Focus Area 1: Prevent HIV and STDs

  • Goals and Objectives
  • Goal #1: Decrease HIV morbidity in New York State
  • Goal #1:Interventions by Levels of Health Impact Pyramid
  • Goal #2: Increase early access to and retention in HIV care in New York State
  • Goal #2: Interventions by Levels of Health Impact Pyramid
  • Goal #3: Decrease STD morbidity in New York State
  • Goal #3: Interventions by Levels of Health Impact Pyramid
  • Goal #4: Decrease HIV and STD disparities in New York State
  • Goal #4: Interventions by Levels of Health Impact Pyramid
  • Goal #5: Increase and coordinate Hepatitis C Virus (HCV) prevention and treatment capacity In New York State
  • Goal #5: Interventions by Levels of Health Impact Pyramid
  • Interventions by Sector

Defining the problem

HIV/AIDS, sexually transmitted diseases (STDs) and hepatitis C (HCV) are significant public health concerns. New York State (NYS) remains at the epicenter of the HIV epidemic in the country, ranking first in the number of persons living with HIV/AIDS. By the end of 2010, approximately 129,000 New Yorkers were living with HIV or AIDS, with nearly 3,950 new diagnoses of HIV infection in 2010.1 Furthermore, 123,122 New Yorkers had STDs, representing 70 percent of all communicable diseases reported Statewide in 2010.2 The number or people with chronic or resolved cases of HCV in NYS exceeded 175,000 between 2001 and 2009. However, many of those with chronic HCV do not know they are infected, and recently it has been noted that more New Yorkers are dying from HCV than from HIV.

The same behaviors and community characteristics associated with HIV also place individuals and communities at risk for STDs and viral hepatitis. STDs increase the likelihood of HIV transmission and acquisition. Epidemiological data increasingly point to HIV, STDs and HCV as "syndemics", or infections which occur in similar groups of people with the same behavioral risk factors. Notably, in the United States in 2010, the leading cause of death among people with HIV was liver disease from co-infection with HCV.3

The impact of HIV, STDs and HCV is greater in some population groups. For instance, non-Whites have rates of infection that are several times higher than Whites. Prevention interventions, including those that affect underlying factors such as stigma and discrimination, are needed to address these historical inequities. People of color account for more than 75 percent of new HIV diagnoses and, for persons living with HIV, the racial/ethnic distribution is 21 percent White, 43 percent Black, 32 percent Hispanic, 1.2 percent Asian/Pacific Islander, 0.1 percent Native American and 2.8 percent more than one racial group. Data on race and ethnicity of people with STDs and HCV suggest significant disparities exist as well. Men who have sex with men, transgender persons and women of color continue to have much higher rates of these diseases than the general population. Though HIV among injection drug users has decreased steadily (due in large part to expanded access to sterile syringes), HCV among drug injectors is prevalent.

Multiple drug regimens exist for HIV, STDs and HCV, although some are more effective than others. A key approach to preventing more infections is to identify infected people as soon as possible and link them to care. The health of infected people will improve, and the likelihood they will transmit the infection to others will be reduced. Early initiation of antiretroviral medication is recommended for HIV and reduces through viral suppression the chances that HIV-positive persons will infect others. For bacterial STDs such as Syphilis, Gonorrhea and Chlamydia, infections can be cured, though Cephalosporin-resistant Gonorrhea is a growing concern. Many barriers prevent people from getting into care, as well as remaining compliant to a prescribed regimen. More than half of all HCV infections are undiagnosed, mainly because the level of testing is low. After 30 years of awareness campaigns, 20 percent of HIV-infected people nationally are still undiagnosed and one-third of diagnoses are made so late that people are diagnosed with AIDS concurrently or within one year. In addition to the lack of better testing strategies, other barriers to care exist, including those with deep societal and historical roots such as poverty, lack of translation services, homelessness, and inadequate educational opportunities. These factors often result in people being at high risk for infection and unable to get appropriate preventive treatment and care. Minimal public transportation in many parts of the State and other obstacles faced by people with disabilities also present significant challenges. Widely available screening for all these diseases and improved access to care are major goals.

Community-driven prevention efforts must be maintained, including the widespread availability of prevention supplies such as sterile injection equipment, and male and female condoms. In addition, there is an important role for biomedical interventions such as HPV vaccination, pre-exposure prophylaxis for HIV, and anti-retrovirals to prevent mother-to-child transmission during childbirth. Continued investments in community-based strategies are needed to ensure the successful implementation of State Medicaid reform and the federal Affordable Care Act. Sustained resources from federal, State and local sources will be necessary to support the activities described here.

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Goals and Objectives for Action

Goal #1: Decrease HIV morbidity in New York State.

Objective 1.1:
By December 31, 2017, reduce the newly diagnosed HIV case rate in New York by 25% to no more than 14.7 new diagnoses per 100,000.
(Data Source: NYS HIV Surveillance System)

Goal #2: Increase early access to, and retention in, HIV care in New York State.

Objective 2.1:
By December 31, 2017, increase the percentage of HIV-infected persons with a known diagnosis who are in care by 9% to 72%
(Data Source: NYS HIV Surveillance System)
Objective 2.2:
By December 31, 2017, increase the percentage of HIV-infected persons with known diagnoses who are virally suppressed to 45%.
(Data Source: NYS HIV Surveillance System)

Goal #3: Decrease STD morbidity in New York State.

Objective 3.1:
By December 31, 2017, reduce the Gonorrhea case rate among persons aged 15-44 in New York by 10% to no more than 183.1 cases per 100,000 females and 199.5 cases per 100,000 males.
(Data Source: NYS STD Surveillance System)
Objective 3.2:
By December 31, 2017, reduce the Chlamydia case rate in New York among females aged 15-44 years by 10% to no more than 1,458 cases per 100,000 population.
(Data Source: NYS STD Surveillance System)
Objective 3.3:
By December 31, 2017, reduce the case rate of primary and secondary Syphilis by 10%, to no more than 10.1 cases per 100,000 for males and 0.4 cases per 100,000 for females.
(Data Source: NYS STD Surveillance System)
Objective 3.4:
By December 31, 2017, reduce the congenital Syphilis case rate by 10% to no more than 9.6 cases per 100,000 live births.
(Data Source: NYS STD Surveillance System)

Goal #4: Decrease HIV and STD disparities in New York State.

Objective 4.1:
By December 31, 2017, decrease the gap in rates of new HIV diagnoses by 25% between Whites and Blacks to 45.7 per 100,000 population, and between Whites and Hispanics to 22.3 per 100,000.
(Data Source: NYS HIV Surveillance System)
Objective 4.2:
By December 31, 2017, meet the National HIV/AIDS Strategy benchmarks for viral suppression among non-white racial and ethnic groups and men who have sex with men (MSM).
(Data Source: NYS HIV Surveillance System)

Goal #5: Increase and coordinate hepatitis C (HCV) prevention and treatment capacity in NYS.

Objective 5.1:
By December 31, 2017, increase by 10% the percentage of New Yorkers reporting ever having been tested for HCV.
(Data Source: Behavioral Risk Factor Surveillance System)
Objective 5.2:
By December 31, 2017, increase the percentage of people that screen positive for HCV who also receive an HCV diagnostic test to 50%.
(Data Source: NYS HIV Surveillance System)
Objective 5.3:
By December 31, 2017, increase the percentage of HCV diagnosed Medicaid recipients who are in care to 50%.
(Data Source: Medicaid)

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Goal #1: Prevent HIV and STDs - Interventions for Action

Goal #1: Decrease HIV morbidity in New York State.
Levels of Health Impact Pyramid* Interventions
Counseling and Education
  • Increase peer-led interventions around HIV care navigation, testing and other services.4
  • Launch educational campaigns to improve health literacy and patient participation in health care, especially among high-need populations, including Hispanics and lesbian, gay, bisexual and transgender (LGBT) groups.5
Clinical Interventions
Long-Lasting Protective Interventions
Changing the Context to Make Individuals' Decisions Healthy
  • Design all HIV interventions to address at least two co-factors that drive the virus, such as homelessness, substance use, history of incarceration and mental health.6
  • Assure cultural competency training for providers, including gender identity and disability issues.7
  • Implement quality indicators for all parameters of treatment for all health plans operating in New York State. An example would be raising the percentage of HIV-positive patients seen in HIV primary care settings screened for STDs per clinical guidelines.8
Socioeconomic Factors
* Frieden T., "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 2010; 100(4): 590-595

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Goal #2: Increase early access to and retention in HIV care in New York State

Goal #2: Increase early access to and retention in HIV care in New York State.
Levels of Health Impact Pyramid* Interventions
Counseling and Education
  • Launch educational campaigns to teach patients how to navigate the recently re-designed Medicaid program and Affordable Care Act provisions.9
  • Empower people living with HIV/AIDS to help themselves and others around issues related to prevention and care.9
  • Educate patients to know their right to be offered HIV testing in hospital and primary care settings.10,11
Clinical Interventions
  • Maximize the use of the health home model to all eligible at-risk persons before they suffer severe health consequences.12
Long-Lasting Protective Interventions
  • Introduce generic HIV drugs to the ADAP and Medicaid formularies as they come off patent between 2013 and 2017.13
Changing the Context to Make Individuals' Decisions Healthy
  • Advocate for HIV testing rates as an eQARR measure and recommend that the National Committee for Quality Assurance (NCQA) add HIV testing to the list of HEDIS measures, or make the proportion of eligible patients screened for HIV a published quality indicator for all Article 28 facilities.14
  • Bolster linkage to care efforts and transitional planning through improved delivery of HIV/AIDS care information to newly diagnosed patients.15
  • Consider removing written consent provisions for HIV testing except for persons in the criminal justice system.16
Socioeconomic Factors
  • Offer HIV services in settings that can assist with linkage to housing, nutrition, employment, and transportation services.17
  • Advocate for an insurance safety net that includes populations not currently covered under ACA (e.g., undocumented immigrants).18
  • Consider requiring HIV testing to be covered by all insurance programs without co-payments or deductibles.19
* Frieden T., "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 2010; 100(4): 590-595

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Goal #3: Decrease STD morbidity in New York State

Goal #3: Decrease STD morbidity in New York State.
Levels of Health Impact Pyramid* Interventions
Counseling and Education
  • Ensure that all students attending public and charter schools in New York receive comprehensive, evidence-based, age-appropriate, medically accurate, unbiased sex education.20
  • Provide oversight to ensure school compliance with recommended comprehensive sexual health education.21
  • Promote interventions directed at high-risk individual patients, such as therapy for depression.22
  • Promote group or behavioral change strategies in conjunction with HIV/STD efforts.23
Clinical Interventions
Long-Lasting Protective Interventions
Changing the Context to Make Individuals' Decisions Healthy
  • Assure that consent issues for minors are not a barrier to HPV vaccination.24
  • Develop STD diagnosis and treatment capacity in settings beyond government clinics.25
  • Update STD statute to assure appropriate data-sharing between HIV and STD registries with providers of record, and between and within State and local health departments.26
  • Establish formal partnerships between schools and/or school clinics, and community-based organizations to deliver health education and support teacher training programs.27
Socioeconomic Factors
* Frieden T., "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 2010; 100(4): 590-595

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Goal #4: Decrease HIV and STD disparities in New York State

Goal #4: Decrease HIV and STD disparities in New York State.
Levels of Health Impact Pyramid* Interventions
Counseling and Education
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.28
  • Use social media and social network strategies to engage persons at risk.29
Clinical Interventions
Long-Lasting Protective Interventions
  • Work with local police and prosecutors to end stop-and-frisk condom seizures and the introduction of the possession of condoms as evidence of prostitution and prostitution-related offenses.30
  • Revise and update provisions of the State STD statute around forced isolation, treatment and imprisonment to be consistent with current public health practice.31
Changing the Context to Make Individuals' Decisions Healthy
  • Diversify funding for STD screening and treatment so providers can receive payment when and where an uninsured patient seeks treatment.32
  • Help public health professionals implement existing treatment guidelines by establishing systems such as computerized decision-making support or in-service on new intake.33
  • Increase scope of condom access programs.34
Socioeconomic Factors
  • Increase the number and percentage of minority children who receive a quality education or, possibly, who graduate from high school.35
* Frieden T., "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 2010; 100(4): 590-595

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Goal #5: Increase and coordinate Hepatitis C Virus (HCV) prevention and treatment capacity In New York State

Goal #5: Increase and coordinate Hepatitis C Virus (HCV) prevention and treatment capacity In New York State.
Levels of Health Impact Pyramid* Interventions
Counseling and Education
  • Develop treatment literacy materials for HCV patients.36
  • Support social media and mass-marketing campaigns related to HCV.37
Clinical Interventions
  • Expand HCV rapid testing, especially in HIV testing sites or where HIV testing is done routinely.38
  • Evaluate and support opportunities to integrate HCV diagnosis and treatment into primary care, HIV clinics, prison health services, syringe exchange programs and oral substitution-drug therapy programs.39
  • Make testing for HCV a routine part of primary care visits.39
  • Establish a network of liver scan and HCV viral load monitoring sites for referrals of chronically infected HCV patients.40
  • Develop an HCV data registry, similar to the HIV registry.41
  • Improve the HCV surveillance system.41
Long-Lasting Protective Interventions
  • Remove age restrictions on the purchase of syringes without a prescription.42
Changing the Context to Make Individuals' Decisions Healthy
  • Increase geographic coverage and participation in syringe exchange programs.43
  • Advocate for enhanced federal funding for a national safety net program including HCV.44
Socioeconomic Factors
* Frieden T., "A Framework for Public Health Action: The Health Impact Pyramid". American Journal of Public Health. 2010; 100(4): 590-595

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Interventions and Activities by Sector

Change can be made across all sectors to improve health outcomes for people living with HIV/AIDS. Below are examples of how your sector can make a difference.

Healthcare Delivery System

Goals #1-4:
Decrease HIV and STD morbidity and disparities; increase early access to and retention in HIV care.
  • Increase peer-led interventions around HIV care navigation, testing and other services.
  • Launch educational campaigns to improve health literacy and patient participation in health care, especially among high-need populations, including Hispanics, and lesbian, gay, bisexual and transgender (LGBT) groups.
  • Design all HIV interventions to address at least two co-factors that drive the virus, such as homelessness, substance use, history of incarceration and mental health.
  • Assure cultural competency training for providers, including gender identity and disability issues.
  • Implement quality indicators for all parameters of treatment for all health plans operating in New York State. An example would be raising the percentage of HIV-positive patients seen in HIV primary care settings who are screened for STDs per clinical guidelines.
  • Launch educational campaigns to teach patients how to navigate the recently redesigned Medicaid program and Affordable Care Act provisions.
  • Empower people living with HIV/AIDS to help themselves and others around issues related to prevention and care.
  • Educate patients to know their right to be offered HIV testing in hospital and primary care settings.
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.
  • Use social media and social network strategies to engage persons at risk.
  • Revise and update provisions of the State STD statute around forced isolation, treatment and imprisonment to be consistent with current public health practice.
  • Help public health professionals implement existing treatment guidelines by establishing systems such as computerized decision-making support or in-service on new intake.
  • Increase scope of condom access programs.
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.
  • Develop STD diagnosis and treatment capacity in settings beyond government clinics.
  • Ensure that all students attending public and charter schools in New York State receive comprehensive, evidence-based, age-appropriate, medically accurate, unbiased sex education.
  • Provide oversight to ensure school compliance with recommended comprehensive sexual health education.
  • Promote interventions directed at high-risk individual patient, such as therapy for depression.
  • Promote group or behavioral change strategies in conjunction with HIV/STD efforts.
  • Assure that consent issues for minors are not a barrier to HPV vaccination.
  • Update STD statute to assure appropriate data sharing between HIV and STD registries with providers of record, and between and within State and local health departments.
  • Establish formal partnerships between schools and/or school clinics, and community-based organizations to deliver health education and support teacher training programs.
Goal #5:
Increase and coordinate HCV prevention and treatment capacity.
  • Develop treatment literacy materials for HCV patients.
  • Support social media and mass marketing campaigns related to HCV.
  • Expand HCV rapid testing, especially in HIV testing sites or where HIV testing is done routinely.
  • Evaluate and support opportunities to integrate HCV diagnosis and treatment into primary care, HIV clinics, prison health services, syringe exchange programs and oral substitution-drug therapy programs.
  • Make testing for HCV a routine part of primary care visits.
  • Establish a network of liver scan and HCV viral load monitoring sites for referrals of chronically infected HCV patients.
  • Develop an HCV data registry, similar to the HIV registry.
  • Remove age restrictions on purchasing syringes without a prescription.
  • Increase geographic coverage and participation in syringe exchange programs.
  • Advocate for enhanced federal funding for a national safety net program, including HCV.

Employers, Businesses And Unions

Goal #3:
Increase early access to and retention to HIV care.
  • Consider requiring HIV testing to be covered by all insurance programs without co-payments or deductibles.

Media

Goals #1-4:
Decrease HIV and STD morbidity and disparities, increase early access and retention to HIV care.
  • Launch educational campaigns to improve health literacy and patient participation in health care, especially among high-need populations, including Hispanics, and lesbian, gay, bisexual and transgender (LGBT) groups.
  • Launch educational campaigns to teach patients how to navigate the recently redesigned Medicaid program and Affordable Care Act provisions.
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.
  • Use social media and social network strategies to engage persons at risk.

Community-Based Organizations

Goals #1-4:
Decrease HIV and STD morbidity and disparities, increase early access and retention to HIV care.
  • Increase peer-led interventions around HIV care navigation, testing and other services.
  • Launch educational campaigns to improve health literacy and patient participation in health care, especially among high-need populations including, Hispanics, and lesbian, gay, bisexual and transgender (LGBT) groups.
  • Assure cultural competency training for providers, including gender identity and disability issues.
  • Launch educational campaigns to teach patients how to navigate the recently redesigned Medicaid program and Affordable Care Act provisions.
  • Empower people living with HIV/AIDS to help themselves and others around issues related to prevention and care.
  • Educate patients to know their right to be offered HIV testing in hospital and primary care settings.
  • Maximize the use of the health home model to all eligible at-risk persons before they suffer severe health consequences.
  • Advocate for HIV testing rates as an eQARR measure and recommend that the National Committee for Quality Assurance (NCQA) add HIV testing to the list of HEDIS measures, or make the proportion of eligible patients screened for HIV a published quality indicator for all Article 28 facilities.
  • Bolster linkage to care efforts and transitional planning through improved delivery of HIV/AIDS care information to newly diagnosed patients.
  • Consider removing written consent provisions for HIV testing except for persons in the criminal justice system.
  • Offer HIV services in settings that can assist with linkage to housing, nutrition, employment, and transportation services.
  • Advocate for an insurance safety net that includes populations not currently covered under the ACA (e.g. undocumented immigrants).
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.
  • Use social media and social network strategies to engage persons at risk
  • Work with local police and prosecutors to end stop-and-frisk condom seizures and the introduction of the possession of condoms as evidence of prostitution and prostitution-related offenses.
  • Revise and update provisions of the State STD statute around forced isolation, treatment and imprisonment to be consistent with current public health practice.
  • Help public health professionals implement existing treatment guidelines by establishing systems such as computerized decision-making support or in-service on new intake.
  • Increase scope of condom access programs.
  • Ensure that all students attending public and charter schools in New York receive comprehensive, evidence-based, age-appropriate, medically accurate, unbiased sex education.
  • Provide oversight to ensure school compliance with recommended comprehensive sexual health education.
  • Promote interventions directed at high-risk individual patient, such as therapy for depression.
  • Promote group or behavioral change strategies in conjunction with HIV/STD efforts.
  • Assure that consent issues for minors are not a barrier to HPV vaccination.
  • Update STD statute to assure appropriate data sharing between HIV and STD registries with providers of record, and between and within State and local health departments.
  • Establish formal partnerships between schools and/or school clinics, and community-based organizations to deliver health education and support teacher training programs.
Goal #5:
Increase and coordinate HCV prevention and treatment capacity.
  • Develop treatment literacy materials for HCV patients.
  • Expand HCV rapid testing, especially in HIV testing sites or where HIV testing is done routinely.
  • Evaluate and support opportunities to integrate HCV diagnosis and treatment into primary care, HIV clinics, prison health services, syringe exchange programs and oral substitution-drug therapy programs.
  • Make testing for HCV a routine part of primary care visits.
  • Increase geographic coverage and participation in syringe exchange programs.
  • Advocate for enhanced federal funding to develop a national safety net program that includes HCV.

Other Governmental Agencies

Goals #1, 2:
Decrease HIV and STD morbidity and disparities
  • Increase the number and percentage of minority children who receive a quality education, or possibly, who graduates from high school. Governmental (G) and Non-Governmental

Governmental (G) and Non-Governmental (NG) Public Health

Goals #1-4:
Decrease HIV and STD morbidity and disparities, increase early access and retention to HIV care.
  • Increase peer-led interventions around HIV care navigation, testing and other services. (G) (NG)
  • Launch educational campaigns to improve health literacy and patient participation in health care, especially among high-need populations, including Hispanics, and lesbian, gay, bisexual and transgender (LGBT) groups. (G) (NG)
  • Ensure that all students attending public and charter schools in New York receive comprehensive, evidence-based, age-appropriate, medically accurate, unbiased sex education. (G) (NG)
  • Provide oversight to ensure school compliance with recommended comprehensive sexual health education. (G) (NG)
  • Promote interventions directed at high-risk individual patients, such as therapy for depression. (G) (NG)
  • Promote group or behavioral change strategies in conjunction with HIV/STD efforts. (G) (NG)
  • Assure that consent issues for minors are not a barrier to HPV vaccination. (G) (NG)
  • Update STD statute to assure appropriate data sharing between HIV and STD registries with providers of record, and between and within State and local health departments. (G) (NG)
  • Design all HIV interventions to address at least two co-factors that drive the virus, such as homelessness, substance use, history of incarceration and mental health. (G)
  • Assure cultural competency training for providers, including gender identity and disability issues. (G) (NG)
  • Implement quality indicators for all parameters of treatment for all health plans operating in New York State. An example would be raising the percentage of HIV-positive patients seen in HIV primary care settings who are screened for STDs per clinical guidelines. (G)
  • Launch educational campaigns to teach patients how to navigate the recently re-designed Medicaid program and Affordable Care Act provisions. (G) (NG)
  • Empower people living with HIV/AIDS to help themselves and others around issues related to prevention and care. (G) (NG)
  • Educate patients to know their right to be offered HIV testing in hospital and primary care settings. (G) (NG)
  • Maximize the use of the health home model to all eligible at-risk persons before they suffer serious health consequences. (G) (NG)
  • Introduce generic HIV drugs to the ADAP and Medicaid formularies as they come off patents between 2013 and 2017. (G)
  • Advocate for HIV testing rates as an eQARR measure and recommend that the National Committee for Quality Assurance (NCQA) add HIV testing to the list of HEDIS measures, or make the proportion of eligible patients screened for HIV a published quality indicator for all Article 28 facilities. (G) (NG)
  • Bolster linkage to care efforts and transitional planning through improved delivery of HIV/AIDS care information to newly diagnosed patients. (G) (NG)
  • Consider removing written consent provisions for HIV testing except for persons in the criminal justice system. (G)
  • Offer HIV services in settings that can assist with linkage to housing, nutrition, employment and transportation services. (G) (NG)
  • Advocate for an insurance safety net that includes populations not currently covered under the ACA (e.g. undocumented migrants). (G) (NG)
  • Use social media and social network strategies to engage persons at risk. (G) (NG)
  • Revise and update provisions of the State STD statute around forced isolation, treatment and imprisonment to be consistent with current public health practice. (G)
  • Help public health professionals implement existing treatment guidelines by establishing systems such as computerized decision-making support or in-service on new intake. (G)
  • Increase scope of the condom access program.
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training (G) (NG)
  • Develop STD diagnosis and treatment capacity in settings beyond government clinics. (G)
  • Establish formal partnerships between schools and/or school clinics, and community-based organizations to deliver health education and support teacher training programs. (G) (NG)
Goal #5:
Increase and coordinate HCV prevention and treatment capacity.
  • Improve the HCV surveillance system. (G)
  • Develop treatment literacy materials for HCV patients. (G) (NG)
  • Support social media and mass-marketing campaigns related to HCV. (G)
  • Expand HCV rapid testing, especially in HIV testing sites or where HIV testing is done routinely. (G) (NG)
  • Evaluate and support opportunities to integrate HCV diagnosis and treatment into primary care, HIV clinics, prison health services, syringe exchange programs and oral substitution-drug therapy programs. (G) (NG)
  • Make testing for HCV a routine part of primary care visits. (G)
  • Establish a network of liver scan and HCV viral load monitoring sites for referrals of chronically infected HCV patients. (G)
  • Develop an HCV data registry, similar to the HIV registry. (G)
  • Remove age restrictions on the purchase of syringes without a prescription. (G)
  • Increase geographic coverage and participation in syringe exchange programs. (G) (NG)
  • Advocate for enhanced federal funding for a national safety net program, including HCV. (G) (NG)

Policymakers and Elected Officials

Goals #1-4:
Decrease HIV and STD morbidity and disparities, increase early access and retention to HIV care.
  • Consider requiring HIV testing to be covered by all insurance programs without co-payments or deductibles.
  • Advocate for an insurance safety net that includes populations not currently covered under the ACA (e.g. undocumented immigrants.)
  • Consider removing written consent provisions for HIV testing except for persons in the criminal justice system.
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.
  • Diversify funding for STD screening and treatment so providers can receive payment when and where an uninsured patient seeks treatment.
  • Increase scope of condom access programs.
  • Work with local police and prosecutors to end stop-and-frisk condom seizures and the introduction of the possession of condoms as evidence of prostitution and prostitution-related offenses.
  • Revise and update provisions of the State STD statute around forced isolation, treatment and imprisonment to be consistent with current public health practice.
  • Increase the number or percentage of minority children who receive a quality education.
  • Ensure that all students attending public and charter schools in New York receive comprehensive, evidence-based, age-appropriate, medically accurate, unbiased sex education.
  • Provide oversight to ensure school compliance with recommended comprehensive sexual health education.
  • Promote group or behavioral change strategies in conjunction with HIV/STD efforts.\
  • Assure that consent issues for minors are not a barrier to HPV vaccination.
  • Update STD statute to assure appropriate data sharing between HIV and STD registries with providers of record, and between and within State and local health departments.
Goal #5:
Increase and coordinate HCV prevention and treatment capacity.
  • Advocate for enhanced federal funding for a national safety net program, including HCV.
  • Remove age restrictions on purchase of syringes without a prescription.
  • Make testing for HCV a routine part of primary care visits.

Communities

Goal #1-4:
Decrease HIV and STD morbidity and disparities; increase early access and retention to HIV care.
  • Assure cultural competency training for providers, including gender identity and disability issues.
  • Launch educational campaigns to teach patients how to navigate the recently re-designed Medicaid program and Affordable Care Act provisions.
  • Empower people living with HIV/AIDS to help themselves and others around issues related to prevention and care.
  • Educate patients to know their rights to be offered HIV testing in hospital and primary care settings.
  • Bolster linkage to care efforts and transitional planning through improved delivery of HIV/AIDS care information to newly diagnosed patients.
  • Offer HIV services in settings that can assist with linkage to housing, nutrition, employment, and transportation services.
  • Advocate for an insurance safety net that includes populations not covered under the ACA (e.g. undocumented immigrants).
  • Implement Statewide anti-stigma initiative across all individual and community levels with money and other resources.
  • Use social media and social network strategies to engage persons at risk.
  • Work with local police and prosecutors to end stop-and-frisk condom seizures and the introduction of the possession of condoms as evidence of prostitution and prostitution-related offenses.
  • Revise and update provisions of the State STD statute around forced isolation, treatment and imprisonment to be consistent with current public health practice.
  • Increase scope of condom access programs.
  • Ensure that all students attending public and charter schools in New York State receive comprehensive, evidence-based, age-appropriate, medically accurate, unbiased sex education.
  • Provide oversight to ensure school compliance with recommended comprehensive sexual health education.
  • Increase the number and percentage of minority children who receive a quality education, or possibly, who graduate from high school.
  • Promote interventions directed at high-risk individual patient, such as therapy for depression.
  • Promote group or behavioral change strategies in conjunction with HIV/STD efforts.
  • Assure that consent issues for minors are not a barrier to HPV vaccination.
  • Establish formal partnerships between schools and/or school clinics, and community-based organizations to deliver health education and support teacher training programs.
Goal #5:
Increase and coordinate HCV prevention and treatment capacity.
  • Develop treatment literacy materials for HCV patients.
  • Evaluate and support opportunities to integrate HCV diagnosis and treatment into primary care, HIV clinics, prison health services, syringe exchange programs and oral substitution-drug therapy programs.
  • Remove age restrictions on purchasing syringes without a prescription.
  • Increase geographic coverage and participation in syringe exchange programs.
  • Advocate for enhanced federal funding for a national safety net program, including HCV.

Philanthropy

Goals #1-4:
Decrease HIV and STD morbidity and disparities, increase early access and retention to HIV care.
  • Launch educational campaigns to improve health literacy and patient participation in health care, especially among high-need populations including, Hispanics and lesbian, gay, bisexual and transgender (LGBT) groups.
  • Launch educational campaigns to teach patients how to navigate the recently re-designed Medicaid program and Affordable Care Act provisions.
  • Educate patients to know their right to be offered HIV testing in hospital and primary care settings.
  • Implement a Statewide anti-stigma initiative across all individual and community levels with money and other resources for social marketing and training.
  • Diversify funding for STD screening and treatment so providers can receive payment when and where an uninsured patient seeks treatment.

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