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AIDS At 20: Frontline STD Clinics

Martin Algaze knows that, twenty years after acquired immune deficiency syndrome was first identified, many New Yorkers have relaxed about it. "We know there's been a 'complacency effect' setting in over the last few years among all the populations at risk for AIDS," says Algaze, who works for Gay Men's Health Crisis, the oldest AIDS service and advocacy group. "They think AIDS is over."

The result is another in a long line of tragedies. "It appears that more people are having unsafe sex," Algaze says.

One reason health workers know this is that the syphilis rate in New York City has more than doubled in the first quarter of this year. The numbers seem too puny to be alarming. Dr. Susan Blank, assistant commissioner of the health department's Sexually Transmitted Disease Control Program says there were 57 cases of infectious Syphilis in the first three months of this year, up from 26 during the last three months of 2000. But the health department fears that this upswing may foreshadow another rise in HIV infections, particularly among men having sex with men.

The connection between sexually transmitted diseases (STDs) and AIDS transmission is not generally known to the public. But specialists in the field have known since the early 1990's that syphilis, gonorrhea, chlamydia, and trichomoniasis increase a person's vulnerability to AIDS by two to five times. These STDs also make a person with HIV much more infectious to their sexual partner(s).

Thus the alarm about the spike in the syphilis rate, and the effort by the Department of Health to get the word out about how prompt diagnosis and treatment of STDs are important facets of AIDS prevention. Says Blank, "Every time we can cure a case of syphilis, we're preventing HIV."

That underscores the importance of New York City's ten STD clinics.

The free and confidential clinics in the five boroughs provide confidential diagnosis and treatment on a walk-in basis. Upon arriving at the clinic, patients are asked to fill out a form (and identified by a number, not a name), stating their reasons for coming to the clinic. A clinician does an examination. (All are board-certified doctors and physician assistants who specialize in diagnosing and treating STDs). If necessary, specimens are taken, and tested at the on-site laboratory. If it is indicated by the tests that a patient has an STD, he will be given medication before he leaves the clinic. HIV counseling and testing are also offered at the clinics.

The free clinics are an invaluable service for those who are uninsured and unable to afford a doctor's care. Minors, says the Department of Health, do not need parental consent for examination and treatment. And unlike AIDS, syphilis is curable.

The complacency towards AIDS is a result of a regiment of drug treatment called HAART, which stands for Highly Active Anti-Retroviral Therapy, which has been mostly a blessing, Algaze admits. "That these drugs are working is very good news. Many of these people were preparing to die. Now many of them are even going back to work." Still, he warns, HAART isn't an unmixed blessing. The drugs don't work for everybody. Some people suffer side effects so bad they can't take the drugs.

And they are very expensive-"they can cost as much as $15,000 to $20,000 yearly." The co-payment, even with insurance, can be as much as $100 a month, for just one class of drugs. Algaze added that "the most affordable way for people to take these drugs is via mail-in programs through your insurance company," as this can be much cheaper than getting them from a pharmacy.

Another thing to keep in mind: the HAART drugs, as far as clinicians know, have to be taken for life. There are no long-term studies on lifelong effects yet. They are not a cure. There is still no vaccine for uninfected people. And the new-case rate for AIDS in the U.S. is a steady 40,000 per year. In the past 20 years, AIDS has killed 75,000 New Yorkers,or about one fifth of all the Americans who have succumbed to it.

More Resources on AIDS:

  • For information about getting help with STDs and treatment, see the Health Department's web site. Anyone wanting more information on syphilis can call the city's STD HOTLINE at 212-427-5120, Monday through Friday, 9:00 a.m. to 4:00 p.m., or ask their doctor.
  • GMHC - Oldest and largest voluntary AIDS crisis organization. Information about AIDS, services and treatment, and extensive list of links to other on-line AIDS resources. GMHC Hotline: 1-800-AIDS-NYC.
  • The Body - Doctors' answers to questions from people living with HIV, chat and bulletin boards on AIDS-related topics, 30,000-document library that is updated daily.
  • Critical Path AIDS Project - Critical Path provides easy access to the full range of potentially life-extending or life-saving AIDS prevention, treatment, and referral information.
  • Michael Callen-Audre Lorde Community - Provides information about the services they offer to the gay, lesbian, and bisexual community, plus volunteer and job opportunities.
  • POZ Magazine - Monthly magazine that reports on the impact AIDS has on life, politics, culture, and society, plus the Spanish POZ magazine, POZ en Espanol, and MAMM, a magazine for anyone whose life has been affected by breast and reproductive cancers.
  • Centers for Disease Control - CDC's Divisions of HIV/AIDS Prevention-with recent headlines, FAQs about AIDS, and links.
  • God's Love We Deliver - Provides highly nutritious meals, free of charge, for all people living with AIDS. Features nutrition information and information on how to become a client.
  • National Minority AIDS Council - This website supports NMAC's mission of developing leadership within communities of color for the fight against AIDS.
  • New York City Department of Health- Provides HIV/AIDS treatment, prevention, and counseling information and surveillance data for the city.
  • Healthopedia - AIDS resource
  • - AIDS resource

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