Prevention and Support Services
- HIV/STD Field Services
- Criminal Justice Initiative
- Lesbian, Gay, Bisexual and Transgender HIV Initiative
- Lesbian, Gay, Bisexual and Transgender (LGBT) Health & Human Services Initiative
- Harm Reduction Initiative
- Expanded Syringe Access Demonstration Program (ESAP)
- New York State Department of Health Opioid Overdose Prevention Program
- New York State Safe Sharps Collection Program
- HIV/STD Prevention Services for Young People
- HIV/STD Prevention Services for Women
- Infertility Prevention Project
- Syphilis Elimination Community Mobilization Initiative
- HIV/STD Partner Services
- NYSCondom Program
The primary goal of the Bureau of HIV/STD Field Services is to reduce and prevent the incidence of sexually transmitted diseases including HIV and Hepatitis infections that can also spread through injection. Critical to achieving this goal is a delivery of disease prevention services including education and counseling, disease screening, case investigation, partner notification, risk reduction counseling and condom distribution. Program staff carries out partner services and collaborate with providers who diagnose and treat individuals with HIV and/or STDs to promote and expedite partner services.
The program benefits individuals with disease and their partners and communities benefit from earlier identification and treatment of undiagnosed infections and reduced transmission risk among its members. Staff is located in six regional offices statewide and offer free confidential and anonymous disease screenings and disease intervention services. HIV/STD prevention services include partner services, which is a broad array of activities that are offered by the state and county health departments to persons with HIV infection, syphilis, gonorrhea or Chlamydial infections and their partners. Activities conducted by the Bureau of HIV/STD Field Services expands the health department’s ability to conduct disease screening and surveillance to identify new infections and ensure timely treatment and linkage to medical care and other needed services for at-risk individuals.
HIV/STD Field Service staff utilizes a community-based strategy specifically designed to reach individuals at high risk for HIV and STD. A variety of strategies targeted at HIV/STD high seroprevalence areas, including special initiatives and marketing campaigns and partnership through regional referral arrangements with community-based providers, increase the potential for those at risk to receive information about testing options. Clients can easily access information about HIV/STDs and the availability of local testing by calling the program's statewide toll-free hotlines or by accessing the web site.
HIV/STD Field Services staff conducts a variety of community and correctional-based educational and outreach activities that provide additional opportunities for high-risk individuals to access disease screening outside of traditional clinical settings.
Mara San Antonio-Gaddy
Director, Bureau of HIV/STD Field Services
Division of HIV/STD?Hepatitis C Prevention
The Criminal Justice Initiative (CJI) was developed in response to the emerging prevention and service needs of HIV infected and at risk detainees, inmates and formerly incarcerated individuals in New York State. Its goal is to provide a comprehensive, seamless continuum of quality HIV/STI/HCV prevention and supportive services to individuals in a correctional setting and formerly incarcerated individuals returning to their home communities. These services are designed to diminish HIV/STI/HCV transmission and improve the health and well-being of individuals living with HIV and AIDS. The CJI uses multiple strategies to ensure effective service delivery.
The services provided in correctional settings may include HIV/STI/HCV prevention interventions, peer educator training, anonymous HIV testing and partner services (with the option to convert to confidential), HIV supportive services, and transitional planning. This initiative also funds community-based organizations to provide re-entry assistance for formerly incarcerated individuals living with HIV/AIDS. Services include transportation, supportive services, risk reduction counseling, coordination of health and human services, referral to community case management and Project START, which is an evidence based community re-entry intervention. For correctional settings where the AIDS Institute directly provides anonymous HIV testing and partner services and the inmate chooses to convert to confidential status, a direct link to CJI contractors is provided to assist inmates with appropriate HIV-related support services while incarcerated and to provide re-entry services upon release. CJI contractor services are a compliment to the long-standing HIV prevention and support collaboration between the NYS Department of Corrections and Community Supervision (DOCCS) and the New York State Department of Health (DOH). This strong collaboration allows for the targeted distribution of Health Resource Portfolios and Work Release Packets containing HIV/STI/HCV prevention information and male and female condoms that are provided to inmates as they leave the facility.
In state correctional facilities, the CJI also supports the Prison HIV Hotline. This hotline offers state inmates the opportunity to call collect for HIV/STI/HCV information and counseling. The hotline is also a clearinghouse for HIV/STI/HCV-related information and provides transitional planning and referral services for HIV positive inmates upon release.
The New York State Department of Health, through the AIDS Institute, also receives a sub-allocation in the form of a Memorandum of Understanding with the Office of Children and Family Services. This sub-allocation is used for HIV prevention education and HIV counseling and testing of youth engaged in care, coordination of care for HIV infected youth and HIV training programs for agency staff.
Director, Bureau of Community Based Services
Division of HIV Prevention
In 1994, the AIDS Institute developed the Lesbian, Gay, Bisexual, and Transgender (LGBT) HIV Prevention Initiative. This initiative supports the provision of effective behavior-based HIV prevention interventions and HIV-related supportive services -- including alcohol, substance use and mental health counseling -- that address the needs of gay men/men who have sex with men (MSM), lesbians/women who have sex with women (WSW), persons who have sex with multiple genders, and transgender individuals.
Seventeen organizations are funded under the initiative to implement programs designed to achieve the following goals:
- increase the number of high-risk LGBT individuals who know their HIV serostatus;
- assist HIV-infected LGBT individuals with access to health care and supportive services as early as possible; and
- increase the number of HIV-infected and high-risk LGBT individuals who access primary HIV prevention interventions to increase the use of condoms and to positively influence the individual’s knowledge, attitudes, beliefs and behaviors regarding HIV/AIDS transmission.
To achieve these program goals, contractors employ a range of HIV prevention strategies, including:
- Outreach - conducted in the community and targeting high-risk sub-populations of LGBT individuals to promote and facilitate access to HIV counseling and testing services, individual- and group-level HIV/AIDS/STD education and risk reduction counseling, and other HIV prevention interventions and supportive services provided by the agency and elsewhere in the community.
- Individual- and Group-level HIV Prevention Interventions - single or multiple sessions of health education and HIV and STD risk reduction counseling tailored for and targeting LGBT individuals who are at very high risk for HIV infection. Interventions are designed to assist individuals with developing skills to adopt healthy behaviors and to support his/her efforts to reduce or prevent the risk for HIV infection or transmission. Interventions also facilitate the individual’s access to HIV counseling and testing services, health care and social support services to improve the person’s quality of life.
- Community-level HIV Prevention Interventions - designed to improve the health of LGBT individuals through a focus on specific sub-populations of the community. Interventions serve to increase community awareness of HIV/AIDS and adoption of behaviors known to reduce or prevent the risk for HIV infection or transmission by influencing the social norms, shared beliefs and values held by members of the community. Interventions may also address the underlying policies and socio-economic factors that contribute significantly to community members’ risks for HIV infection and transmission. Community-level HIV prevention interventions include community mobilization efforts, community-wide events, and presentation and distribution of HIV/AIDS educational information.
- HIV counseling, testing and referral services either directly or through a collaborative agreement with a provider of HIV CTR services.
In addition to the programs funded under the Lesbian, Gay, Bisexual and Transgender HIV Prevention Initiative, the AIDS Institute contracts with various community-based HIV service organizations throughout New York State to provide a broad range of HIV prevention and supportive services to LGBT communities. These programs are supported with funds awarded under the Communities of Color Peer Initiative, the Community Service Program Initiative, the Multiple Service Agency Initiative, as well as with Ryan White Title II funds.
Director, LGBT Unit
Bureau of Special Populations
Division of HIV/STD/Hepatitis C Prevention
The Lesbian, Gay, Bisexual & Transgender Health and Human Services (LGBT HHS) initiative is broadly geographically diverse, with providers serving the LGBT community as far west as Buffalo and as far south as the furthest reaches of Long Island, including programs in Rochester, Syracuse, Binghamton, Albany, the Southern Fingers Lakes, the Hudson Valley, Westchester and Rockland counties and New York City. It supports an equally broad and diverse service range including services for youth, seniors, mental health and substance abuse prevention, communities of color and lesbian specific projects. Several grants also support research on LGBT health and human services and education for the broader community of health providers on the health and human service needs of the LGBT community. One grant to an organization with a statewide reach was awarded to provide or arrange for technical assistance and training for grantees; develop and implement an annual conference for programs funded by this initiative and other remerging organizations; and to coordinate requests for information and promote awareness, sensitivity and knowledge of LGBT Issues and concerns in response to requests from a variety of State agencies.
The primary goals of this initiative are:
- improved access and services for LGBT Individuals, their families and support systems
- improved health outcomes and quality of life; and
- increased organizational and community capacity to serve LGBT individuals, their families and support systems.
- Support for and participation in Statewide LGBT POC Health Summit held in October 2011
- First ever statewide needs assessment of LGBT health and human services needs.
- Recommendations on the needs assessment completed September, 2010
- LGBT Families Issues Conference in Binghamton in 2011
- Second Pride and Joy Families Conference in April 2011
- Workshops for grantees on developing logic models and effective evaluations in the Fall 2010-2011
- Technical Assistance Conferences for grantees that covered topics such as time and effort reporting, cultural competency, evaluation methodology, budget modifications, and budgeting in difficult economic times
LGBT HHS Unit Coordinator
Division of HIV/STD/Hepatitis C Prevention
Injection drug use is one of the risk factors for new AIDS cases in New York State. To date, the number of cumulative AIDS cases among injecting drug users is reported to be more than 85,000. The AIDS Institute recognizes that harm reduction strategies are needed to prevent the transmission of HIV and hepatitis B and C to substance users, their sexual partners, and children.
Significant reductions in the number of new HIV cases among injection drug users (IDUs) have been possible with the implementation of harm reduction models with an emphasis on syringe access services and disposal. IDU transmission is no longer the primary cause of HIV transmission in NYS. IDUs accounted for 5.4% and 12.4% of all HIV and AIDS diagnoses respectively in 2009.
The Harm Reduction Initiative supports comprehensive and complementary services with funds from the Centers for Disease Control and Prevention (CDC), the Ryan White CARE Act Part A and B, and the New York State Department of Health (NYSDOH). Harm Reduction Initiative contractors receive funding from a combination of these sources to provide an array of services to substance users, their families, and communities. The CDC funds HIV prevention services to substance users including outreach, interventions delivered to individuals and groups, and support groups. Ryan White Part A funds harm reduction/recovery readiness/relapse prevention services to HIV positive substance users which includes intakes and assessment, individual and group counseling, support groups, acupuncture, referrals to health care, supportive services, and substance use treatment. The Mental Health Services in Harm Reduction Settings Initiative, also funded by Ryan White Part A, provides mental health services including psychiatric intakes and assessments, and individual and group interventions. Ryan White Part B funds counseling and supportive services targeted to special populations to address regional priorities. Comprehensive services also include the provision of STDs and hepatitis C prevention education, screening and referrals for care and treatment. The New York State Department of Health funds comprehensive harm reduction/syringe exchange programs as described below.
In May 1992, the Department of Health filed emergency regulations for authorization to conduct hypodermic syringe and needle exchange programs. Section 80.135 of Title 10 of the State of New York Official Codes, Rules and Regulations provides the regulatory authority by which community based, not-for-profit organizations, and government entities may be granted a waiver to obtain, possess, and furnish hypodermic syringes and needles without a prescription in programs designed to reduce the transmission of HIV. The target population is injection drug users (IDUs) who are not ready, willing, or able to abstain from drug use or enter substance use treatment programs. The regulations require that syringe exchange services be provided within a comprehensive harm reduction model, where clients can learn methods for risk reduction measures for themselves and their partners. Programs must elicit community support in order to receive approval for their waiver applications.
In addition to the provision of clean injection equipment, harm reduction services include:
- outreach and education on risk reduction practices related to sexual and drug-using behaviors;
- distribution and demonstration of male and female condoms and dental dams;
- distribution and demonstration of bleach kits and safer injection techniques;
- distribution of other harm reduction supplies and literature; and
- provision of supportive services, HIV counseling and testing, partner notification assistance, case management, health care, legal, and housing services. Programs must provide referrals for these services if they are unable to provide them directly.
There are currently twenty one approved harm reduction/syringe exchange programs in New York State: fourteen in New York City, and one each in Buffalo, Rochester, Ithaca/Binghamton, Mount Vernon, Albany, Syracuse and Long Island. Approved programs have collectively enrolled more than 150,000 injection drug users through 4/31/12; 73% male, 26% female, 1% transgender; 96% are over the age of 30 ; 45% Latino, 25% African American, 28% Caucasian, 2% more than one race.
Program models include street-side services, mobile vans, storefront centers, walking teams, and visits to single room occupancy hotels and the Peer Delivered Syringe Exchange (PDSE) Model. Syringe exchange programs (SEPs) have shown a rapid and remarkable rate of growth along with strong evidence of effectiveness.
Researchers from the Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Center have conducted evaluations of New York State's syringe exchange programs. Following are some of the findings from its research:
- comparison of HIV among injection drug users (IDUs) show a significant decrease in transmission in IDUs. In 1990, it was estimated that 50% of IDUs were infected with HIV. In 2000, the percentage of infected IDUs had decreased to 20%. For 2002, it is estimated that there has been a further decline in HIV infection in IDUs to 13-15%;
- there is a 76% decrease in the buying or renting of syringes among SEP participants; and
- there is a 50% decrease in borrowing or sharing of used syringes.
The Beth Israel study also demonstrated that syringe exchange does not attract people to drug use. In fact, among SEP participants the frequency of injecting declined by 8%. Further, the findings show a threefold increase in the number of participants who use alcohol pads as a disinfectant before injecting. This practice results in a decrease in the number of injection-related infections.
Syringe access in New York State (Syringe Exchange and the Expanded Syringe Access Program –ESAP) has yielded impressive results. In 1992, 52% of the State’s AIDS cases were attributable to injection drug use. By 2009, only 5.4% of new HIV cases were linked to drug injection.
The number of referrals provided by syringe exchange programs continues to increase. Over 200,000 referrals have been made to detoxification and substance use treatment programs, health care services, HIV counseling and testing, and social services.
Director, Harm Reduction Unit
Division of HIV/STD/Hepatitis C Prevention
In May 2000, the New York State Legislature enacted Chapter 56 of the Laws of 2000 creating the Expanded Syringe Access Program (ESAP). The purpose of this program is to reduce the transmission of blood borne diseases, including HIV and hepatitis, by enhancing access to clean, sterile syringes. Under this program, up to ten syringes may be sold or furnished to a person 18 years of age or older without a prescription by pharmacists, health care facilities, and health care practitioners who have registered with the New York State Department of Health.
As of May 31, 2012 there are 3,231 registered ESAP providers. Of these registered providers about 40% are located in the five boroughs of New York City. The remaining ESAP providers are located throughout the rest of the state. There are ESAP-registered providers in every New York State county with the exception of Hamilton.
Of the registered providers, 3,131 (96.9%) are pharmacies. Major pharmacy chains account for about 70% of all registered pharmacies. In addition to pharmacies there are 100 other providers enrolled including hospitals, nursing homes, clinics and private practitioners. About 2.6 million syringes are sold without a prescription annually.
To find ESAP-registered pharmacies, medical providers or Article 28 facilities where you can obtain syringes without a prescription call 1-800-541-AIDS (1-800-541-2437) or visit the NYS Department of Health website to see a listing of registered ESAP providers by county, as well as sharps collection sites.
Wesley E. Badillo, MD, MPH
Coordinator, Expanded Syringe Access Program
Division of HIV/STD/Hepatitis C
Drug overdose is a significant problem in New York State. Data indicates that over 1,000 fatalities resulted from accidental overdoses in 2008; close to 70% of these deaths involved the use of opioids, including heroin and prescribed analgesics and many of these deaths and the morbidity from non-fatal overdoses can be prevented. In 2008, there were 21,202 opioid-related hospital admissions, as well as 9,135 opioid-related emergency room visits that did not result in a hospital admission.
Most overdoses are not instantaneous and the majority of them are witnessed by others; many overdose fatalities are preventable, especially if witnesses have had appropriate training and are prepared to respond in a safe and effective manner. Prevention measures include understanding specific risk factors (such as polydrug use and recent abstinence), recognizing the signs of an overdose, and responding appropriately. Responses include contacting emergency medical services (EMS, 911), providing rescue breathing and administering naloxone, an FDA-approved drug, which reverses the effects of opioid overdoses.
A life-saving law in NYS took effect in 2006 overseen by the State Department of Health, making it legal in New York State for non-medical persons to administer naloxone to another individual to prevent an opioid overdose from becoming fatal. Eligible providers include: hospitals, diagnostic and treatment centers, health care practitioners, drug treatment programs, not-for-profit community-based organizations and local health departments.
New York State acknowledges the value of the Opioid Overdose Prevention Program and encourages citizens to become aware and embrace this prevention program, which has saved more than 520 lives since its inception. There are over 70 approved opioid overdose prevention programs in NYS.
Learn to recognize and prevent an opioid overdose. For information about training and programs, please call the New York State Department of Health, AIDS Institute at 1-212-417-4770 or visit the website.
Alma R. Candelas
Director, Division of HIV/STD/Hepatitis C Prevention
The New York State Safe Sharps Collection Program was established in 2001 as an important component of the Expanded Syringe Access Program (ESAP). Safe disposal of used sharps including hypodermic needles and syringes is critically important for the health and safety of New Yorkers and the State’s environment. When these sharps come from places other than health care settings--such as individual residences and non-health-related facilities--there are specific considerations and challenges. Fortunately, New York has special programs and options designed to address them.
Hospitals and Nursing Homes
In New York State, all hospitals and nursing homes are required by law to accept household sharps.
For more information on location and hours of operation, please visit the Directory online.
Syringe Exchange Programs (SEPs):
NYS-Authorized Syringe Exchange Programs provide new sterile syringes to injection drug users as an intervention to reduce transmission of HIV, hepatitis B and C and other blood-borne infections. Services are provided utilizing a harm reduction approach to public health. SEPs also collect used syringes. Currently there are 21 SEPs operating at 50 sites. Approximately 3 million syringes are exchanged annually through these programs. SEPs also accept household-generated sharps from non-SEP participants. For more information on sites location and hours of operation, visit the web site.
New York State Safe Sharps Collection Program
Through the New York State Safe Sharps Collection Program, pharmacies, health clinics, community-based organizations, public transportation facilities, housing projects, police stations, bus depots and other venues have become settings for safe sharps collection.
The NYS Department of Health provides sharps collection kiosks and/or wall mounted units to most sites. It also makes available small personal sharps containers, known as Fitpacks.
There are over 135 sites in 23 counties registered in the program. Seven of the Sharps Collection Programs have registered their mobile vans as collection sites. To view the list of alternative collection sites, visit the NYSDOH website.
There is an application process to become part of this program and participating organizations are required to comply with state and local hazardous waste regulations. The application can be obtained online.
Wesley E. Badillo, MD, MPH
Coordinator, Expanded Syringe Access Program
Division of HIV/STD/Hepatitis C Prevention
The primary goal of the HIV/STI Prevention Services for Young People Initiative – Sexual Health Promotion for Young People through Youth Leadership and Community Engagement (SHPYL) - is to reduce HIV infection, sexually transmitted infections (STIs) and unintended pregnancies among youth in New York State (ages 13-24) by creating communities that support and promote optimal sexual health for young people. Programs funded through this initiative build on their target community’s assets and strengths to create an environment that promotes and supports the sexual health and comprehensive well-being of its youth.
Funded programs are expected to reduce STIs, HIV infection and unintended pregnancy among youth by fostering communities that support and provide comprehensive sexual health and risk reduction education and services, and other related services to young people. Programs use youth leaders, who in strong partnership with adults, work to address and change the environment in their communities that increases young people’s risk for STIs, HIV infection and unintended pregnancy.
Programs use a positive youth development approach in all aspects of these programs by focusing on positive outcomes; building on the strengths and assets of young people and communities; and viewing young people as valuable resources, contributors and leaders. Programs create and foster youth and adults in partnership to achieve the initiative’s goals; provide young people with meaningful decision-making roles; collaborate with all segments of a community to contribute to the well-being of young people; and recognize the importance of on-going, positive opportunities and relationships to help young people succeed as adults.
Programs funded under this initiative provide services and implement strategies to achieve outcomes among the populations identified at-risk and in the targeted community. These outcomes are related to young people trained as program leaders; young people in the community; parents, family members and other adults; an increased awareness of and support in the community for promoting optimal sexual health to include education about comprehensive sexual health and HIV/STI /unintended pregnancy risk reduction; and increased access to youth –friendly sexual health services (e.g. HIV counseling and testing, STI screening, testing and treatment, reproductive health care).
School-based HIV Prevention Education
The AIDS Institute and the New York State Education Department, through a memorandum of understanding, collaborate to accomplish the following activities:
- Provide training opportunities and follow-up technical assistance for education professionals, including those who work with adolescents, elementary school children, and special populations including incarcerated youth, youth in alternative situations, special education youth, sexual minority youth, (gay, lesbian, bisexual, transgender and questioning youth) and pregnant and parenting youth
- Establish a system for continual review of HIV/AIDS prevention education materials,
- Provide training opportunities that develop and enhance partnerships with traditional and non-traditional partners to promote effective policies and programming, i.e. community-based organizations, non-governmental organizations, higher education, school nurses, and school boards of education
- Develop and market strategies to develop and promote healthy youth development norms using youth development, supportive learning environments and coordinated school health approaches
- Design and/or identify effective training models, modules, and agendas for HIV and STI prevention and HIV/STI-related education within a youth development framework
Director, Adolescent Health Unit
Bureau of Maternal and Child Health
Center for Community Health
As of December 31, 2008, 125, 718 people were presumed living with HIV or AIDS in NYS. Data from the New York State Department of Health (NYSDOH) and New York City Department of Health and Mental Hygiene (DOHMH) indicates that eighty-eight (88%) percent of all females living with HIV/AIDS are women of color: 56.% Black, 29.6% Hispanic, 11.3 % White, 2.4% Asian/Pacific Islander, Native American/Alaskan Native, and women of two or more races. The concentration of the HIV epidemic among women of color is dramatic. Heterosexual contact and injection drug use are the most frequently reported HIV transmission categories among women living with HIV/AIDS in NYS: 36% and 21% respectively. However, epidemiologists estimate that approximately 60% of women initially placed in the unknown risk category will be reclassified as heterosexual cases. It is important to note that sexual transmission continues to account for an increasing proportion of new infections, and that STDs are a major factor fueling the epidemic particularly among persons of color.
By identifying individuals who are infected with HIV and other STDs and then treating their STDs, new HIV infections may be significantly reduced. The largest group of women affected by HIV and AIDS are poor women, women of color and women who are marginalized in society. These women frequently have unstable housing, poor nutrition, sexually transmitted infections, a history of problematic alcohol and other substance use, and mental health issues.
Women are in need of comprehensive services to access a full range of clinical, mental, health and social services which will improve their well being and the overall quality of life for them and their families.
Funding to support HIV/STD prevention services for women is awarded to contractors located throughout the State, including community-based organizations, hospitals, and community health centers.The target populations for the initiative are women, particularly women of color who are at high risk for HIV and/or STD infection and women who are already infected. The Women's Services Unit provides program oversight, contract management and technical assistance to the providers participating in this initiative. Agencies selected to participate in this initiative are required to develop or enhance comprehensive HIV/STD prevention and support programs for women, their partners and families.
The key components/service areas of this initiative include: HIV/STD counseling and testing in clinical, community-based, and outreach settings; targeted and enhanced outreach to recruit and engage at-risk and HIV/STD infected women who are not engaged in ongoing prevention, care and/or supportive services; multi-session individual and group behavioral interventions targeted to women at-risk and women living with HIV/STD to minimize future transmission or acquisition of HIV/STDs ; strong referrals, linkages and follow-up to comprehensive care and services for both at-risk and women identified as HIV/STD infected.
Programs funded to provide HIV/STD prevention services for women through this initiative will:
- Reduce HIV and STD among women who are at high risk for these infections through innovative services. These services include prevention interventions that help women initiate and sustain behavior change over time and reduce the risk of HIV/STD transmission or acquisition
- Provide information about the benefits of knowing one’s HIV/STD status and make testing more accessible by using rapid testing technology. Testing is complemented by comprehensive care and supportive services for HIV/STD -infected individuals
- Promote improved understanding among women regarding the role of STDs in HIV transmission
- Improve direct access to STD screening and treatment
- Improve the quality of life for women at high risk for HIV and STDs through a comprehensive prevention approach. This may include addressing the following: violence and trauma; mental health; alcohol and other substance use; access to health care; and partner engagement in the prevention of HIV and STDs
Director, Women's HIV/STD Prevention Services
Bureau of Special Populations
Division of HIV/STD/Hepatitis C Prevention
Chlamydia is a bacterial infection that is spread through sexual contact with an infected person. Approximately 75 percent of women and 50 percent of men infected with the disease have no symptoms and may not seek health care. If undetected, Chlamydia may result in pelvic inflammatory disease which leads to additional complications such as ectopic pregnancy, infertility, and chronic pelvic pain. Chlamydia infection also contributes to complications for newborns. Given the high rates of asymptomatic infection, screening is essential to detecting untreated infections.
The New York State Infertility Prevention Project (IPP) is a joint effort between the Bureau of STD Prevention and Epidemiology, the Bureau of Maternal and Child Health and public health laboratories at the state and local level to decrease the prevalence of Chlamydia infection. IPP focuses on establishing efficient systems for screening, diagnosis and treatment of women and their sex partners at risk for Chlamydia infection. The Bureau of STD Prevention and Epidemiology uses IPP funds to pay for laboratory testing at selected STD, adolescent, college, community health center, jails and juvenile detention facilities. The Bureau of Maternal and Child Health provides oversight of testing in selected family planning clinics. Prevalence monitoring data is collected from participating IPP providers to assess trends in Chlamydia positivity. These data also contribute to national prevalence monitoring efforts. Through this collaborative, over 100,000 women and 30,000 men are screened for Chlamydia annually. Positivity among women ranges from an average of 4% among female family planning clients to 9% among female and 11% among male STD clients.
The NYS IPP is a member of the United States Department of Health and Human Services (HHS) Region II IPP and in collaboration with regional partners from New York City, New Jersey, Puerto Rico, and the U.S. Virgin Islands, establishes programmatic policy and practice for Chlamydia screening, laboratory testing, treatment, and partner management.
Alison Muse, MPH
Division of Epidemiology, Evaluation and Research
The Bureau of STD Prevention and Epidemiology currently uses Centers for Disease Control and Prevention (CDC)-awarded syphilis elimination funds to support contracts with two community-based organizations (CBO) for community mobilization activities. Both projects develop and implement locally-tailored activities to reduce the incidence of early syphilis infections in counties with the highest morbidity in New York State (excluding New York City). Agencies are encouraged to actively involve community members in the development, implementation and evaluation of all activities. Each agency has tailored their projects to meet the unique needs and assets within their respective communities.
Agencies have the opportunity to address syphilis infection through a variety of means, including:
- adding targeted screening education and testing into existing STD/HIV prevention programming;
- developing unique social networking approaches to promote syphilis testing through peer referral to local health department and other partnering medical providers;
- promoting outreach, risk reduction education and syphilis testing in nontraditional venues (e.g., bathhouses, health clubs, bars/dance clubs) that may have patrons at high risk for syphilis infection;
- training CBO staff to conduct on-site syphilis testing through phlebotomy;
- developing new and traditional media campaigns to deliver targeted syphilis awareness, prevention and testing messaging; and
- providing education and resources for health care providers to better serve the prevention and health care needs of gay men/men who have sex with men, including STD screening.
The two agencies, collectively serving Long Island, Mid-Hudson Valley, Capital District and North Country, both have a long-standing relationship with their communities. Each agency has developed a multi-component plan to increase awareness, promote testing and reduced sexual risk behaviors that are appropriate for the diverse communities. Project areas recognize the impact of geographical barriers to accessing care and have incorporated methods to reduce these barriers through expanded outreach and education in satellite locations.
Public Health Educator
Bureau of STD Prevention and Epidemiology
Division of Epidemiology, Evaluation and Research
The goal of the Bureau of STD Prevention and Epidemiology (BSTDPE) is to prevent and control sexually transmitted diseases through surveillance, field epidemiology, education, screening services, quality assurance, and research and evaluation. The responsibilities of BSTDPE include the delivery of partner services for persons infected with an STD or HIV-positive patients. HIV/STD partner services is a broad array of services that are offered by trained health department staff to persons with HIV, syphilis, gonorrhea or Chlamydia infection and their partners. A critical function of partner services is partner notification, a process through which infected persons are interviewed to elicit information about their partners who can then be confidentially notified of their possible exposure or potential risk. Other functions of partner services include prevention counseling, testing for HIV and other STDs, proper treatment and referral, as well as linkage to medical care and other needed prevention services. Partner services is an evidence-based intervention that has been shown to identify persons with untreated infection and reduce disease transmission.
BSTDPE has oversight of partner services activities in commissioned counties in New York State outside of New York City either through direct funding or programmatic monitoring of local health department (LHD) partner services. All newly-diagnosed individuals with early syphilis or HIV infection are assigned to health department staff for partner services. In addition, newly-diagnosed gonorrhea and Chlamydia patients are followed by partner services staff to ensure appropriate treatment with priority cases assigned for partner services. BSTDPE’s Technical Assistance Unit is comprised of veteran partner services supervisors who, in collaboration with the NYS STD/HIV Prevention Training Center, provide quality assurance, training and mentoring to partner services staff in regional and local health department STD programs. The Technical Assistance Unit also conducts contract monitoring of disease intervention activities in selected LHDs. BSTDPE also has programmatic oversight of data systems for collecting and evaluating HIV/STD partner services outcomes and reports partner services performance indicators to both national and state stakeholders.
Robert J. Reed
Director, Bureau of STD Prevention and Epidemiology
Division of Epidemiology, Evaluation and Research
The AIDS Institute has provided free condoms and other safer sex materials to organizations serving sexually active New Yorkers with -- or at risk for -- HIV and STDs since its creation in 1983. That effort was enhanced in 2007 with the on-line New York State Condom Program (NYSCondom), accessible at http://www.health.ny.gov/nyscondom. After registering with NYSCondom, eligible organizations may request a wide variety of safer sex supplies, including several brands of male condoms, female condoms, personal lubricant, and dental dams. These providers then distribute the condoms and other safer sex materials at no cost to their clients, patients and others in the community.
Not-for-profit organizations, licensed health care facilities and government entities are eligible to participate in NYSCondom. These community partners are then encouraged to develop or refine strategies for effective local condom distribution, as well as to promote condom use, safer sex and sexual health.
NYSCondom has had consistent growth since its inception, and the demand for its products has been robust. Between July 1, 2010 and June 30, 2011, NYSCondom furnished over 11.9 million male condoms and over 120,000 female condoms to over 400 organizations at 583 different sites. These sites included 22 high school-based health clinics, 37 Planned Parenthood-affiliated clinics, 22 Designated AIDS Centers, 89 primary care clinics, 34 local health departments; and a wide range of AIDS Institute contractors.
Mark R. Hammer
Division of HIV/STD/Hepatitis C Prevention