25 Years of HIV in New York City: Lessons from Surveillance

Thomas, Pauline

doi:10.1093/jurban/78.4.669

Cited by 15 publications

(7 citation statements)

References 15 publications

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“…This is the largest substance use treatment system in New York City, and as shown in Fig 1 , our study participants come from many different areas of the city. HIV infection among entrants into this treatment system has tracked consistently with HIV infection data from other sources in New York City [ 10 , 41 – 45 ]. Most importantly, there is close agreement between HIV incidence measured in the Risk Factors study and estimated HIV incidence in data from the New York City Department of Health and Mental Hygiene HIV Surveillance unit [ 10 ].…”

Section: Discussionmentioning

confidence: 92%

Potential geographic "hotspots" for drug-injection related transmission of HIV and HCV and for initiation into injecting drug use in New York City, 2011-2015, with implications for the current opioid epidemic in the US

et al. 2018

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ObjectiveWe identified potential geographic “hotspots” for drug-injecting transmission of HIV and hepatitis C virus (HCV) among persons who inject drugs (PWID) in New York City. The HIV epidemic among PWID is currently in an “end of the epidemic” stage, while HCV is in a continuing, high prevalence (> 50%) stage.MethodsWe recruited 910 PWID entering Mount Sinai Beth Israel substance use treatment programs from 2011–2015. Structured interviews and HIV/ HCV testing were conducted. Residential ZIP codes were used as geographic units of analysis. Potential “hotspots” for HIV and HCV transmission were defined as 1) having relatively large numbers of PWID 2) having 2 or more HIV (or HCV) seropositive PWID reporting transmission risk—passing on used syringes to others, and 3) having 2 or more HIV (or HCV) seronegative PWID reporting acquisition risk—injecting with previously used needles/syringes. Hotspots for injecting drug use initiation were defined as ZIP codes with 5 or more persons who began injecting within the previous 6 years.ResultsAmong PWID, 96% injected heroin, 81% male, 34% White, 15% African-American, 47% Latinx, mean age 40 (SD = 10), 7% HIV seropositive, 62% HCV seropositive. Participants resided in 234 ZIP codes. No ZIP codes were identified as potential hotspots due to small numbers of HIV seropositive PWID reporting transmission risk. Four ZIP codes were identified as potential hotspots for HCV transmission. 12 ZIP codes identified as hotspots for injecting drug use initiation.DiscussionFor HIV, the lack of potential hotspots is further validation of widespread effectiveness of efforts to reduce injecting-related HIV transmission. Injecting-related HIV transmission is likely to be a rare, random event. HCV prevention efforts should include focus on potential hotspots for transmission and on hotspots for initiation into injecting drug use. We consider application of methods for the current opioid epidemic in the US.

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Section: Discussionmentioning

confidence: 92%

Potential geographic "hotspots" for drug-injection related transmission of HIV and HCV and for initiation into injecting drug use in New York City, 2011-2015, with implications for the current opioid epidemic in the US

et al. 2018

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“…This number can be limited through 1) providing very good access to sterile injection equipment to reduce the need for syringe sharing, 2) providing medication for opioid use disorder (MOUD) to reduce injecting, and 3) providing ART to reduce infectiousness. As noted in the introduction, NYC has not achieved the 90-90-90 ART treatment goals for PWID—less than 40% of PWID who are on ART are at viral suppression ( New York City Department of Health, 2019 ). However, with the good access to sterile injecting equipment (with large syringe service programs and low-cost, non-discriminatory pharmacy sales) and the ready availability of MOUD (no waiting lists for entry into treatment), HIV incidence has remained very low since the early 2010s.…”

Section: Discussionmentioning

confidence: 99%

Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic

Jarlais

Bobashev

Feelemyer

et al. 2022

Drug and Alcohol Dependence

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“…1, our study participants come from many different areas of New York City. HIV infection among entrants into this treatment system has tracked consistently with HIV infection data from other sources in New York City [38–42]. Most importantly, there is close agreement between HIV incidence measured in the Risk Factors study and estimated HIV incidence in data from the New York City Department of Health and Mental Hygiene HIV Surveillance unit [16].…”

Section: Discussionmentioning

confidence: 74%

Geographic distribution of risk (“Hotspots”) for HIV, HCV, and drug overdose among persons who use drugs in New York City: the importance of local history

et al. 2019

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Aims To identify geographic “hotspots” for potential transmission of HIV and HCV and for drug overdose among persons who use heroin and cocaine in New York City and to examine historical continuities in problem drug use hotspots in the city. Methods A total of 2714 study participants were recruited among persons entering Beth Israel substance use treatment programs. A structured questionnaire was administered and blood samples for HIV and HCV testing were collected. Hotspots for potential virus transmission were defined as ZIP codes with 10+ participants, 2+ persons infected with the virus and engaging in transmission behavior, and 2+ persons not infected and engaging in acquisition behavior. ZIP codes with 3+ persons with previous overdoses were considered potential hotspots for future overdoses. Results Participants resided in 166/178 (93%) of the ZIP codes in New York City. Injecting drug use was reported in 150/178 (84%) of the ZIP codes. No zip codes were identified for injecting-related HIV transmission, 5 zip codes were identified for sexual HIV transmission, 3 for HCV transmission, and 8 for drug overdose. Many of the ZIP code potential hotspots were in neighborhoods long associated with drug use: Lower Eastside and Harlem in Manhattan, the South Bronx, and Central Brooklyn. Discussion Heroin and cocaine use requiring treatment were reported from almost all ZIP codes in New York City, indicating needs for widely dispersed harm reduction services. Identified hotspots should be targeted for reducing sexual transmission of HIV, transmission of HCV, and drug overdoses. Some of the hotspots have persisted as problem drug use areas for 40 to over 100 years. Monitoring of drug use patterns in historical hotspot neighborhoods may permit early identification of and response to emerging drug use-related health problems. Persistent historical hotspots for problem drug use present a complex problem for implementing harm reduction services that deserve additional research.

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25 Years of HIV in New York City: Lessons from Surveillance

Cited by 15 publications

References 15 publications

Potential geographic "hotspots" for drug-injection related transmission of HIV and HCV and for initiation into injecting drug use in New York City, 2011-2015, with implications for the current opioid epidemic in the US

Potential geographic "hotspots" for drug-injection related transmission of HIV and HCV and for initiation into injecting drug use in New York City, 2011-2015, with implications for the current opioid epidemic in the US

Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic

Geographic distribution of risk (“Hotspots”) for HIV, HCV, and drug overdose among persons who use drugs in New York City: the importance of local history

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