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HIV Link is now called STAR Community Link, to reflect the STAR Program's expansion beyond HIV care and its connection to the local and global communities it serves.

The mission of the Special Treatment and Research (STAR) Program is to provide and enhance quality healthcare locally and globally through the integration of treatment, prevention, research, and education.

Spring/Summer 2015

PrEP and PEP Services at STAR and HEAT Programs

An estimated 50,000 individuals become infected with the human immunodeficiency virus (HIV) in the United States annually. A new prevention strategy, pre-exposure prophylaxis (PrEP), is intended for high-risk populations to reduce their risk of becoming infected with HIV. PrEP includes daily medication and routine follow-up. When used consistently, PrEP is shown to reduce the risk of HIV infection. If delivered effectively and used in combination with other proven prevention methods, PrEP may play a significant role in helping to address the HIV epidemic in the United States. The widespread implementation PrEP is one of the cornerstones of Governor Cuomo's blueprint to end the status of AIDS as an epidemic in New York State by 2020.

Post-exposure prophylaxis or PEP stands for post-exposure prophylaxis. It involves taking antiretroviral medicines as soon as possible (preferably less than 36 hours), but generally no more than 72 hours (3 days) after one may have been exposed to HIV, to try to reduce the chance of becoming HIV-positive. These medicines keep HIV from making copies of itself and spreading through the body. Two pills are usually prescribed, and they must be taken for 28 days. PEP is not always effective; it does not guarantee that someone exposed to HIV will not become infected with HIV.

Both the STAR Health Center (SHC) and the Health and Education Alternatives for Teens (HEAT) Programs at SUNY Downstate follow NYS Department of Health AIDS Institute PrEP/PEP guidelines and offer them as part of a comprehensive prevention plan including risk-reduction counseling, free condoms, sexually transmitted infection (STI) screening, and mental health and substance use screening. When PEP/PrEP is indicated, the physician provides the client with an initial assessment and treatment with monthly monitoring for HIV status, adherence, and side effects, followed by monitoring every three months.

The SHC initially began providing PrEP/PEP to HIV negative partners of HIV positive SHC clients. Recently SHC began actively publicizing PrEP/PEP services to the public using two professionally designed PrEP brochures (one targets men who have sex with men (MSM) and a second targets heterosexual couples). Referrals for PrEP at the SHC can be made by calling 718-270-3745.

HEAT's PrEP services are built into routine HIV testing services that it provides at community partner sites (e.g., Brooklyn & Medgar Evers Colleges, Hetrick-Martin Institute, Community Counseling & Mediation Services). Clients who mention high-risk sexual activity during HIV testing are informed about PrEP services; a HEAT staff member contacts interested clients to provide more detailed information on PrEP benefits, answers all questions, and then schedules the client for screening and medical assessment. Potential clients attend HEAT-sponsored community events and young PLWHA discuss PrEP benefits within their social networks. HEAT recently developed a promotional PrEP/PEP video played on monitors around SUNY-DMC.

The HEAT Program is currently involved in a targeted pilot project, in conjunction with the NYS Department of Health AIDS Institute, to identify needed resources to implement routine use of PrEP and establish a foundation for statewide implementation of PrEP as part of a comprehensive prevention plan. While HEAT will offer PrEP to any adolescent or young adult below the age of 25 years, the project has targeted interest in addressing the prevention needs of MSM and transgender women, two groups who have the highest rates of new HIV infections. As an adolescent/young adult program, HEAT is well situated to engage this population and learn about the challenges of PrEP implementation. Many issues such as insurance status, lack of parental consent in minors and confidentiality around sexual identity and behavior among youth have already been identified as challenges to be considered in offering PrEP to HEAT's younger population. Referrals for PrEP at HEAT can be made by calling 718-467-4446.

Community Partner Spotlight: HEAT Program
For the inaugural issue of STAR Community Link, we are focusing on the Health and Education Alternatives for Teens (HEAT) Program, directed by Jeffrey Birnbaum, MD, MPH. HEAT is the STAR Program's counterpart serving HIV+ and at risk youth and young adults. HEAT's adolescent-focused, single-site, "one stop shopping" model provides comprehensive, age appropriate, culturally competent HIV care and supportive services for heterosexual and lesbian, gay, bisexual, and transgender (LGBT) youth, most of whom are Black and Latino. Services include outreach, HIV testing and linkage to care, HIV primary medical and mental health care, supportive services, and access to clinical research; all provided by an interdisciplinary team. STAR and HEAT collaborate to provide many services to HIV+ women and their families, especially those involving pregnancy and follow up of HIV exposed newborns as well as a well-established program for transitioning HIV+ youth from HEAT into adult care at STAR. STAR also provides enhanced data systems support to HEAT.


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