From Blueprint to Action: NYS Department of Health Holds Regional Discussions in New York City on Ending the AIDS Epidemic
September 24 2015
Regional discussions hosted by the New York State Department of Health AIDS Institute are underway to gather community input about how best to implement Governor Cuomo’s Blueprint to End the AIDS Epidemic in New York State by 2020. These neighborhood-by-neighborhood meetings in counties throughout the state are intended to engage local community leaders and advocates in developing an Action Plan for best practices and opportunities for future partnerships and planning. Amida Care’s CEO Doug Wirth served on the Task Force to End the Epidemic, and Amida Care is a proud community partner in the discussion series.
In New York City, discussions were held in the Bronx in August, in Upper and Lower Manhattan on September 21 and 22, and in Brooklyn on Sept. 24. Upcoming discussions are scheduled for Queens and Staten Island. Key questions raised include “What do we need to move forward?”, “Which initiatives are working well?” and “What are the gaps and needs?”
At the Manhattan meetings, moderated by Johanne Morne of the New York State AIDS Institute, speakers included The Hon. Gale Brewer, Manhattan Borough President; Demetre Daskalakis, Assistant Commissioner, New York City Department of Health and Mental Hygiene; Charles King, President and CEO of Housing Works and a member of Amida Care’s Board of Directors; and Dan O’Connell, Director of the NYS AIDS Institute.
The central goal of the Blueprint is to reduce the rate of annual HIV infections in the state from 3,000 per year to fewer than 750. The three pillars of the Blueprint are:
- expanding HIV testing to identify people who are infected and don’t know it
- linking and retaining people diagnosed with HIV in care to help them become virally suppressed
- providing access to pre-exposure prophylaxis (PrEP) for HIV-negative people at greater risk of infection to help prevent them from becoming infected
The good news for New York City is that of the people who are in care, 85% are virally suppressed. But an estimated 9% of people with HIV in NYC are unaware of their status—including close to 3,500 in Manhattan alone—and 22,000 throughout New York State. Speakers and meeting participants, including several representatives of community-based HIV organizations, stressed the need to focus attention on populations that are disproportionately affected by HIV/AIDS and have a high incidence of infection, including young men who have sex with men (MSM) (particularly African Americans and Latinos), people with substance abuse issues, and transgender individuals. Seventy-two percent of all new infections in New York State in 2013 were among the MSM and transgender populations.
Participants also highlighted the need for New York City to provide funding to support the goals of the Blueprint (80% of people living with HIV/AIDS in New York State reside in New York City), and for existing funding to be applied where it is needed most.
Charles King stressed how far we’ve come since the days when HIV was a death sentence. “Now, when we discover that a person is HIV positive, we’re saving a life, because we can do something about it—and in doing so, we’re saving the lives of the people who may have been infected by that person,” he said. Both he and Daskalakis emphasized that “the only HIV test people need to be scared of is the one they’ve never had.”Attendees participated in facilitated group breakout discussions and reported back on ideas and recommendations for advancing the Blueprint. Key action plan points from the Manhattan meetings included the following:
- Testing and linkage to care and treatment are essential to reduce the spread of HIV and improve health outcomes. New York Knows and New York Links are among the initiatives that promote HIV testing, linkage to care, and retention in care to improve viral load suppression rates and health outcomes. To reduce the risk of transmission, those who test positive must be linked to a treatment plan that can increase their chances of suppressing their viral load. Antiretroviral therapy treatment for all those who test positive should also begin as soon as possible to maximize effectiveness. Those who test negative and are at greater risk of infection may be candidates for PrEP, which has been shown to prevent infection.
- Community engagement and education are needed for building awareness, ensuring that people get tested and are in care, and combating stigma around HIV and use of PrEP. Grassroots campaigns and community partnerships are among the ways attendees identified to reach populations at greater risk of infection. More provider education and training is also needed.
- Social determinants of health, such as lack of housing and unemployment, have an impact on HIV/AIDS health outcomes. These factors highlight the importance of programs that address housing, legal, and vocational assistance in addition to physical and behavioral health issues.
Support for specific advocacy action items was also encouraged. These include:
- Statewide age-appropriate sex education in schools
- Ability of minors to consent to treatment for STDs
- Statewide decriminalization of syringe possession (New York is one of only 8 U.S. states where syringe possession is a crime)
Amida Care, the largest Medicaid special-needs health plan in New York State, specializes in providing comprehensive health coverage and coordinated care to Medicaid and Medicare members with chronic conditions, including HIV and behavioral health disorders. By working work closely with members to address their health care needs, Amida Care has generated many impressive health outcomes that save lives and money and align with the goals of the End the Epidemic Blueprint:
- A 93% success rate in getting members on anti-retroviral medications
- A 70% viral load suppression rate among our members
- Over 93% member engagement in care
- A 35% reduction in overall medical expenses
- A 74% decrease in hospital admissions/readmissions