Strengthening Screening for HIV, Hepatitis C, and STIs: An Innovative           Partnership between the Health Department and Community Health Centers in New York           City

To date, little data has been collected from homeless adolescents regarding their access to, and utilization of, health care. In this study, 68 adolescents aged 16-25 were interviewed after being randomly selected from among those who came to a drop-in center for homeless youth in New York City in July 1996. The interviews followed a standardized questionnaire designed to collect demographic information as well as to assess past and current use of medical services. Prior to homelessness, 68% of subjects had been utilizing medical services on a regular basis, and the principal sources of care were as follows: hospital clinics, 51%; community health centers, 33%; and private physician offices, 22% (with more than one facility utilized in some cases). By contrast, 90% of participants reported having received care during homelessness, 68% of whom obtained regular health care at shelters, 32% at drop-in centers, and 25% at hospital clinics. Despite the fact that 42.4% of the sample was covered by health insurance at the time of interview, only 10% of subjects reported having ever been denied health care at any facility visited. Taken together, these findings suggest that, in the population studied, an increase in the percentage of adolescents regularly utilizing medical services occurs upon homelessness, coincident with a shift in utilization from hospital clinics and community health centers to shelters and drop-in centers. These results clearly warrant further study on the access and utilization of health care by homeless adolescents. If substantiated, the present findings call fo renewed efforts toward optimizing health care delivery to homeless adolescents at shelters, drop-in-centers, and other such facilities where these individuals utilize medical resources most frequently.

Download Full-text

Molecular Types of Methicillin-Resistant Staphylococcus aureus and Methicillin-Sensitive S. aureus Strains Causing Skin and Soft Tissue Infections and Nasal Colonization, Identified in Community Health Centers in New York City

Journal of Clinical Microbiology ◽

10.1128/jcm.00591-15 ◽

2015 ◽

Vol 53 (8) ◽

pp. 2648-2658 ◽

Cited By ~ 18

Author(s):

Maria Pardos de la Gandara ◽

Juan Antonio Raygoza Garay ◽

Michael Mwangi ◽

Jonathan N. Tobin ◽

Amanda Tsang ◽

...

Keyword(s):

New York ◽

Staphylococcus Aureus ◽

New York City ◽

Soft Tissue ◽

York City ◽

Community Health Centers ◽

Health Centers ◽

Soft Tissue Infections ◽

Content Type ◽

Clonal Type

In November 2011, The Rockefeller University Center for Clinical and Translational Science (CCTS), the Laboratory of Microbiology and Infectious Diseases, and Clinical Directors Network (CDN) launched a research and learning collaborative project with six community health centers in the New York City metropolitan area to determine the nature (clonal type) of community-acquiredStaphylococcus aureusstrains causing skin and soft tissue infections (SSTIs). Between November 2011 and March 2013, wound and nasal samples from 129 patients with active SSTIs suspicious forS. aureuswere collected and characterized by molecular typing techniques. In 63 of 129 patients, the skin wounds were infected byS. aureus: methicillin-resistantS. aureus(MRSA) was recovered from 39 wounds and methicillin-sensitiveS. aureus(MSSA) was recovered from 24. Most—46 of the 63–wound isolates belonged to the CC8/Panton-Valentine leukocidin-positive (PVL+) group ofS. aureusclone USA300: 34 of these strains were MRSA and 12 were MSSA. Of the 63 patients withS. aureusinfections, 30 were also colonized byS. aureusin the nares: 16 of the colonizing isolates were MRSA, and 14 were MSSA, and the majority of the colonizing isolates belonged to the USA300 clonal group. In most cases (70%), the colonizing isolate belonged to the same clonal type as the strain involved with the infection. In three of the patients, the identity of invasive and colonizing MRSA isolates was further documented by whole-genome sequencing.

Download Full-text

Implementing data-to-care initiatives for HIV in New York state: assessing the value of community health centers identifying persons out of care for health department follow-up

AIDS Care ◽

10.1080/09540121.2017.1363851 ◽

2017 ◽

Vol 30 (3) ◽

pp. 391-396 ◽

Cited By ~ 16

Author(s):

Rachel Hart-Malloy ◽

Shakara Brown ◽

Kathleen Bogucki ◽

James Tesoriero

Keyword(s):

New York ◽

Community Health ◽

Community Health Centers ◽

New York State ◽

Health Department ◽

Health Centers ◽

York State

Download Full-text

A Surveillance-Based Hepatitis C Care Cascade, New York City, 2017

Public Health Reports ◽

10.1177/0033354918776641 ◽

2018 ◽

Vol 133 (4) ◽

pp. 497-501 ◽

Cited By ~ 7

Author(s):

Miranda S. Moore ◽

Angelica Bocour ◽

Fabienne Laraque ◽

Ann Winters

Keyword(s):

New York ◽

New York City ◽

Hepatitis C ◽

York City ◽

Population Level ◽

Health Department ◽

Department Of Health ◽

Care Cascade ◽

Laboratory Surveillance ◽

Direct Acting

Objectives: The care cascade, a method for tracking population-level progression from diagnosis to cure, is an important tool in addressing and monitoring the hepatitis C virus (HCV) epidemic. However, little agreement exists on appropriate care cascade steps or how best to measure them. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) sought to construct a care cascade by using laboratory surveillance data with clinically relevant categories that can be readily updated over time. Methods: We identified all NYC residents ever reported to the DOHMH surveillance registry with HCV through June 30, 2017 (n = 175 896). To account for outmigration, death, or treatment before negative RNA results became reportable to the health department, we limited the population to people with any test reported since July 1, 2014. Of these residents, we identified the proportion with a reported positive RNA test and estimated the proportion treated and cured since July 2014 by using DOHMH-developed surveillance-based algorithms. Results: Of 78 886 NYC residents ever receiving a diagnosis of HCV and tested since July 1, 2014, a total of 70 397 (89.2%) had ever been reported as RNA positive through June 30, 2017; 36 875 (46.7%) had initiated treatment since July 1, 2014, and 23 766 (30.1%) appeared cured during the same period. Conclusion: A substantial gap exists between confirming HCV infection and initiating treatment, even in the era of direct-acting antivirals. Using this cascade, we will monitor progress in improved treatment and cure of HCV in NYC.

Download Full-text