In New York City, we are close to winning a battle that for decades seemed unwinnable: the annual number of new HIV diagnoses has fallen to historic lows. The fear and stigma associated with sexual health is gradually being replaced with honesty and hope.
Today, March 15, we mark a milestone in our efforts to end the epidemic of HIV — the reopening of the Chelsea Sexual Health Clinic, a landmark building that dates back a century and was the epicenter of the fight to address the AIDS crisis.
In Chelsea, the community knows the importance of neighborhood-based care; they saw how a public health crisis has the potential to devastate a community. So when the Chelsea Clinic shuttered in 2015 for much-needed renovations, the response was overwhelming. We realized we should have engaged advocates sooner, and once we did, they became vocal partners. As a result, the new Chelsea Clinic is even better than we had hoped. The community helped shape our innovative programs to end the epidemic of HIV and ensured that the clinic reopened sooner than planned.
While today is a celebratory day, there is still much more work to do. In 2016, rates of chlamydia, gonorrhea, and syphilis rose across New York City, with Chelsea having the highest rates of gonorrhea and syphilis. We are also seeing too many new HIV diagnoses among women, and unacceptable disparities in who gets infected — 90 percent of new diagnoses are among Black and Latina women. And, of course, the right number of new infections for our city is zero.
These challenges are taking place against the backdrop of broad attacks on sexual health initiatives by the federal government. On the heels of World AIDS Day 2017, President Trump dismissed all members of the HIV/ AIDS Presidential Advisory Council, and Congress has already slashed $5 million in sexually transmitted infection (STI) prevention funding from the Centers for Disease Control and Prevention.
To make matters worse, President Trump wants to allocate $75 million in his 2019 budget toward abstinence-only and “personal responsibility” education programs. The lesson is plan: wait to have sex until marriage in order to prevent pregnancy and STIs, including HIV. We know from many years of scientific, evidence-based research that this approach simply does not work.
The fact is, the best way to reduce the incidence of STIs, including HIV, is through sex education and prevention programs. That’s why we are lucky to live in New York City with an administration and City Council that defies reckless federal actions. At the Chelsea Sexual Health Clinic and its seven sister locations across the city, we are scaling up — not cutting back. It is critical that New Yorkers have access to high-quality, low- to no-cost sexual health care. The Chelsea Clinic has a dedicated area for “express testing,” where patients can be screened for STIs, including HIV, without seeing a doctor first. The building is now bright and open, a physical representation of the judgment-free and welcoming care the staff offers. Coming for a screening does not feel stigmatizing; rather, the clinic is a space that encourages people to simply take responsibility for their health and wellbeing.
In addition to providing basic STI services such as testing and treatment, the Chelsea Clinic is at the forefront of HIV prevention and treatment. We provide immediate initiation of daily PrEP (pre-exposure prophylaxis), a pill that significantly lowers the risk of HIV infection; emergency PEP (post-exposure prophylaxis), a medication for people who are HIV-negative and may have been exposed to HIV; and anti-retroviral therapy for people who are newly diagnosed or living with HIV.
It took grassroots support to bring us to this historic moment. As the federal government retreats from its role as a public health leader, we need activists to continue to enact change and inspire others in the country to follow. Make sure your voice is heard. In the fight to end the epidemic of HIV and reduce STIs, the Chelsea Sexual Health Clinic is a huge step forward. We are excited to welcome you back.
Dr. Mary T. Bassett is commissioner of the New York City Department of Health and Mental Hygiene.