ABSTRACT In 2023, the Congenital Syphilis Elimination Strategic Planning Group was convened by the New York State Department of Health and New York City Department of Health and Mental Hygiene as a community-led strategic planning process to develop a statewide elimination framework following a 410% increase in congenital syphilis cases from 2012 to 2022. Forty-three representatives from public health, healthcare, community organizations, and academia participated. Organized into 7 subcommittees and guided by a Steering Committee grounded in health equity and trauma-informed engagement, the group met over 13 months to identify actionable strategies. Using a structured prioritization process, members produced 6 prioritized and 18 general recommendations for implementation, linked to community collaborators. Strengths included rapid mobilization, inclusive leadership, and integration of community and public health expertise, whereas challenges involved gaps in statewide representation and the absence of a metrics committee. This initiative demonstrates a feasible, replicable model for equity-centered public health planning through authentic community partnership.
Hepatitis C virus (HCV) infection disproportionately impacts people who inject drugs (PWID). Understanding the prevalence and correlates of current and lifetime HCV infection is necessary to inform prevention, testing and treatment efforts among PWID to reduce HCV burden and achieve HCV elimination targets in this population From June 2021-December 2023, 751 PWID were recruited from syringe service harm reduction programs (SSP) and by referral from communities around New York State (NYS). Participants completed web-based surveys on risk factors and social determinants of health and were tested for HCV antibody and RNA to assess their current and lifetime HCV status (never infected, previously infected, or currently infected). Controlling for recruitment site as a fixed effect, a multivariate mixed logistic regression model was built to assess factors significantly associated with HCV status. Among PWID, 58% had a lifetime history of infection, and 29% were currently infected (50% among those with a lifetime history of infection). Daily/almost-daily injection, opioid injection, homelessness, and experience of abscess (all past-year) were significantly associated with current infection, as was younger age. Past-year SSP utilization was associated with a lifetime history of infection. PWID are a priority population to achieve HCV elimination in NYS. Our findings show that HCV burden is high among PWID utilizing SSPs. Expanding access to HCV care and treatment in harm reduction service settings while also providing services to address social determinants of health may be an effective strategy to progress towards reducing the burden of HCV among PWID.
Benzodiazepines are among the most prescribed psychotropic drugs worldwide, yet their potential association with suicide remains poorly understood and often overlooked, raising questions that current clinical practice and safety guidelines have yet to address. This study aimed to conduct a meta-analysis to quantitatively synthesize existing evidence on the association between prescribed benzodiazepine use and suicidal behaviors, explore potential mechanisms underlying this relationship, and identify gaps in the current literature. Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published in PubMed between 2016 and 2025, supplemented with earlier studies identified in a prior systematic review. Eligible studies examined the association between prescribed benzodiazepines and suicidal behaviors. Pooled estimates were calculated using a random-effects model to assess heterogeneity, and publication bias was evaluated using Egger’s regression test. Twenty-one studies met inclusion criteria. Benzodiazepine use was associated with a significantly elevated risk of suicide (pooled effect size = 2.74; 95
OBJECTIVES:There is a significant knowledge gap regarding medication for opioid use disorder (MOUD) and hepatitis C virus (HCV) service provision in U.S. jails. To address this gap, characterized screening, treatment, and discharge planning capacity for OUD and HCV in New York State (NYS) jails outside of New York City. STUDY DESIGN:Cross-sectional study. METHODS:Between August and September 2022, 46 of 58 (80%) NYS jails completed a NYS Department of Health survey to determine jails' capacities to implement MOUD and capacity to screen, test and treat HCV. Surveys were completed prior to the October 2022 statewide mandate deadline to provide MOUD in jails. RESULTS:Most (90%) NYS jails reported offering MOUD care continuation for individuals entering their facilities and 88% offered MOUD initiation. Naltrexone was most frequently used for initiation (67%) and buprenorphine for continuation (79%). Self-reported staff capacity to provide HCV screening was high (89%), yet 41% offered routine opt-in HCV screening and only 15% offered opt-out. Most facilities (84%) continued HCV treatment, though only 29% initiated treatment for newly diagnosed individuals. Although half of facilities (51%) had referral agreements with a community provider to facilitate post-release linkage, limited rapid test kits and education resources were barriers to jail-based HCV services. CONCLUSIONS:MOUD availability in NYS jails is promising, but limited HCV service availability suggests support is needed to overcome financial and structural barriers. Strategies such as universal opt-out testing at intake, and task shifting jail-based discharge planning from staff to patient/peer navigators could significantly improve care in jail settings and during reentry.
Background: In the United States, up to 75% of primary care patients go untested for HIV each year, and nearly two-thirds of adults report never having been tested for HIV. Integrated HIV and STI testing, combining these tests into a single visit, is recommended as a status neutral approach to prevention. Setting: Over 200 New York State Department of Health-funded primary care clinics, hospitals, health centers and community-based organizations funded to conduct integrated screening. Methods: We analyzed weekly testing data from December 2022 to January 2024 to prospectively evaluate whether integrated HIV and STI testing events and results occurred within 30 days of each other. We also assessed group differences in integrated testing by sex at birth, gender, race/ethnicity, risk, organization type, and pre-exposure prophylaxis (PrEP) status using Pearson’s Chi-square tests and calculated prevalence ratios using log binomial models stratified be PrEP usage. Analyses were restricted to individuals with an HIV-negative status. Results: Integrated testing was completed for 69% for individuals on PrEP and 39% for those not taking PrEP, with significant differences observed across all client-specific categories at p < 0.001. Except for age group, variations in integrated screening levels by client characteristics were similar by PrEP status. Individuals who identified as female at birth, as non-Hispanic Black, without an elevated risk, and those tested in non-hospital settings were significantly less likely to experience integrated screening. HIV-test reactivity was 0.04% among integrated testers and 0.15% for HIV-only testers. STI-test reactivity was 4.9% among integrated testers and 7.8% for STI-only testers. Conclusions: A significant gap was identified in integrated testing among providers specifically funded to perform it, resulting in missed opportunities for identification of HIV and other sexually transmitted infections. Integrating HIV and STI testing at a systems level will require significant changes to the perceived individual- and provider-level risks and benefits associated with testing.
