NEW YORK CITY – May 23, 2005 – The New York City Commission on HIV/AIDS today released for public comment a draft of a report with recommendations on drastically reducing the spread of HIV, significantly improving control of the epidemic in New York City, and further strengthening the City’s position as a national and global model for HIV/AIDS prevention, treatment, and care.
The public is invited to provide written comments on the draft report’s contents and recommendations beginning today through Monday, June 13. Visit http://www.nyc.gov/html/doh/html/ah/ah-nychivreport.shtml to download a copy of the draft report. Comments can be sent to the Commission via email at firstname.lastname@example.org. People can also request copies of the report through 311 and mail comments to HIV/AIDS Commission Report, 125 Worth Street, CN 28, New York, NY 10013.
New York City continues to be the epicenter of the HIV/AIDS epidemic in the United States. There are more than 100,000 people living with HIV/AIDS (PLWHA) in the City today, representing approximately 1 out of 6 people living with HIV/AIDS in the United States. Many of these people have not been diagnosed. Each year in New York City, there are still approximately 4,000 people newly diagnosed with AIDS and 1,700 deaths from AIDS. About 1,000 people each year - 3 people every day - first learn they are HIV-positive at the time they receive an AIDS diagnosis, up to a decade after they become infected. In the 25 years since the emergence of HIV/AIDS, the epidemic has changed dramatically. Today, more than 80% of new AIDS diagnoses and deaths are among African Americans and Hispanics, who comprise half of the City’s population. Black men are nearly 3 times more likely to be living with HIV/AIDS than other New Yorkers, with black men age 40-54 about 7 times more likely. A third of new HIV and AIDS diagnoses in NYC are among women, more than 90% of whom are black or Hispanic.
“HIV/AIDS prevention and care continue to be among our most critical public health priorities," said New York City Health Commissioner and Co-Chair of the Commission, Thomas R. Frieden, MD, MPH. "More needs to be done to expand voluntary HIV testing, distribute condoms more widely, expand harm reduction, and improve treatment outcomes. We thank the Commission for putting together these critical recommendations.”
- Make condoms much more widely available
- Expand harm reduction programs
- Expand drug treatment programs and facilitate referrals
- Expand Prevention With Positives initiatives
- Improve HIV prevention among HIV-negative people with continued risk-taking behaviors
- Expand social marketing programs that work
- Improve HIV/AIDS health education in schools
- Reduce HIV-related stigma in order to improve HIV prevention, testing, and treatment
- Evaluate prevention programs and expand those that work
Expand Voluntary Testing and Linkage to Care
- Increase voluntary HIV testing and linkage to care of those who test HIV-positive
- Advocate for making HIV testing an integrated part of normal medical care
- Ensure that reimbursement schedules maintain the existing testing and counseling infrastructure
- Increase citywide availability of HIV testing, especially rapid tests
- Support a high-visibility social marketing and media campaign
- Monitor HIV testing closely
- Evaluate testing programs and expand those that are effective
Improve Treatment Outcomes
- Preserve and strengthen treatment, case management, and support services to further improve patient outcomes
- Increase housing opportunities and improve allocation based on client needs
- Expand mental health, behavioral health, and harm reduction services and co-locate them with HIV/AIDS care
- Increase access to care by:
- Further improving health care worker and community staff training;
- Enhancing patient education and empowerment; and
- Disseminating information on service availability to PLWHA and service providers
Scott E. Kellerman, MD, MPH, Assistant Commissioner for HIV/AIDS Prevention and Control, added: “The Commission’s draft recommendations will significantly strengthen our response to the epidemic. We welcome input from the community to ensure that we are addressing the needs of New Yorkers living with HIV/AIDS and are doing everything we can do to stop the spread of HIV and control the epidemic.”
About the Commission
The Commission, a panel of 21 individuals who serve as key policy advisors on HIV/AIDS issues, was created in December 2003. The Commission includes individuals from diverse backgrounds, including executive directors of AIDS service organizations, HIV prevention researchers, and persons who are living with HIV/AIDS. Each member has more than a decade of experience in HIV/AIDS work.
The Commission provides guidance on how New York City can improve prevention, diagnosis, treatment, and control of HIV/AIDS. It supplements the work of the New York City Department of Health and Mental Hygiene’s (DOHMH) Bureau of HIV/AIDS Prevention and Control, which manages and coordinates the agency’s HIV/AIDS activities. It also complements the work of the New York City Prevention and Planning Group, as well as the HIV Health and Human Services Planning Council, which determines how the City disburses funds received under the federal Ryan White Title I CARE Act.
Comments by Commission Members
Spencer Cox, Founder and Executive Director of the Medius Institute for Gay Men's Health, and a person living with HIV/AIDS said, “This report makes clear that, with the best of intentions, we’ve made HIV testing inaccessible and difficult to administer. Almost a quarter of people with HIV in New York City don’t get diagnosed until they’re already seriously ill. For most of those people, earlier treatment could have prevented progression to full-blown AIDS. We haven’t been protecting HIV-positive people from discrimination, but abandoning them to disease progression. Now there is finally a consensus that we’ve got to make HIV testing universally available, easy to access, and fully integrated into routine medical care.”
Don C. Des Jarlais, PhD, Director of Research, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, and a world-renowned researcher in the field of HIV prevention among injection drug users and syringe exchange programs, said, “New York has had dramatic success in reducing HIV transmission from sharing needles and syringes. We have reduced the rate of new infections among drug injectors by 75%. We now need to urgently address sexual transmission, which is often associated with the use of a variety of different drugs.”
Jay Dobkin, MD, Associate Attending Physician, Department of Infectious Diseases, Columbia-Presbyterian Hospital, said, “Since many aspects of HIV and AIDS have changed over 25 years, it is important to reassess what we do to prevent, diagnose, and treat this potentially devastating infection. The Commission report highlights the enormous progress we have made but also points to areas where much remains to be done. The steps needed to decrease new HIV infections, diagnose cases earlier, and ensure that the full benefit of modern treatment is achieved are not easy and not free of controversy. If fully implemented, the Commission's recommendations should enable many more New Yorkers to avoid needless infection, illness and death. This makes it imperative that we not accept the status quo.”
Debra Fraser-Howze, President/CEO, National Black Leadership Commission on AIDS, said, “We are pleased with this report, but it is impossible for one document to capture all that needs to be done to fight this epidemic. We welcome community comments and we acknowledge the Department of Health and Mental Hygiene for furthering our efforts."
Mathilde Krim, Chairperson, American Foundation for AIDS Research (AmFAR), said, "HIV/AIDS is a dark and growing cloud looming over our city. No medical treatment can as yet cure it nor is there as yet - if ever there will be - a vaccine to protect from it. However, much has been learned over the last two decades. HIV's spread in a population can be hindered by a combination of different approaches and progression of disease from HIV infection to AIDS can be much slowed by antiretroviral therapies. Our city authorities are to be commended for having searched what new or improved means could be applied towards the better control of HIV/AIDS. The interventions recommended here would certainly hasten the day when New York City's AIDS epidemic can effectively be held in check."
Frank Oldham, Director of the Harlem Director's Group, said, "The Commission's report is the first bold step toward ending the high rates of HIV infection and death in communities like Harlem. The report reflects the Mayor's and Commissioner's strong commitment to making New York City the national model for improving HIV services, treatment, and care and, most importantly, improving the lives of people living with HIV/AIDS. As a person living with HIV, I am confident in the report's findings and commend the Bloomberg administration for moving with such decisiveness on this issue.”
Ana Oliveira, Executive Director of the Gay Men’s Health Crisis, said, "As a member of the Commission, I want to encourage members of the community to read the report and provide feedback so New York City can move to a more advanced level of commitment in the fight against HIV and AIDS. It is only through community participation and collaboration that we will win this battle."
Tokes Osubu, Executive Director, Gay Men of African Descent, said, “The work of the Commission is a testament of the City's commitment, under the leadership of the Health Department, to remain at the forefront of the battle to combat the spread of HIV. My hope is that this report will be used as a reference guide by service providers and everyday New Yorkers alike regarding what needs to be done."
Dennis Walcott, NYC Deputy Mayor for Policy, Co-chair
Thomas R. Frieden, MD, MPH, Commissioner, NYC Dept. of Health and Mental Hygiene, Co-chair
Moisés Agosto-Rosario, Vice President & Managing Director, Community Access
Allan Clear, Executive Director, Harm Reduction Coalition
Spencer Cox, Founder and Executive Director of the Medius Institute for Gay Men's Health
Humberto Cruz, Executive Deputy Director, Div. of HIV Health Care, NYS Department of Health, AIDS Institute
Don C. Des Jarlais, PhD, Director of Research, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, Specialist in HIV prevention among injection drug users
Jay Dobkin, MD, Director, AIDS Center; Physician, Infectious Diseases, Columbia-Presbyterian Hospital
Verna Eggleston, Commissioner, NYC Human Resources Administration
David D. Ho, MD, Director and CEO, Aaron Diamond AIDS Research Center
Debra Fraser-Howze, President/CEO, National Black Leadership Commission on AIDS
Mathilde Krim, PhD, Chairperson, American Foundation for AIDS Research (AmFAR)
Kim Nichols, ScM, MS, Co-Executive Director, African Services Committee
Frank Oldham Jr., Executive Director, Harlem Directors Group
Tokes Osubu, Executive Director, Gay Men of African Descent
Ana Oliveira, MA, Executive Director, Gay Men's Health Crisis
Jairo Enrique Pedraza, Director of International Programs, Cicatelli Assoc., Inc.
Elaine E. Reid, CSW, Co-Chairperson-Elect, NYC Prevention Planning Group
J. Edward Shaw, Co-Chair, NYC Prevention Planning Group, People Living With AIDS Committee
Terry Troia, Executive Director, Project Hospitality
Rona M. Vail, MD, Clinical Director, HIV Services, Callen-Lorde Community Health Center