The Health Department today released a new Vital Signs report about rectal STIs and the risk for later HIV infection among gay, bisexual, and other men who have sex with men (MSM).
According to the report, 1 in 15 (7 percent) of HIV-negative MSM who were diagnosed with rectal gonorrhea or rectal chlamydia, or both, at the Health Department’s Sexual Health Clinics were diagnosed with HIV within one year of their diagnosis. From 2011 to 2016, there were steady increases in the number of rectal gonorrhea and chlamydia diagnoses reported citywide to the Health Department.
According to the report, 1 in 15 (7 percent) of HIV-negative MSM who were diagnosed with rectal gonorrhea or rectal chlamydia, or both, at the Health Department’s Sexual Health Clinics were diagnosed with HIV within one year of their diagnosis. From 2011 to 2016, there were steady increases in the number of rectal gonorrhea and chlamydia diagnoses reported citywide to the Health Department. This is attributable to an increase in the number of laboratories offering rectal testing, the increases in the number of health care providers who tested patients, and potentially more people with these STIs. However, an analysis of the data suggest that cases are underdiagnosed, and thus underreported. The Vital Signs can be found here.
Screening for and diagnosing rectal gonorrhea and chlamydia among MSM is critical for targeting HIV prevention interventions. The Health Department is working to increase clinical screening of rectal STIs through health care provider education. MSM diagnosed with a rectal STI should talk to their doctor about the HIV drug PrEP or visit a Sexual Health Clinic to meet with a Health Department provider.
“With STI rates increasing in the City and nationally, it is so important that everyone gets screened and know their status,” said Health Commissioner Mary T. Bassett. “New Yorkers should find health care providers who are knowledgeable about their sexual health as well as HIV and other STI prevention services that they need. Residents should get tested regularly to ensure that they, as well as their partners, have safe and healthy sex lives.”
“Preventing sexually transmitted infections, including HIV, is extremely important,” said Dr. Demetre Daskalakis, Deputy Commissioner for the Division of Disease Control. “I encourage the use of condoms, which prevent most STIs and HIV, and encourage all New Yorkers to get tested frequently. I am so proud of the Health Department for all of its efforts in making sure that all residents are sexually healthy and safe.”
Vital Signs report highlights
- One in 15 (7 percent) HIV-negative MSM who were diagnosed with rectal gonorrhea and/or rectal chlamydia in Health Department Sexual Health Clinics were diagnosed with HIV within a year.
- HIV incidence was highest among Black MSM with rectal gonorrhea and/or chlamydia (15 percent versus 3 percent among Whites and 5 percent among Latinos).
- HIV incidence was also high among MSM with concurrent rectal gonorrhea and chlamydia infection (11 percent, or 1 in 10 MSM with concurrent rectal infections).
- At the Health Department Sexual Health Clinics, all patients reporting receptive anal sex are screened for rectal STI – more than 5,000 MSM per year. From 2014 to 2016, more than 10 percent had rectal chlamydia and 3 percent had concurrent infections each year.
- Despite national, state and local recommendations to screen MSM who engage in receptive anal sex for rectal gonorrhea and chlamydia, not enough health care facilities across the City are reporting these diagnoses among HIV-negative men. Only 118 facilities reported at least one case of rectal gonorrhea or chlamydia among HIV-negative MSM in 2015.
- In 2015, the majority of rectal gonorrhea and chlamydia diagnoses were reported by providers and facilities in neighborhoods where many MSM live. However, there were neighborhoods in Queens and Brooklyn where a large number of MSM live, but where very few diagnoses of rectal STIs were reported. This indicates a need for increased rectal STI screening.
The Health Department is committed to addressing the spread of STIs and ensuring that all New Yorkers are healthy and safe. Services and initiatives include:
The City’s clinics offer low- to no-cost services, including STI screening of extragenital sites such as the rectum and throat. The clinics also offer PrEP initiation for eligible patients, with linkage to longer-term care and PEP, an emergency medication for people who are HIV-negative and may have been exposed to HIV. This year, the agency reopened the Chelsea Sexual Health Clinic after a multi-year renovation to modernize its historic 1930s building. The newly revamped clinic will provide expanded sexual health services, including state-of-the-art HIV treatment and prevention as well as express testing services.
- PrEP and PEP Detailing Campaign
The PrEP and PEP public health detailing campaign involving one-on-one educational clinic visits has reached more than 2,500 providers at more than 1,300 clinical sites in New York City. Practices that recently diagnosed HIV and other STIs among Black and Latino MSM were prioritized, as were practices in high poverty neighborhoods.
The PlaySure Network for HIV prevention is a network of clinical and nonclinical providers working together to ensure that all New Yorkers have access to HIV testing, HIV treatment, and PrEP and PEP. Members work collaboratively to promote patient-specific approaches to sexual health, increase access to PrEP and PEP for people (especially those without insurance) who may be exposed to HIV – including gay and bisexual men, transgender people, and people who have a partner living with HIV, and refer people with HIV to care services so they can get treated and become virally suppressed.
The Health Department has educated providers on the importance of extragenital STI screening – screening for areas outside the genital region or organs – and it recently published this bulletin on taking sexual history. A sexual history can identify the sex of a patient’s sex partners, which leads to appropriate screening.
New York City’s LGBTQ Health Care Bill of Rights details current health care protections on local, state and federal levels that LGBTQ New Yorkers can use to ensure that they receive the same quality of care as their cisgender, heterosexual peers. This document reiterates that health care providers and their staff cannot legally provide LGBTQ people with a lower quality of care because of their sexual orientation, gender identity or gender expression. For copies of the LGBTQ Health Care Bill of Rights, please visit nyc.gov/health/lgbtq or call 311.