With the rate of sexually transmitted diseases on the rise nationwide and a higher incidence of HIV diagnoses than neighboring states, New Jersey officials have rolled out a public health campaign to expand awareness of these problems, encourage more testing, and connect residents with appropriate treatments or preventative measures.
The Department of Health launched a social media campaign in December to highlight the growing incidence of chlamydia, gonorrhea, and syphilis — the three most common STDs — which have reached record highs nationally. The DOH added search tools to its website to connect visitors with services, provided educational materials to public health agencies around the state, and is working with doctors directly to increase STD screenings. Half of all sexually active young people will get an STD by age 25, officials said, and many cases go untreated.
“Our hope is that this startling fact will encourage health care providers, parents, and educators to talk frankly and openly to adolescents about how they can get STDs and how to prevent them,” DOH communications director Donna Leusner explained.
But traditional STDs are only part of the agency’s focus. The outreach effort, led by the Division of HIV, STD and TB Services, also aims to spread the word about PrEP services — Pre-exposure prophylaxis — which can protect users against HIV, the virus that causes AIDS. The treatment, approved by the federal government in 2012, involves a daily dose of anti-retroviral medication, along with education and regular screening and has been shown to cut HIV transmission in half, or better, in trials.
Health Commissioner Cathleen D. Bennett kicked off the campaign on December 1 in conjunction with World AIDS Day, joining healthcare leaders, patient advocates, and others in Jersey City to walk from Jersey City Medical Center to City Hall. The state provides tens of thousands of free, confidential rapid-HIV tests each year, and Bennett urged patients to get tested and reminded physicians to include HIV or STD screening in their regular routine.
Once considered a death sentence, the incidence of HIV and AIDS has declined in recent years, but more than 1.2 million people nationwide are living with the virus — including roughly 37,000 in New Jersey — according to the federal Centers for Disease Control and Prevention. That said, one in eight don’t know they are carrying the disease —or one in two under the age of 24.
While the rate of diagnoses in the Garden State has dropped 37 percent over the past decade, the number of new diagnoses per capita (15.8 per 100,000 people) was higher than other states in the region (which averaged 9.8 per 100,000), CDC data showed. More than three-quarters of these cases impact people of color.
PrEP treatments have become a hot topic in recent weeks, as the Bill and Melinda Gates Foundation announced a $140 million investment to develop technology to deliver the medicine through a long-acting implant that could help prevent HIV infection for nearly a year.
The concept holds significant promise, especially for patients in the developing world, since it doesn’t require a strict schedule of daily pills to be effective. In the United States, PrEP is recommended for certain high-risk individuals —someone in a relationship with a person with AIDS, or an IV drug user — not the general public.
In New Jersey, the DOH started a pilot program in January 2016 with seven counselors working to coordinate PrEP care in certain hard-hit communities, Leusner said. This was expanded in July to involve two dozen staff members who work in hospitals, federally qualified health centers (FQHCs0, AIDS organizations, and other sites around the state. The program is fueled by $2.4 million in state and federal funds, she said. (To find treatment services for HIV/AIDS or STDs, residents can visit the website or call the AIDS/STD Hotline at 800-624-2377.)
Nonprofit healthcare providers like Planned Parenthood, which operates dozens of clinics around the state, are also promoting access to PrEP services and encourage patients to learn more about the treatment. The Hyacinth Foundation, New Jersey’s leading AIDS advocacy organization, also offers information about PrEP treatment and funds a trio of counselors to help patients stay safe. (As of now, only one HIV drug — Truvada — is approved for PrEP use.)
While treating STDs like chlamydia, gonorrhea and syphilis is fairly straightforward — all are generally curable with antibiotics — federal health officials are concerned about the recent rise in these diseases. In October, the CDC reported that data from 2015 showed chlamydia cases had jumped 6 percent over 2014 numbers, while gonorrhea increased 13 percent and syphilis rose 19 percent — the highest rates in decades. Leusner said there were nearly 40,000 cases of these three diseases in New Jersey in 2015.
“We have reached a decisive moment for the nation,” Dr. Jonathan Mermin, a CDC director, said in October. “STD rates are rising, and many of the country’s systems for preventing STDs have eroded. We must mobilize, rebuild and expand services — or the human and economic burden will continue to grow.”
Mermin said that, since most STD cases go undiagnosed, better education about the problem and access to testing would help address the trend. Untreated STDs put others at risk and can lead to chronic health problems, like infertility. The CDC estimates these diseases cost the United States healthcare system nearly $16 billion annually.