NYC’s Health Department’s Sexual Health Clinics are now hubs for HIV care as well as HIV prevention
New York City (NYC) is affected by the largest HIV epidemic in the United States, with 121,616 people living with HIV/AIDS in 2015. To End the HIV Epidemic, NYC has committed to achieving 600 or fewer new HIV infections per year by 2020.
Almost all new HIV infections in NYC are sexually transmitted. Each year, approximately 10% of NYC’s new HIV cases are diagnosed at the NYC Department of Health and Mental Hygiene (DOHMH) Sexual Health Clinics, including 20% of NYC’s acute infections.
The Sexual Health Clinics have long been reliable sources of rapid HIV testing as well as diagnosis and onsite treatment of syphilis, gonorrhea, chlamydia, and other sexually transmitted infections (STIs). Our clinics have expanded services as part of the ETE effort to improve NYC’s sexual health safety net. The Sexual Health Clinics now can initiate HIV treatment onsite, at the time of HIV diagnosis through a program called “JumpstART.” We launched JumpstART in November 2016, and have provided immediate HIV treatment to 81 newly diagnosed patients through the second quarter of 2017 (see figure). In the second quarter of 2017, we diagnosed 58 new HIV cases and 37 (64%) of those initiated antiretroviral therapy in our clinics through the JumpstART program, before we placed these patients in longer term HIV primary care.
The Sexual Health Clinics now offer biomedical HIV prevention (PEP and PrEP) as well, which provide an opportunity to engage people who would most benefit from HIV prevention services. Since implementing PEP28 in Fall 2016 to the second quarter of 2017, we have provided a full cycle of PEP to 809 patients, 356 of those in the second quarter of 2017, an uptake surpassing our expectations. Starting in one clinic in December 2016, PrEP initiation is currently available in four clinics and we have initiated 292 patients on PrEP through Q2 of 2017, 164 of those in the second quarter of 2017.
Paramount to initiating HIV services is our improved capacity to assure that our patients have support in navigating the health care system. Newly-hired navigation staff help our patients access benefits, complete administrative work, and receive linkage to longer term healthcare settings as indicated by the patient’s current HIV status (i.e. status neutral care).
It’s not about just having the services available to prevent and treat HIV: it’s about having them be accessible. The New York City Department of Health & Mental Hygiene (NYC DOHMH) operates eight Sexual Health Clinics throughout the city. Our services continue to be available on a walk-in basis for persons 12 years and up, without parental notification, and without regard to insurance or immigration status. All 8 of our sites operate at least five days per week, and some sites include Saturday and evening hours. Our express services, which provide STI screening without having to see a doctor, are now available to any asymptomatic patient who wants them – a real safety net!
These are just some of the enhancements ETE has made possible within the Sexual Health Clinics. We at the NYC Department of Health and Mental Hygiene (DOHMH) Sexual Health Clinics are proud to serve New Yorkers and make HIV history!
Editor’s Note: This has been a guest blog collaboration from the NYC DOHMH Bureau of STD Control and the ETE Dashboard team