing and Treating Hepatitis C: https://www.hcvguidelines.org/
The American College of Obstetricians and Gynecologists Clinical Practice Guidelines for Viral Hepatitis in Pregnancy: https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/09/viral-hepatitis-in-pregnancy
US Centers for Disease Control and Prevention (CDC) Recommendations for Hepatitis C Testing among Perinatally Exposed Infants and Children (2023): https://www.cdc.gov/mmwr/volumes/72/rr/rr7204a1.htm?s_cid=rr7204a1_e&ACSTrackingID=USCDC_921-DM116215&ACSTrackingLabel=MMWR%20Recommendations%20and%20Reports%20%E2%80%93%20Vol.%2072%2C%20November%203%2C%202023&deliveryName=USCDC_921-DM116215
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/

In this episode, Dr. Steven Fine discusses some of the latest data that might be used to support startingpatients who are unable to take oral antiretroviral medications on long acting, injectable ARV. Patients whoconsider this off label use because their HIV viral load was not suppressed on oral treatment would have to becarefully selected and well supported. Related Content: 
Long-acting Injectable Cabotegravir/Rilpivirine Effective in a Small Patient Cohort With Virologic Failure on Oral Antiretroviral Therapy. James B. Brock, Peyton Herrington, Melissa Hickman, and Aubri Hickman. Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center. Jackson, Mississippi, USA. Clinical Infectious Diseases, Volume 78, Issue 1, 15 January 2024, Pages 122–124, https://doi.org/10.1093/cid/ciad511
CROI 2024: Abstract number 628 24 Week Viral Suppression in Patients Starting Long-Acting CAB/RPV Without HIV Viral Suppression. Matthew D Hickey, Janet Grochowski, Francis Mayorga-Munoz, Elizabeth Imbert, John D. Szumowski, Jon Oskarsson, Mary Shiels, Samantha Dilworth, Ayesha Appa, Diane V Havlir, Monica Gandhi, Katerina Christopoulos. Division of HIV, Infectious Disease, & Global Medicine, University of California, San Francisco, CA, United States.
CROI 2024: ABSTRACT NUMBER 212. SESSION TITLE. Special Session. Clinical Late-Breaking Oral Abstracts. SESSION NUMBER Oral Session-14. Long-Acting Injectable CAB/RPV is Superior to Oral ART in PWH With Adherence Challenges: ACTG A5359. Aadia I. Rana, Yajing Bao, Lu Zheng, Sara Sieczkarski, Jordan E. Lake, Carl J. Fichtenbaum, Tia Morton, Lawrence Fox, Paul Wannamaker, Jose R. Castillo-Mancilla, Kati Vandermeulen, Chanelle Wimbish, Karen T. Tashima, Raphael J. Landovitz
CEI toll free line for NYS providers: 866-637-2342
https://ceitraining.org/

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:
CEI toll free line for NYS providers: 866-637-2342
https://ceitraining.org/