New York state has been focused on HIV, notably on addressing how COVID-19 affects the state’s efforts to end the HIV epidemic and on promoting pre-exposure prophylaxis, or PrEP, the daily tablet that prevents HIV-negative people from contracting HIV.
This week, October 25 to 31, marks the second annual PrEP Aware Week, a social media campaign spearheaded by the New York State Department of Health. This year’s theme, “This Is Why I PrEP,” highlights the fact that people choose to take PrEP for a variety of reasons. And because this year’s event takes place amid the COVID-19 pandemic, the health department is distributing 15,000 PrEP Aware face masks.
“Though our attention is focused on the [COVID-19] pandemic response, we cannot forget other important public health measures, like PrEP,” said New York state’s health commissioner, Howard Zucker, MD, JD, in a press release. “PrEP is an important pillar of New York state’s effort to End the AIDS epidemic, and events like PrEP Aware Week help advance our message that PrEP is widely available, affordable and effective.”
To learn more about PrEP Aware Week and related information about HIV prevention, visit PrEPforSex.org.
PrEP was just one of many topics discussed during an October 22 webinar titled “COVID-19’s Impact on New York’s Plan to End HIV: A Discussion.” (You can watch a video of the talk at the top of this article.) Nonprofit community health plan Amida Care and LGBT publication Gay City News hosted the discussion.
Moderated by Paul Schindler, editor-in-chief of Gay City News, the discussion included David Collymore, MD, the chief medical officer and senior vice president of clinical affairs at Acacia Network; Anisha Gandhi, PhD, MPH, the acting assistant commissioner and director of racial equity and social justice initiatives for the New York City health department’s Bureau of HIV; Asa Radix, MD, senior director of research and education at the Callen-Lorde Community Health Center; Ahmed Mohamed, a civic engagement and community organizer at the New Pride Agenda as well as a PrEP consumer; Johanne Morne, MS, director of the New York State Department of Health’s AIDS Institute; and Doug Wirth, MSW, president and CEO of Amida Care.
New York state saw many improvements on the HIV front in 2018 and 2019, before COVID-19 hit. In fact, last October, Governor Andrew Cuomo announced that the state was on track to end AIDS by 2020, in part because of a record low number of new HIV cases and a huge spike in people taking PrEP.
Panelists discussed how their organizations have had pivot to telehealth and virtual offerings due to the new coronavirus but also noted that many clients preferred in-person meetings because their facilities offered affirmative and safe environments. This was particularly true for LGBT clients.
The health experts said they observed a drop in PrEP prescriptions since the start of the COVID-19 crisis and still encounter inequities in PrEP uptake. “We continue to see…that PrEP is being utilized at greater rates among men who have sex with men who are white,” noted Ghandi, as reported in a Gay City News article on the webinar. “We are not seeing that same kind of progress with PrEP uptake among men who have sex with men who are Black or Latino, among transgender women, and cisgender women, even though they continue to make up a significant proportion of new diagnoses.”
To continue New York state’s HIV progress, the panelists suggested, the state should highlight more individualized health care as well as better mental health care and even allow Medicaid to cover smartphone expenses so clients could have more access to telehealth services.
Amida Care expanded on the webinar’s topic in a related policy brief titled “A Pandemic and an Epidemic: COVID-19 and Ending HIV in New York,” which notes that sexual health clinics reduced services amid COVID-19. In fact, only 25% of such clinics reported being able to offer HIV testing as of April 1. What’s more, only one of eight sexual health clinics operated by the New York City health department remained open after COVID-19 struck the city this spring (two more are now open).
Amida Care’s brief lists the following HIV-related recommendations for these various groups:
For Public Health Agencies:
- Focus on the communities placed at elevated risk.
- Strengthen access to Medicaid to help address health disparities.
- Implement a quality measure to track progress on HIV goals.
- Increase PrEP update among New Yorkers on Medicaid.
- Support immediate initiation of antiretrovirals.
- Learn from experience using at-home test kits.
- Remove prior-authorization requirements of PrEP.
For Health Plans and Providers:
- Use telehealth services to support PrEP utilization.
- Proactively improve access to sexual health services, including an HIV test and PrEP.
discussion upon diagnoses of a sexually transmitted infection.
- Implement cultural competency training and care.
- Get tested.
- Visit your primary care physician.
- If symptoms arise, don’t wait.
- Talk to your provider about PrEP.