STD Testing in New York

New York STD Data

STD data & statistics in New York

NY rate of syphilis and chlamydia is one of the highest in the United States, as per a report from the National Council for Home Safety and Security (NCHSS) using the year 2017 data provided by CDC STD Surveillance Report. CDC claims that several factors are responsible for increasing the rate of STDs in the state. These include limited access to STD prevention/care, cuts to programs at the state and local levels, and a decreased use of condoms. These issues continue to drive an increase in disease prevalence. Furthermore, about half of the STD infections are identified in people aged 15-24.

In NY, the primary and secondary syphilis rate in 2011 was 5.6/100,000 people, which rose to 10.2/100,000 by 2015. In 2015, the state ranked 7th in primary/secondary syphilis rates, 12th in overall chlamydia rate (524/100,000), and 16th in gonorrheal infections (129.4/100,000) among the 50 US states. Between 2011 and 2015, NY reported 66 cases of congenital syphilis.

Among females, the reported rate of chlamydial infection was over 650 cases/100,000 females. This rate was around 1.7 times higher than males that reported 389.8 cases/100,000 males.

By 2018, the number of STD cases increased considerably. CDC ranked NY 10th, 10,8th 10th, and 24th among the 50 US states for total chlamydia, gonorrhea, primary/secondary syphilis, and congenital syphilis diagnoses, respectively. The highest rates of STIs (sexually transmitted infections) in the state was noticed among the youth, bisexual, gay, and MSM (men who have sex with men).

As far as ethnicities are concerned, the largest share of new STD diagnoses was reported among non-Hispanic African-Americans. Moreover, chlamydia was the most commonly reported STI in the state with approx. 119,670 diagnoses, which is 2.4% higher than the 2017 statistics and the largest number of diagnoses since chlamydial infection became reportable in 2000. Females aged 15-24 were at the highest risk of getting infected with chlamydia.

By 2018, the rate of gonorrheal infection increased 9.4% with 37,322 diagnoses. The percentage of increase was higher among males than females with 10% and 5.6%, respectively. Moreover, males aged between 20 and 34 and females aged 15 and 24 reported the highest proportion of cases.

Primary/secondary syphilis diagnoses rose to 12.8% in 2018, and 93% of the cases were reported among males. Despite the overall higher rate of diagnoses among males, primary/secondary syphilis has quadrupled among females since 2014.

The Bronx was at number 1 both in NY's statewide and citywide comparison the higher rates for STIs with over 23,700 reported cases (1.903 cases/100,000 people). Brooklyn had the highest rate of STDs infection in the country. Out of 100,000 residents of Brooklyn, around 817.6 have chlamydia, 18.7 have syphilis, and 285.9 have a gonorrheal infection. Its number of chlamydia cases is the 6th highest in the country.

However, this data represents just a portion of the actual STDs burden in NY. Many syphilis, gonorrhea, and chlamydia cases remain undiagnosed and hence, unreported. Many other STIs like genital herpes, human papillomavirus, and trichomoniasis aren't reported at all.

Testing for HIV is Vital

HIV testing is fundamental for slowing down the spread of HIV infection. However, a majority of people remain unaware of their health status. That's why they are least likely to take precautionary measures that would help prevent virus transmission to others, and the rate of HIV cases keeps inclining.

The Centers for Disease Control and Prevention (CDC) reported that 85% of over 1 million US citizens living with HIV are aware of their condition. About 40% of the new infections are transmitted by individuals who aren't aware that they are the virus's carriers. People who remain undiagnosed are at a higher risk of developing several life-threatening ailments, including cancer, organ failure, and AIDS.

CDC suggests that testing is the most significant first step towards preventing HIV transmission. According to the agency's revised HIV prevention guidelines, everyone aged between 13 and 64 must undergo testing and make it a part of their regular health care. Those at a higher risk must get tested annually.

For people with undiagnosed HIV, testing is the first step in maintaining a healthy life and preventing HIV transmission. The National Institutes of Health clinical trial revealed that early HIV diagnosis and treatment could prove to be immensely beneficial for those infected with the virus. They are at an increased personal health advantage than those who are diagnosed late or remain undiagnosed.

HIV tests are usually quite accurate. However, no test is efficient enough to detect HIV immediately after a person gets infected. That's why the sooner it is detected, the better chances of the person enjoying a healthy life again would be.

There are currently three types of HIV diagnostic tests available, including NAT (nucleic acid tests), Antibody Tests, and Antigen/Antibody Tests. The initial HIV test would be either an antibody or an antigen/antibody test.

In case the initial test is a self-test or a rapid test, and its result is positive, the individual must immediately visit a health care provider for follow-up testing. Conversely, if the initial test is conducted at a laboratory, and its result is positive, the lab will carry out the follow-up testing using the same blood samples.

New York has been able to reduce the number of HIV cases per year due to its dedicated efforts to expand the network of treatment. It typically begins with an effective citywide testing program. So far, the state has expanded the testing web to community health centers, businesses, colleges, hospitals, and churches.

By the end of 2017, the state dropped to number four in the number of new diagnoses with 2769/100,000 people and ranked 9th in the rate of new HIV diagnoses with 12.7/100,000 people. This shows the effectiveness of early testing addressing the HIV epidemic across the state.

HIV Rates in New York

For decades, New York State has remained the HIV epidemic's epicenter in the USA. However, there has been a considerable reduction in the number of new cases within the past few years. In 2018, around 127,162 people were living with HIV in New York. The same year, 2,456 people were diagnosed with HIV. However, the state still has more persons living with HIV than any other US state.

In the state, New York City is home to the largest HIV population, apart from being the largest city in the country. In 2018, around 100,644 people in the city were infected with HIV, while 1,812 individuals were diagnosed with the virus. On the other hand, Brooklyn has the greatest number of cases than any other borough, despite that the virus has reached a historic decline across New York City.

About one-third of all the cases in 1917 were diagnosed in Brooklyn with 558 new cases. This number was approx—100 more than other boroughs. The Bronx reported 440 cases, Queens had 358, Manhattan had 375, and Staten Island had 31 cases in 2018. The highest HIV diagnosis rates in 2018 were reported in Crown Heights and Lower Manhattan.

Research suggests that there is a strong link between high HIV rates and low-income areas in New York. Such as northern Brooklyn and upper Manhattan, both recorded higher rates of HIV infected people, and the patients had high levels of poverty. Similarly, African-Americans and Latinos are the highly impacted demography group as 8 out of 10 HIV carriers living in varying poverty levels were either black or Latino. Out of the 1917 diagnoses, 1761 lived in poverty. Eight hundred seventy-nine of them were African-Americas, 697 were Latinas, and 219 were White.

On the whole, New York City has observed an incredible 67% reduction in the number of new cases since 2001.

State Initiatives to Reduce STDs

In 1984, the AIDS Institute established the Community Service Programs (CSPs), NY's first community-based institution that provided HIV/STD/Hepatitis prevention facility and client support services.

The CSP was later renamed Regional Prevention and Support Programs. The institute receives funding from the state and serves as a foundation for strengthening the region's capacity to deal with the STDs crisis. The agency is responsible for building and expanding HIV/STD/HCV-related programs across NY.

The 14 RPSS providers have a significant role in implementing the AIDS Institute and Division of HIV/STD/HCV Prevention strategies. These also happen to be crucial partners in achieving the Ending the Epidemic goals. Ending the Epidemic (ETE) is a revolutionary initiative launched by the health ministry in 2014 to prevent HIV transmission rate by reducing the number of STDs cases across the region.

NY provides funding to the Regional Prevention and Support Programs for targeted client engagement, targeted HIV testing, linking the patients to care services, STD/HCV screening, behavioral counseling, and offering effective interventions for people living with HIV, their families.

Additionally, the agency provides guidance for HIV-negative people to prevent them from engaging in high-risk sexual behaviors. It is also the agency's responsibility to offer navigation and linkage to care and ensure comprehensive PrEP/PEP education and screening. Promoting condom use, educating HIV-positive individuals and their partners, easy access to condoms, treatment adherence, and additional supportive services such as transportation are also part of its plan.

The NY health department offers prevention interventions and client services in the criminal justice and community settings. It also addresses the needs of those living with HIV and those at risk of HIV/STD/HCV, including young men of color, men who have sex with men, heterosexual men, substance users, transgender males/females, and females engaged in high-risk behaviors. The department must offer supportive services after considering the unique cultural and social needs of the particular demography group.

Expected outcomes for 2020-2021 from state intervention strategies including reducing disease incidence, decreasing the rate of HIV/STD/HCV transmission, increasing the proportion of HIV/STD/HCV -positive people who are aware of their status, and increasing the proportion of infected people to prevention, treatment, and medical care services.

State Initiatives to Reduce HIV

New York was the first jurisdiction that launched a statewide initiative to eliminate HIV/AIDS. The state launched the Ending the Epidemic Initiative (ETE) in 2014, which has been very effective and yielded historic gains. Through this program, the government aims to end AIDS by decreasing the number of people living with HIV and offer effective treatment options. New York City is the country's first city to achieve the initial goal of reaching a 90% threshold in the diagnosis treatment and suppression as indicated in the Fast-Track Cities initiative.

Since 2014, over 300 metropolises have signed the 2020 challenge in New York, 90% of people living with HIV are aware of their status, 90% of diagnosed HIV infected individuals are receiving proper therapy, and 90% of those receiving treatment have achieved viral suppression.

New York once used to be the epicenter for HIV transmission in the US. As per the recent data, New York City has over 90% of HIV-positive residents already diagnosed and receiving treatment. The state has recorded a downward trend in the number of new HIV cases within the past three years.

This reduction could be partly attributed to New Yorkers as around 32,000 took PrEP (pre-exposure prophylaxis) in 2018, which was 32% more than in 2015. That's how the state managed to reduce the number of new HIV cases from 2400 to less than 2000 in 2019-2020. City surveillance report suggests that despite 17% more New Yorkers living with HIV (approx. 125,000) in comparison to 2001, new diagnoses have reduced in almost every demographic group.

An integral part of the government's plan to curb HIV transmission is increasing medication availability. The government has allocated $20m in state funding for the ETE plan in this regard. According to the latest guidelines from the state government, New York health insurers will start covering PrEP drugs with co-pay. When someone tests positive, the individual is assigned a physician and a case manager. Sometimes the medication is covered under Medicaid, private insurance, or the state's AIDS Drug Assistance Program.

In 2010, the state amended its HIV testing law, and providers must offer tests to individuals aged 13 or above as a part of their routine health care. In 2014, the New York lawmakers also eliminated the need to obtain written consent to carry out an HIV test.

Through ETE, the government hopes to achieve zero HIV transmission via injection drug use and zero AIDS mortality rate. The initiative encompasses three key goals- identifying and linking undiagnosed people with HIV, retaining infected individuals in care, and facilitating improvement in access to PrEP to people at higher risk of contracting the virus.

Sex Education in New York

Young adults and teenagers are disproportionally affected by STDs in NY. Although this age group comprises around 14% of the NY population, it amounts to a considerable chunk of total STDs cases, with 3 out of 5 patients reported among the youth.

Most STDs can have serious health consequences if left untreated, and a majority of them are asymptomatic. That's why comprehensive sex education is fundamental to prevent the youth from getting STDs. Reportedly, by age 18, around 1 in 4 sexually active teenagers in NY will have an STD.

The NY law required all students from grades kindergarten to 12 to obtain health education. Students in higher grades are required to have HIV/AIDS lessons annually.

However, in NY, public schools aren't required by law to make sexual health education as it isn't a part of the New York State Education Department's (NYED) 's health education mandate. From grade k through 12, schools are expected to offer basic HIV/AIDS education, but offering sex-ed is left to local school districts.

As per the law, elementary school classroom instruction must include a sequential sex-ed program for all students. But state regulations haven't specified the feasible number of lessons or duration of instructional time. In 2011, the NYCDOE made sex-ed a mandatory part of educational courses in middle and high schools. NY required one credit or 54 hours of health education for middle schoolers and high schoolers from grades 9-12.

NY's sex-ed policy has a drawback. It only instructs teachers to offer such activities that contribute to students' development of self-worth, respect for their bodies and making constructive decisions about their emotional, social, and physical health. The focus of sex-ed in NY for lower grades is to encourage pupils to become self-reliant in resolving their health issues.

Age, Gender, and Ethnic Disparities of HIV

In New York, African-Americans and Hispanics or Latinos comprise over three-quarters of the total HIV cases diagnosed in 2017. As per the year 2018 statistics, of all the people living with HIV in the state, 71% were males and 28% females. Regarding the racial/ethnic disparity, 37% of the infected individuals were blacks, 35% Hispanics/Latinos, and only 17% were white.

Age-wise, people above 55 years of age accounted for the highest number of cases with 42%, followed by the 45-54 age group that reported 26% cases in 2018. People between the ages 13-24 had the lowest number of cases (2.2%), while the 24-34 and 34-44 age group reportedly had 12% and 15% of all new diagnoses. Black men who have sex with meh were the most at-risk community regarding the rate of HIV transmission. While heterosexual black females were the most at-risk group among females.