It’s pretty bad when the largest city in the country shuts down its largest free HIV testing site. It’s even worse when it takes the media five months to notice. A damning BuzzFeed story suggests that the city of New York isn’t doing enough to get people tested for HIV. Working from a report co-authored by ACT UP and the Treatment Action Group, BuzzFeed reporter Azeen Ghorayshi suggests the city’s health department has been systematically reducing access to free testing and treatment.
At question is Chelsea’s free STD testing site, which was shuttered in March for a multi-year, $17 million renovation to the nearly 80-year old facility. The Chelsea clinic saw nearly 20,000 visits per year, and is located in the New York neighborhood with the highest rates for both HIV and syphilis. Activists object to the closure, even though it’s temporary, because patients were given no warning beforehand. They also say that the city offered too little, too late when it came to alternatives. Mobile testing vans parked in front of the facility didn’t appear until June, and vans transporting patients to other health care sites have been underutilized. The city is redirecting patients to their Riverside clinic, about eighty blocks away.
Demetre Daskalakis is New York’s assistant health commissioner in charge of the Bureau of HIV/AIDS Prevention and Control. He disagrees with ACT UP that the Health Department is to blame. For one thing, he says, under Mayors Bloomberg and DeBlasio the city’s budget for disease control has dropped by 38 percent since 2008. “We’re working really hard to undo the damage that has been done through funding cuts in New York City,” he says.
According to data in the report, visits to city-run STD clinics have also dropped by roughly one-third since 2010. In 2014, the free testing sites administered 212,701 HIV screenings, but on average there are now 80,000 fewer screenings annually than there were in 2010.
There are also other factors at play here. One is Obamacare. With the Affordable Care Act, a lot of New Yorkers now buy their own health insurance and get tested in their own doctor’s office. Private treatment centers aren’t legally required to release the number of negative test results it sees each year, so it’s unclear whether private insurance and Obamacare are absorbing much of the burden that was formerly on the free clinics.
Of course, private insurance doesn’t apply to the 32% of the population that still doesn’t have health insurance, of course. The closure of clinics like the one in Chelsea directly affect at-risk populations like street-based sex workers and young men of color. Those diagnosed with HIV in 2014 at free clinics in New York were overwhelmingly young (60% under 30), overwhelmingly queer (82% were men who have sex with men), and overwhelmingly of color (74% black and/or hispanic).
Rates of syphilis and gonorrhea have also been rising in men nationwide, and New York is no exception. Those diseases are both curable, but syphilis can be spread far and wide before carriers detect any symptoms. Daskalakis also points out that the rise in syphilis diagnoses partly stems from more people are getting tested now than they used to, and that medical advances have let to more infections getting properly diagnosed.
The state of New York recently launched a campaign aiming to slash the number of new HIV infections by 75% over the next five years, but critics have pointed out that Governor Andrew Cuomo only allocated $10 million, one tenth of what some people were expecting, in his most recent budget. That’s also bad news for residents in New York City.
ACT UP is holding a town hall meeting to discuss what it calls “the indifferent and incompetent response of Mayor Bill de Blasio and his health department.” It will be streamed live on YouTube today at 6:30 EDT.