AIDS Institute
A
e Priorities D
Document The Fa
acts New
w York’s Responsee HIV/A
AIDS, hepatitis C (HCV) and sexually traansmitted diseaases (STDs) arre significant public health
h concerns. New York State (N
NYS) remains at the epicen
nter of the HIV eepidemic in th
he country, raanking first in
n the number of peersons living w
with HIV/AIDS. By the end of 2011, approximately 131,000 New Yo
orkers were d
diagnosed presumed liviing with HIV o
or AIDS, with an and p
estim
mated 3,755 n
new diagnose
es of HIV infecction in 2011.. As sh
hown in the ‘C
Cascade of HIV Care’ below
w, most peop
ple living with HIV (PLWH) have not reached the goal of viral supprression, which
h leads to opttimal onal health outcomes and marked redu
uction of perso
Communitie
transsmission risk. es of color con
ntinue to show
w disproportio
onate rates off infection. TThe number of Neew Yorkers with documentted HCV exce
eeded 175,0
000 by 2009. However, maany people livving with chron
nic HCV do no
ot know they are infected.. While newly diagnosed HIV infections among injecction drug userss have been rreduced by 78
8% from 2002
2‐2010, the mostt common risk factor for acquiring HCV remains injection drug use
e with HCV prevalence estiimates in ons who injecct ranging bettween 40 and
d 90 percent. perso
In 20
010 statewide
e, 123,122 STD
D diagnoses w
were reported, represe
enting 70 perccent of all casses of comm
municable disseases reportted. Thus, maany New Yorkeers are at riskk for myriad SSTD complicattions including infertilitty and a highe
er risk of HIV acquisition. Priorrity 1: Increa
ase HIV viral lload suppresssion among PLW
WHA. Actioon: Increase H
HIV testing in
n order to deccrease the num
mber of personns infected wiith HIV, but u
unaware of theirr status. Actioon: Expand eefforts to facillitate linkage and retenntion in HIV ccare to those who have not entered care or are no lonnger retained d in care. Instittute quality of caare methods tto identify an
nd remove barrriers to acceess and retenttion in care. Actioon: Integratee HIV health ccare, preventiion and surveeillance activvities to suppo
ort and monittor linkage and retention in ccare. Todaay, perhaps as many as 23,000 New Yorkers are not awarre that they aare living with
h HIV, and thu
us, are poteentially damagging their ow
wn health as w
well as risking
transsmission of H
HIV to others. A key approaach to prevventing more infections is to identify peeople living withh HIV as soon as possible and link them to care. Earlyy initiation off antiretroviraal medication is recoommended an
nd reduces, th
hrough viral ssuppression, the cchances that HIV‐positive persons will iinfect others.. Apprroximately 711,000 New Yo
orkers living w
with HIV are not vvirally suppreessed. Integgration of Ryaan White and
d other Federal and State fundded services eeffectively sup
pports and prromotes linkaage and reten
ntion in care. Best practicce standards of caare are defineed and suppo
orted by New York State’s Quallity of Care, C
Clinical Guidelines, and Clin
nical Educcation Initiativve. mize participa
ation in healtth insurance Priorrity 2: Maxim
proggrams. Actioon: Continuee to increase iinsurance parrticipation forr eligibble enrollees and safety neet services. Pers ons with insu
urance or other care coverrage have betteer health outtcomes. h Studdies show that as individuaal costs increaase for health
care services, peo
ople access leess preventivee and ongoing
g healtth care and u
utilize more co
ostly emergency health Last update 9.25.1
13 AIDS Institute
A
e Priorities D
Document care.. Using HIV U
Uninsured Carre Program fu
unds to assist indivviduals in obtaaining or main
ntaining insurrance for HIV
V and n
non‐HIV healtth care coverage maximize
es available resou
urces and sup
pports continued engagem
ment in care. Strattegies to incre
ease insurancce coverage fo
or persons with HCV and STD
Ds are needed
d, as well as continued ms for subpopulations without access safetty net program
to afffordable insu
urance. Priorrity 3: Launch
h a coordinatted effort to rreduce new HIV a
and STD infecctions among
g gay men an
nd men who havee sex with me
en (MSM). Actio
on: Develop a
a ‘Coordinatin
ng Committeee’ to oversee a com
mprehensive ssystem of preevention, health care and supportive servicees targeting g
gay men and M
MSM to reducce HIV and STTD infections and increase access to care.. Actio
on: Use surveeillance and o
other pertinen
nt data systeems to inform
m program acttivities and measure succeess. Actio
on: Emphasizze young gay//MSM, especiially young MSM
M of color– ag
ges 13‐24 yearrs old, and fu
urther develop structured
d education a
and outreach programs to addreess their need
ds. Desp
pite available services, gay men and MSSM continue to bee disproportio
onately affectted by HIV/AIDS – making up neearly two thirrds of new diaagnoses. Community‐
driveen prevention
n efforts mustt be maintained, including
the aavailability of risk reduction interventions and neweer biomedical approaches such as pre‐e
exposure prophylaxis and trreatment as p
prevention fo
or HIV. Improving access to care, reten
ntion in care, and treattment adhere
ence will incre
ease viral suppression and decreease transmisssion as well. Priorrity 4: Enhance statewide
e public health
h efforts addrressing Hepattitis C (HCV). Actio
on: Expand H
HCV treatment opportunitiees. Actio
on: Continue to develop a statewide sysstem for screeening high imp
pact populatiions such as iinjection drug
g userss, the baby bo
oomer cohort,
t, and longtim
me sexual partn
ners of HCV‐in
nfected indiviiduals.
With better screening technolo
ogies and incrreasingly effecctive treatments, more peo
ople will be se
eeking HCV Last update 9.25.1
13 care and treatmeent. To ensurre timely acceess to HCV with HCV, care and treatmeent for New Yorkers living w
conttinued funding to integratee HCV care an
nd treatment into primary caree settings is esssential. Impllementation o
of the newly enacted HCV Testing Law will bbe a priority aand will assistt in identifyin
ng the treattment needs of persons born between 1945‐1965.
Priorrity 5: Promo
ote interagen
ncy collabora
ation to addrress sexual heealth awaren
ness, educatio
on, and trea tment and ca
are options fo
or sexually trransmitted infecctions. Actioon: Develop a New York SState sexual h
health plan that addresses HIIV, STD, and p
pregnancy preevention targeeting adolesccents and you
ung adults to ensure the know
wledge needeed to make po
ositive, health
hy, and inforrmed choices regarding seexual health.
Actioon: Develop comprehensive health carre provider educcation and senntinel monito
oring that asssures timely and appropriate sscreening and
d treatment ffor STD/HIV in
n multtiple health caare settings. Wheen including vviral STDs, 1 in
n 4 adolescen
nts will have an STTD, with the number risingg to 1 in 2 sexxually active peopple having an STD by age 2
25. Reproducttive and sexuual health are key primary health issuess for adol escents and yyoung adults.. Providing aaccurate and com prehensive in
nformation to
o protect the health of adol escents and yyoung adults and prepare them for resp onsible decission making iss a public heaalth resp onsibility. The AIIDS Institute: Thee AIDS Institute pro
otects and promottes the health of New YYork State’s diversee population throu
ugh disease surveiillance and the provission of quality prevvention, health carre and support serrvices for those impaccted by HIV, AIDS, ssexually transmittted diseases, viral hepatitis and relate d health concerns . In addition, the Institute promotess the health of LGBT ppopulations, substtance users, and th
he sexual health of
of all New Yorkers.