To reduce the number of new HIV diagnoses on Long Island and Queens, clinicians from Northwell Health’s Center for AIDS Research and Treatment (CART) at North Shore University Hospital are using new technology and data to identify communities where the virus is highly prevalent, and target prevention and treatment efforts there.
The latest reports show there are 130,000 people living with HIV in New York State. On Long Island alone, 6,810 people are HIV-positive. In Queens, nearly 18,000 are infected with the virus.
To help combat this dangerous trend, Joseph McGowan, MD, CART medical director and professor at Northwell’s Center for Health Innovations and Outcomes Research at the Feinstein Institute, presented data at a news conference at the hospital today that identified local HIV “hot spots”—Hempstead, Westbury and Huntington Station on Long Island, and Rosedale and surrounding areas in Eastern Queens.
The CART team developed an extensive survey and customized web-based software, known as RED Cap, to collect and analyze data. The software and epidemiologic data from Northwell and the New York State Department of Health AIDS Institute is able to produce “heat maps” showing the locations of the highest incidence of HIV and other sexually transmitted diseases.
“The software enables us to query, collect and analyze information regarding mental health issues, substance use, housing status and other social issues,” said McGowan. “We’ve linked that to levels of treatment compliance, adherence to appointments and viral suppression rates. These data also demonstrates various health care disparities so we are able to get a comprehensive picture of people living in the community, which helps us better target our efforts.
Dr. McGowan was invited to Atlanta on Wednesday to share his data and response plan with the U.S. Centers for Disease Control & Prevention.
“We know where new HIV diagnoses and sexually transmitted infections are occurring,” McGowan said, “We know where those who don’t have viral suppression live. We are working with community leaders to determine how to reach those affected and ways to engage them in care. We must work together to remove barriers to care.”
Jeffrey Kemp, 35, a longtime Long Island resident who has been living with HIV for 15 years, participated in the conference. Thanks to the treatment he received at CART and a new social media app on his phone, he is stable for the first time and has an undetectable viral load. Kemp said the app was “a life saver.” It kept him on track with doctor appointments, medication reminders and lab results. Users of the GET! app also have the ability to text peer educators, known as Peeps, for questions and support.
The New York State Department of Health AIDS Institute’s YGetIt? Project developed the mobile application GET! The YGetIt? Project is one of 10 projects sponsored by the Health Resources and Services Administration (HRSA) special projects of national significance (SPNS) initiative. The GET! app was developed by Mount Sinai Applab and is currently available on Android and iOS to study participants. Northwell anticipates it will be widely available to the public in 2019.
CART is the only site in New York and one of nine nationwide selected to use the YGetIt app, developed by the New York State Department of Health AIDS Institute. CART recently achieved a milestone of more than 100 app users.
Jessica Clark, community mobilization coordinator at CART, outlined several community initiatives being pursued by Northwell to encourage local residents to get tested for the virus, including: a new collaboration this year with Walgreens in targeted communities to offer free, regular HIV-testing using Northwell’s mobile health van, educating women in high-risk neighborhoods and other outreach efforts. On Long Island alone, it’s estimated that there are approximately 1,000 residents with undiagnosed HIV.
CART’s new research will help identify the best approach for reducing health disparities in low-income communities and improving access to care. Many of the health disparities identified by McGowan’s team reflect the social determinants of health, such as income, housing status, food security, trauma, and incarceration. Health care teams from CART will focus resources and interventions on people with a history of domestic violence, suicide, post-traumatic stress disorder, substance abuse, mental health issues and other factors known to increase the risk of contracting HIV and to reduce adherence to care for those living with HIV.
“As we delve into the outcome disparities that we see among our patients, it has become clear to us that the way we communicate and motivate has to be in the correct cultural context,” said McGowan. “In that regard we are looking to recruit Popular Opinion Leaders within the communities most affected by HIV to instruct us in the best ways to engage hard to reach persons living with or at risk for HIV infection.”
North Shore University Hospital’s Center for AIDS Research and Treatment is the largest New York State-designated AIDS center on Long Island, treating 2,200 patients. Over the past 15 years, the center has seen a 10 percent annual increase in its HIV caseload.
“Our approach is unique,” said McGowan. “We need to get interventions into the community, learn the root causes of health care disparities and communicate and act more effectively.”
—Submitted by Northwell Health