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?