| Releases & Statements
For Immediate Release: April 28, 2006
Contact: Frank Sobrino, Press Secretary
O: (212) 669-4193
City-run clinics set up to diagnose
and treat sexually transmitted diseases, including HIV, were often
unable to provide medical attention and other important services,
according to findings of a recent survey conducted by the office
of Public Advocate Betsy Gotbaum released today.
Investigators from Gotbaum’s
office posing as patients found that:
· Doctors were unavailable
at seven of the city’s 10 STD clinics at 3:00 PM.
· Rapid HIV testing was unavailable
at three clinics.
· STD screening was unavailable
at two clinics.
· Two clinics were unable to
dispense emergency contraception immediately.
· No services were available
at the East Harlem clinic.
· Staff at many clinics reported
that their facilities stopped accepting patients before closing
time.
· Four clinics were unable
to assist Spanish-speaking callers.
“The results of the survey are
disappointing,” Gotbaum said. “Especially in light
of the
critical role these clinics play in
our city’s fight against HIV and other STDs. The goal here
is to reduce any and all barriers to STD screening and testing.
Clearly, there is still much to be done.”
The public advocate’s survey
consisted of two phases: Between February 8 and February 24, surveyors
posing as patients visited each of the city’s 10 STD clinics
on weekdays at 3:00 PM to assess operations and determine whether
particular services were available; in addition, between March
20 and March 22, calls seeking information about services were
placed between 9:00 AM and 4:00 PM.
State law requires the health commissioner
to “promptly examine or arrange for the examination of persons
suspected of being infected with a sexually transmissible disease,”
and to “promptly institute treatment or arrange for the
treatment of those found or otherwise known to be infected with
a sexually transmissible disease.”
The survey results prompted Gotbaum
to call on the Department of Health and Mental Hygiene, which
operates the clinics, to increase the availability of doctors
at the clinics. She also called on DOHMH to ensure that all clinics
provide a full range of services, including STD screenings and
rapid HIV testing, for the entirety of their scheduled hours.
Noting that most clinics stop offering
services by 4:00 PM and that only five open Saturdays—and
even then, until no later than 1:30 PM—Gotbaum called for
expanding clinics’ hours of operation.
Gotbaum also recommended
that DOHMH work to ensure that:
· Clinic staffs consistently
provide women interested in obtaining emergency contraception
with accurate information about the time-sensitive nature of the
medication.
· Clinics are able to assist
non-English speakers.
· Clinic staff is aware of
services offered at all clinics, so as to be able to make informed,
helpful referrals.
“Public clinics are an invaluable
resource to uninsured individuals who may be unable to afford
care elsewhere,” Gotbaum said. “Turning away people
who may need to see a doctor is bad public health practice and
a possible violation of state law.
“The good news is that after
sharing our findings and discussing them with the Department of
Health, I’m confident the agency will act decisively to
address the problems identified.”
When detected early, most STDs can
be treated effectively. Untreated, however, STDs can cause serious
health problems and even lead to death. The rates of chlamydia
and syphilis in New York City are on the rise. The rates in New
York City of these diseases and gonorrhea exceed the national
average.
Research has shown that individuals
with STDs are three to five times more likely than non-infected
individuals to contract HIV if exposed through sexual contact.
In addition, HIV-infected individuals concurrently infected with
another STD are more likely to transmit HIV through sexual contact
than non-HIV-infected individuals. According to the Centers for
Disease Control, the detection and treatment of STDs can significantly
reduce HIV transmission at the individual and community levels.
Home to more than one in six of the
country’s AIDS cases, New York City continues to be the
epicenter of the national AIDS epidemic. Despite the advent of
medical treatments that prolong survival, AIDS continues to take
the lives of HIV-infected individuals.
Timely diagnosis of HIV is particularly
important, as most cases of HIV are transmitted by people unaware
of their HIV status. Rapid HIV testing allows patients to receive
results in as little as 20 minutes. Standard HIV tests take approximately
one week to produce results.
The value of a rapid HIV testing program
can be seen in a CDC study conducted in 2000. CDC found that 30
percent of people who tested HIV-positive, and 39 percent of people
who tested HIV-negative, did not return for their test results.
Providing same-day results helps ensure
individuals learn their test results, making it possible for them
to seek treatment and take steps to ensure their behavior does
not result in transmission of the disease.
Rapid HIV testing was unavailable
at three of the city’s 10 clinics when visited by surveyors.
Gotbaum argued that the costs of ensuring
that clinics run properly and have enough doctors available, as
well as expenses stemming from expanded clinic hours, would be
offset by the savings in public health and human costs. She pointed
to estimates that indicate the average lifetime cost of treating
an HIV infection is $195,000.
“STD prevention efforts are
increasingly shown to be effective and economically sound strategies
for improving the nation’s health,” according to the
director of the CDC’s STD prevention programs, Dr. John
Douglas, who is cited in Gotbaum’s report of the survey
findings.
Investigators from Gotbaum’s
office also found that:
· Phone calls to clinics often
rang unanswered or went to personal voice mailboxes that failed
to identify the line as belonging to an STD or health clinic.
· DOHMH provides inaccurate
information about available Hepatitis services—that is,
clinics did not always offer the Hepatitis services listed on
the DOHMH website.
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