This preview shows page 106 - 119 out of 150 pages.
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.
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 ActivitySex 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 partners112
STI/HIV InterrelationshipsWhat questions do you have?113
Human Papilloma VirusHerpesViral STIs114
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 & transmission115
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 infection116
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 rubbing, dry humping, etc•Mother-to-child during labor or delivery117
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 days118
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 outbreaks119