Topics, Trends & Updates
March 2023
Hot Topics
Updated Guidelines
Rapid ART Initiation
Initiation of ART on the same day that an individual has a reactive result on an HIV screening test, is diagnosed with HIV, or at the first clinic visit is the recommended standard of care for HIV treatment in New York State. To support the standard of ART initiation upon diagnosis, this guideline:
  • Provides guidance for choosing safe and efficacious ART regimens based on known patient characteristics, before results of recommended resistance testing or baseline laboratory testing are available.
  • Identifies antiretroviral regimens to avoid for rapid ART initiation.
  • Provides guidance for recognizing when rapid ART initiation is not appropriate.
  • Encourages clinicians to seek the assistance of an experienced HIV care provider when managing patients with extensive comorbidities.
  • Integrates current evidence-based clinical recommendations into the healthcare-related implementation strategies of the New York State Ending the Epidemic initiative.
  • Provides guidance on funding sources for sustainable access to ART.
Substance Use Harm Reduction in Medical Care
The Clinical Guidelines Program provides evidence-based guidelines on treatment of substance use and SUDs to increase the availability of treatment in general medical settings. With this guideline, the committee aims to promulgate a harm reduction approach to medical care of patients who use substances or have SUDs and to:
  • Promote adoption of practical harm reduction strategies to reduce the negative consequences associated with drug and alcohol use.
  • Increase awareness and use of NYSDOH and local/regional harm reduction resources.
  • Support healthcare providers in recognizing and addressing the effects of stigma, which can pose a barrier to individuals seeking substance use treatment and harm reduction services.
Conversations With CEI Podcast
What We Know About Xylazine: In this episode, host Lauren Walker, Program Director for the Hep C and Drug User Health Center of Excellence at CEI, speaks with special guests Dr. Sharon Stancliff and NYSDOH’s Lisa Skill about the increasing health threat posed by xylazine.

Dr. Stancliff is Associate Medical Director of Harm Reduction in Healthcare, AIDS Institute, NYSDOH. She has been working with people who use drugs since 1990, and currently focuses on opioid overdose prevention. Lisa Skill is a Health Program Coordinator at the NYSDOH AIDS Institute Office of Drug User Health.

Xylazine, often called “tranq” or “tranq dope” on the street, is being used to amplify and extend the effects of other drugs such as stimulants, opioids, and other sedatives. The drug was designed for veterinary use in animals as a sedative and muscle relaxant and is not approved for human consumption. Human use of xylazine was first noted in Puerto Rico in the early 2000s, and has since spread across the U.S. into local drug supplies. In November 2022, the FDA issued a national warning to healthcare professionals to be cautious of the potential for xylazine inclusion in fentanyl, heroin, and other illicit drug overdoses.

This episode will describe xylazine trends and use over time, and provide clinicians with an understanding of the physiologic effects of xylazine intoxication. Dr. Sharon Stancliff and Lisa Skill will also share their clinical and harm reduction recommendations for xylazine intoxication, overdose and withdrawal.
Upcoming Training, Education, and Events
Are You a Subscriber?
If this newsletter was forwarded to you, please subscribe now to make sure you receive the Clinical Guidelines Program news every month and stay current with new and updated guidelines.

Subscribing is as easy as entering your email address. We will send you just 1 email per month, and we do not share our mailing list.
Please subscribe now!
Comment? Question? Suggestion? Drop us a line: We welcome feedback and suggestions, and if you send us a question, we will get back to you as quickly as possible. Please note, however, that we cannot answer questions about the care or treatment of specific patients and cannot provide clinical advice.