Topics, Trends & Updates

November 2024

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Updated Guideline: Doxycycline PEP to Prevent Bacterial STIs

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Lead authors Drs. Daniela DiMarco and Marguerite Urban, with the NYSDOH AI Medical Care Criteria Committee (MCCC), updated the guideline Doxycycline Post-Exposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections. The purpose of this guideline is to support clinicians providing care for adults and adolescents with and without HIV who are at risk of acquiring bacterial STIs through sexual exposure. 


Updates to the guideline include:


  • Recommendations updated in guideline section Biomedical Prevention of STIs
  • Discussion of abstracts from CROI 2024 added throughout



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Updated Guideline: Perioperative Care in Adults With HIV

Updated by lead author Dr. Sangyoon Jason Shin, with the MCCC, the Perioperative Care in Adults With HIV guideline aims to assist clinicians in perioperative care management for adults with HIV, which is largely the same as for adults without HIV. The guideline focuses on concerns specific to patients with HIV.


Updates to the guideline include:


  • Minor revisions made to discussions of preoperative and postoperative care
  • Lenacapavir added to Table 1: Potential Drug-Drug Interactions Between Medications Commonly Used in Perioperative Management and Antiretroviral Agents


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Contents:


Updated Guideline: Prevention and Management of Hepatitis B Virus Infection in Adults With HIV

Contents:


Lead author Dr. Alok Gupta, with the MCCC, has revised the Prevention and Management of Hepatitis B Virus Infection in Adults With HIV guideline for clinicians who provide medical care for adults (≥18 years old) with HIV who are at risk of acquiring HBV or have HBV coinfection.


Updates to the guideline include:


  • Primary HBV vaccination: Recommendation revised to identify 2-dose Heplisav-B vaccine series as the preferred vaccine strategy.
  • Revaccination: Recommendation added on revaccinating with a 3rd dose of Heplisav-B in patients receiving the 2-dose series as the primary vaccination.


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Updated Guideline: PEP to Prevent HIV Infection


Updated Guideline: Prevention and Management of Hepatitis A Virus Infection in Adults With HIV


Conversations With CEI Podcast

The Case for Chronic Pain Management Among People Who Use Opioids: 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. Listen Now

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