GETTING TO ZERO AND ENDING THE EPIDEMIC
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1 GETTING TO ZERO AND ENDING THE EPIDEMIC Benjamin Tsoi, MD, MPH Deputy Director of HIV Prevention New York City Department of Health and Mental Hygiene
2 Getting to Zero (GTZ) UNAIDS Strategy 2
3 By 2015, Getting to Zero (GTZ) UNAIDS Strategy Zero New Infections Zero AIDS-related Deaths Zero Discrimination 3
4 4
5 By 2020, 90% of all people living with HIV will know their status By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression 5
6 6
7 7 Some US Cities with ETE/GTZ Plans District of Columbia Fulton County, Georgia Houston, Texas Pittsburg, Pennsylvania Sacramento, California San Diego County, California San Francisco, California Santa Clara County, California Source: NASTAD,
8 8 Some US States with ETE/GTZ Plans Arizona Colorado Illinois Massachusetts Minnesota New York Oregon Washington Source: NASTAD,
9 Ending the Epidemic in New York
10 Trends in HIV/AIDS New York City, : 2,279 new diagnoses
11
12 Ending the Epidemic: A Recipe Community Science Political Will Health Departments April 2015
13 13
14 14
15 Creating a Blueprint for NY Task Force established with 4 committees 1. Care 2. Prevention 3. Housing and Supportive Services 4. Data Committees reviewed nearly 300 submitted recommendations Developed 44 committee recommendations 15
16
17 What Does Ending the Epidemic Mean? D. Holtgrave
18 What Does Ending the Epidemic Mean? Goal Reduce from 3,000 to 750 new HIV infections per year by the end of Point ETE Plan 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
19 19
20
21 Combination Prevention HIV Neutral Social Marketing Campaign Launched #PlaySure, a combination prevention social marketing campaign, on World AIDS Day 2015 Launched Stay Sure on World AIDS Day 2016 EtE funds to support expansion of placement and social marketing
22 Combination Prevention HIV Neutral Social Marketing Campaign
23 Be Sure. Play Sure. Stay Sure. Key messages Get tested regularly for HIV and other STIs Use condoms and lube as often as possible Take medicines to treat HIV, or take PrEP and PEP to prevent a new infection Be open with both sexual partners and medical providers
24 Published NYC s LGBTQ Health Care Bill of Rights Details health care protections on local, state & federal levels Launched Bare it All sexual health campaign To embolden LGBTQ New Yorkers to talk openly with doctors about their sex lives, drug use & any other issues that affect health Pride Month 2017
25 Expanded STD Services will Make Sexual Health Clinics Destination Clinics Expand hours and triage to improve access M-F schedule for all clinics; Saturdays, select clinics Corona clinic expands to 5 days Triage Nurses at ALL clinics Restore screening services for asymptomatic clients Modernize STD diagnostics HSV testing Hepatitis C Trichomonas testing Enhance HPV-related services Anal/cervical screening (PAPs) Colposcopy High Resolution Anoscopy HPV vaccines Quick Start contraceptives for women Creation of new Welcome to the Clinic video
26 Sexual Health Clinics as HIV Neutral Gateway to Care ONE STOP NYC
27 State of the Art HIV Interventions in Sexual Health Clinics FULL COURSES OF npep IMMEDIATE PrEP STARTS jumpstart SAME DAY ART
28 State of the Art HIV Interventions in Sexual Health Clinics BIOMEDICAL EVALUATION AND INTERVENTION: INSTANT STARTS OF ARV TREATMENT AND PREVENTION SOCIAL WORK ASSESSMENT FOR SOCIAL DETERMINANTS OF RISK OR DISEASE PROGRESSION + INSURANCE CONNECTION NAVIGATION TO LONGITUDINAL CARE FOR BOTH HIV NEGATIVE AND POSITIVE CLIENTS
29 Social Marketing for Sexual Health Clinics 29
30 #PlaySure Network
31 #PlaySure Network
32 #PlaySure Network
33 #PlaySure Network
34 #PlaySure Network
35 #PlaySure Network State PrEP-AP Program Covers medical visit and laboratory tests
36 New Model for PEP Delivery 24 HR PEP LINE (844-3-PEP-NYC) For NYC residents 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
37 PrEP Awareness and Use among MSM*, Sexual Health Survey, Online Sample, NYC, *Sample includes sexually active MSM aged years and who report HIVnegative/unknown status Scanlin et al, IAPAC PrEP Awareness PrEP Use (past 6 mos.) 100% 95% Percentage of participants 80% 60% 40% 20% 0% FDA Approval, July % 37% Spring 2012 (N=304) 41% 49% 61% 2% 4% 2% 2% 3% Fall 2012 (N=330) Spring 2013 (N=273) Fall 2013 (N=373) Spring 2014 (N=297) 81% 7% Fall 2014 (N=331) 86% 85% Spring 2015 (N=328) 15% 14% Fall 2015 (N=314) 28% Spring 2016 (N=531)
38 Will We Reach Our Goal?
39 NYC Achieves UNAIDS Targets for Whites, but Not Latinos & Blacks All PLWH in NYC White PLWH Xia Q et al. JAIDS, 1 November 2016
HIV Prevention in NYC: A Public Health Approach
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