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CDC Recognizes City’s Achievement in 30-Year Battle against HIV.Health Department Now Recommends Antiretroviral Therapy for Those Diagnosed or Living with HIV
NEW YORK CITY — Mayor Michael R. Bloomberg and the New York City Health and Hospitals Corporation (HHC) today announced that HHC has tested more than one million New Yorkers for HIV since 2005 when the public hospitals and health centers began offering HIV screening as a routine part of medical care for patients ages 13 to 64. In recognition of this major milestone, Mayor Bloomberg and HHC President Alan D. Aviles accepted an award from the Centers for Disease Control and Prevention (CDC) during the annual World AIDS Day commemorative breakfast at Gracie Mansion. The Mayor and New York City Health Commissioner Dr. Thomas A. Farley also announced a new recommendation that doctors offer every person with an HIV diagnosis antiretroviral treatment to help them be healthier, live longer and prevent transmission. This marks a change from the current practice that treatment only be offered to those who show signs of damage to their immune systems. The Mayor was joined at the breakfast by City Council Speaker Christine C. Quinn; City Council Members Gale A. Brewer, Daniel Dromm, and Robert Jackson; Dr. Bernard M. Branson, Associate Director for Laboratory Diagnostics, CDC Division of HIV/AIDS Prevention; and the community partners who received City recognition for their work leading the fight against HIV including: Robert Cordero, Executive Director of CitiWide Harm Reduction, Daphne Hazel, Associate Vice-President of Planned Parenthood of New York City’s HIV prevention and access to care program – Project Street Beat; and Guillermo Chacon, the President and CEO of the Latino Commission on AIDS.
“Over the past ten years HIV diagnoses and deaths in New York City have seen a dramatic decline,” said Mayor Bloomberg. “Steady progress in our fight against HIV has turned what used to be a death sentence into a disease that can be prevented and, with antiretroviral therapy, managed. Our collective commitment to preventing HIV transmission, making sure New Yorkers know their status, and linking those who need it with care is reenergized on World AIDS day when we pause to reflect on how far we’ve come in the fight against HIV rededicate our efforts to meet the challenges that remain and remember those we’ve lost.”
“The more we talk about HIV, the more infections we can prevent and lessen the stigma that persists for those who are living with the disease,” said Speaker Quinn. “New generations should be aware and have access to the latest prevention information and not be afraid to speak openly about the disease. No one is immune to the devastating virus regardless of age, income level, sexual identity, race or nationality, and we need to make sure everyone gets tested, and knows their status.”
“Testing is a critical step in a comprehensive strategy to prevent and treat HIV,” said HHC President Alan D. Aviles. “By making voluntary testing available in as many settings as possible, and offering it as a routine medical screening, we are helping New Yorkers who are negative to stay negative and helping those who are positive to access the medical care they need.”
“Our expanded HIV testing initiatives are working,” said Health Commissioner Dr. Thomas Farley. “The Bronx Knows and Brooklyn Knows testing initiatives have resulted in more than 722,000 HIV tests to-date through relationships with community partners and caregivers in these communities. Of the more than 2,000 New Yorkers who newly tested positive, three quarters have already been successfully linked to care. And now with today’s new recommendation for physicians to offer antiretroviral therapy to all their HIV patients regardless of their clinical status, we hope to be doing even more to help those with HIV be healthier, live longer, and prevent spread of the infection to their partners.”
“HRA’s HIV/AIDS Services Administration (HASA) was among the first local government responses to the AIDS epidemic in the nation, and it remains one of the most comprehensive programs of its kind,” said Human Resources Administration Commissioner Robert Doar. “We remain as committed as ever to providing the highest quality of service to New Yorkers living with AIDS and clinically symptomatic HIV illness, and to assist them with the services they need to live independently as medical advances help them lead longer, fuller lives.”
“HHC’s testing initiative is an excellent example that demonstrates the benefits of making HIV testing a routine part of medical care,” said Dr. Branson. “It is even more important now, as data from several studies in heterosexual couples have demonstrated that consistent use of antiretroviral therapy not only helps people with HIV live longer, but can also reduce sexual transmission to an uninfected partner. When HIV testing is linked to appropriate treatment and care, everyone wins.”
HHC, the largest provider of HIV primary care in New York City serves about 40 percent of patients in care in the city and began offering HIV testing as a routine part of medical care five years before New York State began requiring that medical providers do so. Since 2005, HHC has diagnosed 10,700 HIV positive individuals, and linked and retained thousands in HIV primary care, improving their health and the health of the community. In Fiscal Year 2011 alone, HHC facilities tested 195,516 patients – more than three times the number tested just six years earlier and preliminary data suggests that fewer than 3,500 new cases of HIV were diagnosed in New York City for 2010, a more than a 30 percent decrease from 2002. The annual death toll from HIV is also down by more than a third: 933 deaths in 2009. More New Yorkers are getting tested than ever before, and those testing positive are getting into treatment faster, with more consistent care and treatment; more than 90 percent of patients diagnosed positive at HHC facilities are linked to life-saving HIV medical care and treatment within 90 days of being diagnosed.
New York City is taking the lead in advancing treatment protocols as well, with the New York City Health Department today becoming the second in the nation – after San Francisco – to recommend that doctors offer antiretroviral treatment (ART) to every person with who is diagnosed with HIV infection as soon as they are diagnosed, instead of waiting for them to develop damage to their immune systems. Health Department experts have reviewed the studies on ART to date and have concluded that offering ART to all people living with HIV will help people with HIV infection live longer, healthier lives and will greatly reduce their chances of transmitting the infection to their partner. A seminal study found ART to be 96 percent effective in reducing HIV transmission from an HIV-infected person to an HIV-uninfected partner.
Despite this progress, however, more than 110,000 New Yorkers are living with HIV, and the condition disproportionately affects black and Hispanic New Yorkers, who account for more than eight out of 10 new HIV diagnoses in New York City each year. While routine testing helps prevent new infections – both by helping HIV-positive people avoid risky sex and by enabling them to get timely treatment, unfortunately, thousands of HIV-positive New Yorkers have yet to learn their status. Nearly a third of the City’s adults have never been tested – and among those who are newly diagnosed with HIV each year, nearly a fourth receive an AIDS diagnosis within one month of their HIV diagnosis, suggesting that they have gone undiagnosed for periods of a decade or more despite the damage to their own health and the risk to others.
The City is continuing efforts to aggressively outreach to untested New Yorkers, including reaching patients in emergency rooms, in-patient units, out-patient primary care clinics and conducting HIV testing in non-traditional settings like bathhouses and public health fairs. Most recently the City’s Bronx Knows and Brooklyn Knows initiatives, large-scale public education campaigns, are aimed at increasing voluntary HIV testing. Additionally the Health Department provides information to physicians and other providers our Health Alerts and other communications to ensure that providers have the most up-to-date recommendations and that every medical encounter offers the opportunity for testing and treatment discussions to take place.
The City’s approach to HIV programs and services goes beyond health care provision and prevention, with a multi-agency and comprehensive support system. To assist poor New York City Human Resources Administration (HRA) provides the most comprehensive program of its kind in the country, helping New Yorkers living with clinical symptomatic HIV or AIDS live healthier and more independent lives. HRA’s HIV/AIDS Services Administration (HASA) is required by law to assist symptomatic HIV/AIDS clients with intensive case management, timely delivery of benefits and services including Medicaid, cash assistance and food stamps, and emergency housing to all homeless HASA clients. Currently, HASA serves over 32,000 clients, including 4,500 families. Other services include rental assistance, home care and homemaking services, mental health and substance abuse screening and treatment referrals, employment and vocational services, transportation assistance, and SSI or SSD application and appeal.
Over the last ten years the priorities for HASA and its clients include maximizing access to health care and improving the quality and access to emergency or non-emergency housing. Today, HIV/AIDS is a much more manageable disease. People diagnosed with the illness are living longer and the need for crisis intervention is no longer the norm for the vast majority of HASA clients. As a result, HASA has begun shifting its focus away from crisis management and towards a forward-looking future. HASA caseworkers talk to clients about where they see themselves in the future, if they want to return to work or complete their education and believes that clients who become healthier can and will want to transition towards greater independence.
The City’s HHC’s 11 hospitals are Designated AIDS Centers. All HHC hospitals, diagnostic and treatment centers, and clinics offer specialized HIV care to all New Yorkers, regardless of ability to pay or immigration status. To find a public hospital or health center that provides HIV testing and treatment in New York City, visit nyc.gov, or call 311.
New York City Photo by BOSSI