As reported to the New York City Department of
Health and Mental Hygiene by June 30, 2016.
Part 23 Changes and NYC
Sexual Health Clinics
•
Effective July 31, 2017, Sexual Health Clinics that
initiate patients on PrEP may now do so for
eligible minors without parental/guardian
involvement.
•
NYC Sexual Health Clinics will no longer restrict
initiation of ART through JumpstART based on age
•
Providers can either (1) initiate a patient under
18 on JumpstART without parental consent or
notification or (2) provide a referral (based on
assessment of patient and circumstances)
•
Staff prioritizes referral of minors to affiliated
adolescent specialists for follow-up care.
•
PEP28 is available to minors without parental/
guardian involvement at all Clinics.
Prevention/Early Intervention
109
Opportunities
•
HIV Rx, PEP and PrEP prevent the spread
of HIV
•
Can be prescribed to adolescents w/out
parental consent or notification -2017
regulatory change
(PEP was always permissible because of
emergency provisions)
•
HIV prevention services introduce
frequent regular STI screenings
•
Sexual health histories are critical for
identifying risk category and screening
needs – especially for extragenital
screening.
Group Activity
Sex in the City – An Inside
View
•
This activity
shows how
having an STI
can increase
the chances of
both getting
HIV,
or giving
HIV to a sexual
partner
111
Sexual Transmission of
HIV
•
Likelihood of sexual HIV
transmission affected by
•
Viral load
•
Presence of an STI
•
Health of the
“
Pink Parts
”
•
STI screening & treatment
helps to prevents HIV
•
For persons who are HIV
negative
•
For persons living with HIV to
prevent transmitting to
partners
112
STI/HIV
Interrelationships
What questions do you have?
113
Human
Papilloma Virus
Herpes
Viral STIs
114
Herpes Simplex Virus
(HSV)
•
Herpes
–
Recurrent, lifelong viral infection
–
Two Strains
•
HSV-2 – majority of
genital
herpes
in the US
•
HSV-1 – majority of
oral
herpes in
US
•
Strains can infect either site
•
Treatable & manageable –
cannot
be cured
•
Facilitates HIV acquisition &
transmission
115
HSV-1 & HSV-2 Seroprevalence in
Persons >
20 years, NYC – 2004
*
Age-adjusted to the Year 2000 US Standard Population
~ 1,600,000 adult New
Yorkers
with HSV-2
infection
116
Herpes Transmission
–
Vaginal, anal, and oral sex
•
Can be transmitted
even when
there are no sores
and even when
the person is unaware of an
infection
•
Mucous membrane to membrane
contact
•
Direct contact (skin to skin) with
infected sites r
ubbing, dry humping,
etc
•
Mother-to-child during labor or
delivery
117
Herpes Symptoms
•
Most people with Herpes
do
not have or do not notice any
symptoms
•
Main symptom is
small sores
(“outbreaks”) on the mouth,
penis, vagina, or rectum
–
Start as small blisters
–
Become open sores, scab, and
heal completely in approximately
3-14 days
118
Other Herpes Symptoms
•
In addition to outbreak of sores
–
Swollen glands in the groin
–
Vaginal/urethral discharge
–
Burning on urination
•
Outbreaks can happen a few
times per year
–
Some have more or less frequent
outbreaks
119
