addressing syndemics

sexually transmitted infections, hiv, viral hepatitis, and substance use

The New York State Department of Health (NYS DOH) Office of Sexual Health & Epidemiology (OSHE) developed a Data Insights on Sexual Health (DISH) to highlight the syndemic of HIV, Hepatitis C, substance use, and sexually transmitted infections (STIs). A syndemic occurs when two or more health conditions cluster and interact within a population because of social and structural factors, leading to an excess burden of disease and continuing health disparities.

Source:
https://www.health.ny.gov/statistics/diseases/communicable/std/docs/syndemic_dish.pdf

new york state trends

In New York State, rates of early syphilis and gonorrhea have increased from 2015 to 2024, and chlamydia has seen a modest decrease. Individuals diagnosed with an STI commonly report substance use and test positive for HIV and HCV. STI rates are often greater in neighborhoods with high poverty rates, and high levels of poverty in a community are associated with decreased access to health care, including prevention and treatment of STIs, HIV, HCV, and substance use disorders.

integrated health service delivery

The NYS DOH identified integrated health service delivery of primary care and behavioral care services, including mental healthcare and substance use disorder care, as key to improvements in the STI syndemic. This approach acknowledges the multiple health care needs individuals may have and seeks to make services more accessible and comprehensive, thus improving quality of care that patients receive. Integrated health services could look like:

Collaboration between different healthcare settings to coordinate care, including emergency departments, pharmacies, community-based organizations, etc.

Co-locating services, such as STI clinics also offering harm reduction services, allowing people to access STI testing and treatment as well as overdose prevention services in one location.

Consolidating services to address medical and social needs together, such as providing referrals for housing, food, employment, transportation, and health coverage services in addition to routine medical referrals.