A Preventable Health Crisis In the City

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The New York Sun

Remember the much-ballyhooed 2004 New York City Department of Health study that used interviews and brief physical exams to measure the health conditions of adult city residents? One could say that the city was showing us it cared about the health of John and Jane Q. Public — or so it seemed at first.

Supposedly, the purpose of the Health and Nutrition Examination Survey was to better direct the city’s resources to the health needs of New Yorkers. According to one concerned doctor at a Bronx medical center, however, women in the black and Hispanic communities are now at great risk because the city is not acting on the results of its own study.

Doctors have known for years that those who have genital herpes are at much higher risk of contracting HIV if they have sex with HIV-positive partners. About 90% of people who have genital herpes have no idea that they are infected.Those at risk can be identified by a simple blood test.

In April 2005, the data on New York City men and women was presented in an open forum at the Roosevelt Hotel. The medical director of the STD Center for Excellence at Montefiore Medical Center, Jeff Gilbert, attended the conference with 150 other health care providers.

He forwarded me a copy of a data sheet that was distributed at the forum, which contained the HANES conclusions. The chart showed that 60.8% of African American women, 44.7% of Hispanic women, and 20.1% of Caucasian women have herpes-2 virus.

Dr.Gilbert, who has specialized in the area of sexually transmitted diseases for the last 26 years, has been trying in vain to convince the DOH to offer the same blood tests and cultures his center routinely offers to all its patients. He says he cannot understand why the city is not acting on the results of its own study when it is a matter of life and death.

“The city has 10 STD clinics that oversee 110,000 patients,” Dr. Gilbert said, “yet they do not offer HSV cultures and HSV blood tests. We have African American females making up 34% of all new HIV cases in New York City. If a patient gets tested and learns they have genital herpes, they can take the proper precautions to decrease their risk of transmitting their herpes to partners and of acquiring HIV themselves.”

When the good doctor brought this subject up to the directors at the forum, he was told that the problem was financial. However, he says he has a hard time understanding how the same $20 rapid herpes test that his center offers can be problematic for a city agency with a budget that dwarfs his own.

I contacted Julie Schillinger at the city’s STD center to confirm Dr. Gilbert’s assertions, but she was unable to discuss this issue, as such queries are usually handled by someone in press relations. I’m always amazed by movies that show investigative reporters actually getting direct answers from city officials without having to go through the PR hoops. Nevertheless, Dr. Schillinger assured me that someone would be contacting me shortly.

Dr. Gilbert also told me that he spoke with David Baker, the leading authority on infectious diseases in the OB/GYN department at Stonybrook Hospital. Dr. Baker told him that in Africa, the connection between Herpes-Type 2 and HIV is widely known, and that treating the Herpes Type 2 virus has been shown to be effective in decreasing the incidents of HIV.

It is painfully obvious that it costs less to test and treat genital herpes than to deal with HIV and AIDS patients. I asked Dr. Gilbert how he knew that the city clinics were not offering the tests. “You can call any city STD clinic and ask them if they’ll do the blood work and culture for genital herpes. They’ll offer to do a Tzanck smear if a lesion is present, but this test has low sensitivity and cannot distinguish between herpes type 1 from type 2. I just examined a patient referred to me from the Chelsea STD clinic on Monday.”

The city, state, and federal governments have spent billions on treatments and research for AIDS, for which there is still no cure. We’re also constantly told that the AIDS virus does not discriminate. Looking at the city’s chart, I’d say that Herpes Type 2 certainly does discriminate and that the Department of Health needs to connect the dots in a hurry.

Mayor Bloomberg, you said you were concerned about our health when you banned smoking in public areas. How about providing the funding for your health department to really save lives?

The New York Sun

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