Topics, Trends & Updates

January 2025

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Updated Guideline: Diagnosis and Management of Acute HIV Infection

Updated by lead author Dr. Ethan Cowan, with the Medical Care Criteria Committee, the Diagnosis and Management of Acute HIV Infection guideline aims to guide clinicians who provide ambulatory, inpatient, and emergency medical care for adults aged ≥18 years who present with signs or symptoms of acute HIV infection or report an exposure within the past 4 weeks.


Updates to the guideline include:


  • Consent language for HIV testing updated according to New York State law
  • Recommendations on presentation of acute HIV infection divided to address patients who report sexual or parenteral exposure to a person with or at risk of HIV infection within the past month and patients regardless of reported risk
  • Recommendations on diagnosis of acute HIV infection revised to 1) update plasma HIV RNA level at which clinicians can presume a diagnosis of acute HIV and 2) include the potential challenge of diagnosing acute HIV in patients taking PEP


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Top Guidelines in 2024

The Clinical Guidelines Program publishes its guidelines on the program website and on the National Library of Medicine bookshelf, which indexes the guidelines in PubMed. Below are the top guidelines in 2024 on each site based on page view.


  1. Management of IRIS
  2. PEP to Prevent HIV Infection
  3. Doxycycline PEP to Prevent Bacterial STIs
  4. Perioperative Care in Adults With HIV
  5. Screening for Anal Dysplasia and Cancer in Adults With HIV


  1. PEP to Prevent HIV Infection
  2. Substance Use Screening, Risk Assessment, and Use Disorder Diagnosis in Adults
  3. Doxycycline PEP to Prevent Bacterial STIs
  4. Mycoplasma genitalium Management in Adults
  5. HIV Testing

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Conversations With CEI Podcast

Compassionate Care for LGBTQ+ Individuals Struggling With Substance Use Disorder: 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. Listen Now

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