HIV Prevention in NYC: A Public Health Approach
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1 HIV Prevention in NYC: A Public Health Approach Julie Myers, MD, MPH Director of HIV Prevention, Bureau of HIV/AIDS Prevention and Control New York City Department of Health and Mental Hygiene jmyers@health.nyc.gov
2 #ENDAIDSNY2020 Overview Epidemiology and context Strategy and programs Next steps
3 #ENDAIDSNY2020 History of the Epidemic
4 New HIV Diagnoses, NYC, % 80% 70% 60% 50% 40% 30% 20% 10% 0% N= 2,493 HIV Diagnoses Gender #ENDAIDSNY2020 Race/Ethnicity Age Transmission Risk Source: NYC DOHMH, Bureau of HIV Surveillance Data Poverty
5 Lifetime Risk of HIV Diagnosis, by State CDC Estimated Lifetime Risk of HIV
6 Ending the Epidemic (EtE): A Recipe Science Community Political Will Dec #ENDAIDSNY2020 April 2015
7 What Does Ending the Epidemic Mean? Identify persons with HIV who remain undiagnosed and link them to health care. Link and retain persons diagnosed with HIV in health care to maximize viral suppression. Facilitate access to PrEP for HIV negative persons at risk. D. Holtgrave
8 NYC s Strategy and Programs
9 The New York City EtE Plan: Strategies to Address Disparities 1. Transform City STD clinics into: a. Destination Clinics for Sexual Health Services b. Efficient Hubs for HIV Treatment and Prevention 2. Launch PrEP and Repair the PEP Delivery System 3. Make NYC HIV Status Neutral 4. Support Priority Populations Using Novel Strategies 5. Take NYC Viral Suppression from Good to Excellent #ENDAIDSNY2020
10 The New York City EtE Plan: Strategies to Address Disparities 1. Transform City STD clinics into: a. Destination Clinics for Sexual Health Services b. Efficient Hubs for HIV Treatment and Prevention 2. Launch PrEP and Repair the PEP Delivery System 3. Make NYC HIV Status Neutral 4. Support Priority Populations Using Novel Strategies 5. Take NYC Viral Suppression from Good to Excellent #ENDAIDSNY2020
11 The New York City EtE Plan: Strategies to Address Disparities 1. Transform City STD clinics into: a. Destination Clinics for Sexual Health Services b. Efficient Hubs for HIV Treatment and Prevention 2. Launch PrEP and Repair the PEP Delivery System 3. Make NYC HIV Status Neutral 4. Support Priority Populations Using Novel Strategies 5. Take NYC Viral Suppression from Good to Excellent #ENDAIDSNY2020
12 Transform City STD Clinics into Destination Clinics for Sexual Health Services #ENDAIDSNY2020 Expand hours, improve triage Restore screening services for asymptomatic clients Enhance HPV-related services Offer Quick Start contraceptives Engage with community to improve services for priority populations
13 Transform City STD Clinics into Efficient Hubs for HIV Treatment and Prevention #ENDAIDSNY2020 BIOMEDICAL EVALUATION AND INTERVENTION: JumpstART FULL COURSES OF PEP IMMEDIATE PrEP STARTS Instant Starts of ARV Treatment and Prevention SAME DAY ART SOCIAL WORK ASSESSMENT: Social Determinants, Insurance NAVIGATION TO LONGITUDINAL CARE: For both HIV Negative and Positive Clients
14 #ENDAIDSNY2020 STD Clinics: Now Efficient Hubs for HIV Treatment and Prevention PrEP Navigation Launched 10/31/16 ALL CLINICS Over 1300 Encounters PEP 28 Started 10/31/16 ALL CLINICS 397 Patients 61% Black/Latino JumpstART Launched 11/23/16 STARTED IN ONE CLINIC FIVE MORE NOW ON BOARD 47 JumpstARTs 68% Black/Latino PrEP Initiation Started 12/22/16 STARTED IN ONE CLINIC NOW AT 2nd CLINIC 113 PrEP Starts 67% Black/Latino
15 The New York City EtE Plan: Strategies to Address Disparities 1. Transform City STD clinics into: a. Destination Clinics for Sexual Health Services b. Efficient Hubs for HIV Treatment and Prevention 2. Launch PrEP and Repair the PEP Delivery System 3. Make NYC HIV Status Neutral 4. Support Priority Populations Using Novel Strategies 5. Take NYC Viral Suppression from Good to Excellent #ENDAIDSNY2020
16 #ENDAIDSNY2020 Launch PrEP: Detailing Program
17 Launch PrEP: The PlaySure Network #ENDAIDSNY2020
18 #ENDAIDSNY2020 Repair PEP Delivery in NYC 24 HR PEP LINE Clinician staffed Free starter packs e-prescribed to a 24h pharmacy Link to PEP Center next business day PEP CENTERS OF EXCELLENCE Urgent Care Model Immediate starts regardless of insurance status PrEP Linkage
19 The New York City EtE Plan: Strategies to Address Disparities 1. Transform City STD clinics into: a. Destination Clinics for Sexual Health Services b. Efficient Hubs for HIV Treatment and Prevention 2. Launch PrEP and Repair the PEP Delivery System 3. Make NYC HIV Status Neutral 4. Support Priority Populations Using Novel Strategies 5. Take NYC Viral Suppression from Good to Excellent #ENDAIDSNY2020
20 #ENDAIDSNY2020 Prevention=Treatment
21 #ENDAIDSNY2020 Treatment=Prevention
22
23 #ENDAIDSNY2020 The #PlaySure Kit
24 Next Steps
25 Achieving EtE GOALS: New HIV Diagnoses and Estimated Incident HIV Infections, NYC, Total new HIV diagnoses Incident HIV infections Actual Data Projection #ENDAIDSNY2020 The number of new HIV diagnoses from 2010 to 2015 was reported to NYC DOHMH as of June 30, Incident HIV infection estimates from 2010 to 2015 were calculated using the CDC Stratified Extrapolation Approach (SEA). All data from 2016 to 2020 are estimates based on the slope of decline previously observed.
26 Ending the Epidemic (EtE): A Recipe Science Community Political Will #ENDAIDSNY2020 April 2015
27 #ENDAIDSNY Ending the Epidemic: We Have Done it Before Dead Perinatal cases PWID cases 0
28 #ENDAIDSNY2020 Ending the Epidemic: A Reality NYC
29 Acknowledgements NYC DOHMH leadership Mary Bassett Demetre Daskalakis City and State Leadership EtE Task Force Other NYC DOHMH colleagues, including: BHIV Bisrat Abraham Benjamin Tsoi Graham Harriman Sarah Braunstein Lucia Torian Adriana Andaluz Zoe Edelstein Lena Saleh Terrance Gardet Davida Farhat BSTD Susan Blank Christine Borges Tarek Mikati Julie Schillinger Preeti Patela
30 #ENDAIDSNY2020 Thank you!
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