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| Most sexually transmitted infections (STIs) can be cured with the right medicine. Bacterial infections such as chlamydia, gonorrhea and syphilis can be cured with antibiotics. Remember to take the medicine as directed and never share your medication with others. If it is safe to do so, talk to your sex partner(s) about getting tested for STIs. If your current sex partner is infected, it is important they be treated at the same time to prevent you from becoming re-infected. Having an STI and getting it treated does not protect you from future infections!
Some STIs, such as HIV aren't curable, but they are treatable. Talk to your healthcare provider to start treatment as soon as possible. Early treatment not only helps you stay healthy but can also reduce your chance of spreading the virus to someone else.
If left untreated, STIs can cause very serious health problems such as: Gonorrhea can cause men and women to become infertile. Long term infection of syphilis can damage internal organs. HIV can progress to AIDS (acquired immunodeficiency syndrome).
Having one STI also increases your chances of getting other STIs.
According to the Centers for Disease Control and Prevention chlamydia rates across the country have inreased 22% since 2013 and gonorrhea rates have gone up by 67% in the same time frame. However, even more troubling are increases in syphillis rates, including a 154% increase in congenital syphililis rates since 2013. Looking specifically at the Commonwealth, the Massachsuetts Department of Public Health reports similar increases in those three STIs.
This is the final blog in our series as part of National Sexually Transmitted Infection Awareness Month. To learn more about sextually transmitted infections, visit www.bphc.org/STI.
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| Direct services and community coalition focused on racial inequities and providing linkage to care The Boston Public Health Commission (BPHC) announced today that it has been awarded a new five-year grant of $4.8 million from the federal Health Resources and Services Administration (HRSA) for the Boston Healthy Start Initiative (BHSI). The BHSI is focused on eliminating racial inequities in infant mortality and related birth outcomes through direct support of pregnant and parenting women, children and fathers through care coordination, connection to resources, health education, and advocacy. This new grant focuses on the neighborhoods of Roxbury, Dorchester, Mattapan and Hyde Park which are areas of the city that have higher than average infant mortality rates. According to data analyzed by BPHC staff, including some from the most recent Health of Boston report, the infant mortality rate between 2013-2015 for Black women in these four neighborhoods was 10.3 per 1,000 live births is almost double the overall Boston rate (5.8) and is 3.5 times the rate for White women citywide (2.9). Data analysis also shows promise, as the rate of infant mortality in Black babies decreased by 36% between 2006-2015, suggesting that the long-term investments in programs such as BSHI may be having an impact on health outcomes. "The Boston Healthy Start Initiative takes a comprehensive, lived-experience based approach to address some of the causes linked to infant mortality. We have built on the existing community assets and significant progress that has been made over the years. This funding allows us to provide services directly to families and engage the community in addressing the root causes of racial inequities influencing infant mortality," said Monica Valdes Lupi, executive director of the Boston Public Health Commission.
This grant will fund case managers, known as Family Partners, embedded within the Codman Square Health Center, Mattapan Community Health Center, Whitter Street Health Center, Bowdoin Street Health Center and the Teen & Tot Program at Boston Medical Center. BHSI Family Partners provide one-on-one support to mothers during pregnancy and through the first 18 months of the infant's life to support them reach their goals for their family, including help enrolling in health insurance, health education, support with breastfeeding and safe sleep, accessing mental or behavioral health services, among others. They also provide linkage to resources to address social determinants of health: housing and food insecurity issues, education, employment and legal topics. Importantly, family partners bring their lived-experiences to their work which often includes being an advocate on behalf of mothers and babies.
"We are pleased to receive this funding to continue our commitment, advocacy and services in striving for birth equity and optimal population health for individuals of color and communities disproportionately impacted by health inequities. We have made progress in infant mortality rates however there is still much more work to be done, said Heavenly Mitchell, Director, Healthy Start Systems at BPHC.
In addition to funding for family partners, this new grant will fund staffing and programmatic expenses to operate two other programs coordinated by BSHI: the Community Action Network (CAN) and the Father Friendly Initiative. The CAN is a group of community residents and organizations working together to reduce racial inequities in infant mortality and poor birth outcomes in Boston through policy and community level changes. The Father Friendly Initiative provides opportunities to men living in the city of Boston to become fully involved members of their families and community.
BPHC was one of the original grantees of funding from HRSA when it began piloting HSI in 1991. Phone numbers for residents to connect with a BHSI Family Partner can be found on its website, by clicking here.
The Boston Healthy Start Initiative is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) and the Boston Public Health Commission.
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| Many sexually transmitted infections (sometimes called sexually transmitted diseases (STD) or STI) don't cause any symptoms. If you're having sex, getting tested is one of the most important things you can do to protect your health and it's the only way to know for sure if you're infected.
Yearly STI testing is recommended for:
More frequent testing (every 3 to 6 months) is recommended for people at high risk, these include:
You should also get tested:
All adults and adolescents from ages 13 to 64 should be tested at least once for HIV and anyone who has unsafe sex or shares injection drug equipment should get tested for HIV at least once a year.
If you're not comfortable talking with your regular healthcare provider about STI testing, find a clinic near you that provides confidential and free or low-cost testing.
Click here for a list of free and confidential STI testing clinics in Boston.
You can also find a testing site near you by calling the Mayor's Health Line at 617-534-5050 or visit https://www.helpsteps.com.
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| The Community Action Network (CAN) is a group of community residents, representatives from community-based organizations, healthcare, government, and other groups that are working together to eliminate racial and ethnic inequities in infant mortality and poor birth outcomes in Boston by mobilizing the community to do outreach, education, and policy change. Community engagement and leadership is a core strategy of CAN.
The CAN hosted an 'Appreciation' themed meeting on March 21st at the Great Hall at Codman Square Health Center in Dorchester. It was a wonderful meeting where CAN members got to reconnect with each other, celebrate CAN accomplishments, and share resources and announcements. A total of 51 CAN members were in attendance, including 22 new members. "What the Community Action Network is doing through community engagement and advocacy to achieve health equity is a best practice," said Monica Valdes Lupi, Executive Director of the Boston Public Health Commission, who was a special guest speaker at the recent meeting.
Nine CAN members were awarded for outstanding commitment and dedication. If you'd like to learn more about the Community Action Network go to www.bphc.org/CAN or email CAN@BPHC.org.
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| The Boston Public Health Commission (BPHC) received a grant of almost $15 million to fund core medical and support services for people living with HIV/AIDS and their families. BPHC will administer the grant funds to providers located in the Boston Eligible Metropolitan Area (EMA) to improve health outcomes and reduce HIV transmission among hard-to-reach populations and those that are under or uninsured. The grant comes from HRSA’s Ryan White HIV/AIDS Program, a part of the United States Department of Health & Human Services.
“Everyone that is diagnosed with HIV/AIDS deserves the chance to access treatment”, said Chief of Health and Human Services, Marty Martinez. “The Ryan White Program and others supported by the city are intentional in distributing funds for services offered in a variety of settings, including AIDS service organizations, community health centers, substance use treatment agencies, and minority-based agencies. This model is one that works. These new funds will enable us to do even more now as part of a nationwide effort to end HIV/AIDS.”
The Boston EMA is comprised of 308 cities and towns within 10 counties including seven counties in Massachusetts and three counties in New Hampshire. As of December 31, 2017, there were 18,149 people living with HIV/AIDS reported in the Boston EMA. However, in 2017, there were 227 people diagnosed with AIDS, a 27 percent decrease in AIDS diagnoses since 2013.
“This funding demonstrates the commitment of the Mayor, the Boston Public Health Commission and the Boston Ryan White Planning Council to provide life supporting and lifesaving services and medications to our neighbors here in the greater Boston area and southern New Hampshire while we continue our work to stop new HIV infections,” said Stephen Corbett, Chair of the Boston EMA Planning Council.
This funding, together with funding from the City of Boston and other sources, plays a critical role in supporting patients in accessing care across the continuum of HIV prevention and care services. Comprehensive HIV care includes access to antiretroviral therapy, substance use treatment services, mental health treatment, and oral health care. This grant focuses on reducing health disparities and barriers to treatment as well, providing funding support regarding transportation, nutrition, and housing. Included the new grant is Minority AIDS Initiative (MAI) funding that focuses on reducing racial and ethnic disparities throughout the HIV care continuum.
“We are making a real difference in the lives of thousands of people living with HIV/AIDS through the Ryan White Program. The funding empowers patients to access medication and the services that are right for them in order to help them keep their viral load low, and in many cases, thanks to this program, at an undetectable level. The robust funding being provided now will allow us to provide even more of the important wrap-around services patients need,” said Jenifer Leaf Jaeger, MD, MPH, Director of the Infectious Disease Bureau at BPHC.
In January, the Boston Public Health Commission and The Massachusetts Department of Public Health reported an outbreak of new HIV cases in persons who inject drugs in Boston. A couple of months later, a similar outbreak was announced to be occurring in other parts of the state, including in Worcester. These follow the outbreak in Lowell and Lawrence in 2017. The increasing rates of HIV infections in vulnerable populations demonstrates the importance of funds for early detection, treatment and comprehensive prevention efforts targeting people who inject drugs.
The Ryan White Services Division at the Boston Public Health Commission serves as the grantee for the Ryan White Part A grant. Click here to learn more about their work.
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| April is National Sexually Transmitted Infection (STI) Awareness month. It is the perfect time to discuss what we know about STIs and what we can do to protect ourselves from them!
(Note: The hyperlinks above direct you to Fact Sheets that are viewable online and downloadable as a PDF. Each are available in English, Spanish, Cape Verdean Creole, Haitian Creole, Chinese, Portuegese and Vietnamese.)
There are many factors that can increase someone’s risk of infection, including environmental, social and cultural factors. Young people ages 15–24 continue to be at highest risk for most STIs.
The good news? STIs are preventable! There are always risks associated with having sex, but there are ways to reduce your risk of getting STIs. Limit your risk by taking the following steps: - Always use a latex, nitrile or polyurethane condom or barrier (dental dam) when having anal, vaginal, or oral sex.
- Limit your number of sex partners.
- Talk with your partner about their STI status and getting tested.
- Talk with your health care provider about safer sex practices and getting tested.
- Understand that having sex while under the influence of drugs and/or alcohol can increase the likelihood of unprotected sex.
The only 100% effective way to prevent STIs is to not have sex.
All STIs, even HIV, are treatable, and most are curable. That’s why it is important to get tested! The sooner you know you have an STI, the better you can protect your health. If not treated, some STIs can lead to serious health problems. If you have an STI, talk to your partner if it is safe to do so. Keep in mind that if your partner is not treated, your partner will continue to pass the infection back to you, and you will need to be treated again!
Stay tuned for more STI blogs throughout the month!
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| Tuberculosis (TB) is a serious disease and has killed millions of people all over the world throughout history. However, thanks to medical advances and public health efforts, we are now able to prevent and cure most cases of TB. Today, the Boston Public Health Commission joins with the Centers for Disease Control and Prevention, and other organizations all over the world to recognize World TB Day.
Overall, tuberculosis cases are rare in the United States. In fact, about 80% of tuberculosis cases in Boston occur in residents born outside of country. However, anyone can develop the potentially serious disease regardless where they are born. That is why it is important for everyone to understand what TB is, how to recognize the symptoms and to understand what can be done to prevent the spread of it.
"Getting the word out about TB to all communities in Boston is a very important. Through awareness, education and outreach we can continue to drive down the number of TB cases here in Boston and make sure anyone who is infected knows how and where to get treatment right away," says Jennifer Lo, MD, Medical Director of BPHC.
BPHC operates the city's tuberculosis clinic, located at the Boston Medical Center. The clinic treats residents and visitors to the city who are diagnosed with TB. According to the Infectious Disease Bureau at BPHC, there were 42 cases of tuberculosis reported in Boston residents in 2017.
TB is spread by tiny germs that can float in the air. When a person with TB coughs, shouts or sneezes they can spray these germs into the air. If another person breathes in these germs, they can get TB. Even though 70% of those infected with TB have the germs in their lungs, TB can also infect other places in the body such as the bone, brain or lymph glands. Symptoms of TB include coughing, fever and night sweats. Some people may have the TB germ in their body, but do not feel sick. This is called latent or "sleeping" TB infection. A simple test conducted on the skin of a person's arm (called the "TB skin test") can determine quickly whether a person has the TB germ in their body. A blood test is also sometimes used to confirm a diagnosis. Additional tests such as a chest x-ray or sputum (phlegm) test may be needed to confirm a TB diagnosis in some people. People should be tested for TB if they:
- spent time with someone who has TB disease,
- are HIV positive or have another medical problem that weakens their immune system,
- have symptoms of TB disease (fever, night sweats, cough, and weight loss),
- are from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia),
- live or work in places in the United States where TB disease is more common, (homeless shelters, prison or jails, or some nursing homes)
- or use illegal drugs
TB is treatable! There are medications that can cure TB and help people stay healthy. It is important to not stop taking the medications until treatment is complete. If medication is stopped too soon, the TB germ can come back and become very hard to fight off. The Boston Public Health Commission operates the city's tuberculosis clinic. Healthcare providers can refer their patients to the TB clinic (located at Boston Medical Center, Preston Family Building, 5th floor, 732 Harrison Avenue, Boston, MA 02118). To schedule an urgent appointment for a suspected tuberculosis case, healthcare providers should contact the TB Clinic Triage nurse at (617) 534-4875. Remember, TB is treatable and preventable! To learn more about TB click here. |
| Following its Public Health Council meeting, the Massachusetts Department of Public Health (MDPH) released a data brief summarizing results of a study conducted by the Boston Public Health Commission (BPHC) addressing health equity issues in the current opioid epidemic. Specifically, the research team found that Black residents who were treated at local hospitals for opioid overdose were significantly less likely to have accessed state-funded substance use disorder treatment services than their White counterparts following discharge.
“While we have seen differences in opioid overdose rates and opioid treatment rates before, to our knowledge this study for the first time quantifies those differences by the race of the patient. In order to address these lower rates of accessing treatment for Black residents, we need to better understand the many factors influencing the different pathways to treatment,” said Dan Dooley, Director of the Research and Evaluation Office at BPHC and lead author of the data brief.
According to the brief, the odds of receiving subsequent substance use disorder treatment within 30 days following a hospital patient encounter for opioid overdose were 29% lower for Black residents throughout Massachusetts than for their White counterparts; this difference was statistically significant (p<0.05). Among Boston residents, the odds were 58% lower for Black residents in comparison with White residents adjusting for other important risk factors (e.g. age, sex and insurance coverage), and this difference was statistically significant.
The study was a collaboration between MDPH and BPHC researchers, who analyzed 2011-2015 hospital and substance use treatment data, as well as other data sources originally linked as part of the Chapter 55 opioid analytical dataset now identified as The Massachusetts Public Health Data (PHD) Warehouse. Managed by MPDH, the PHD partner program supports a unique collaboration between public, private, and non-profit organizations to analyze population health trends with a focus on fatal and non-fatal opioid overdoses, and other public health priorities.
“The public health data warehouse that DPH established initially under the law known as Chapter 55 has been instrumental in allowing us to examine patterns of substance use treatment and outcomes. This collaboration between DPH and BPHC underscores the benefits of working with a large data system to shed light on disparities in access to care across different demographic groups within Boston and to inform intervention strategies to ensure access for all,” said Monica Bharel, MD, MPH, Commissioner of the Massachusetts Department of Public Health.
Understanding differences in access to care involves studying many factors that influence the pathway to treatment including whether referrals are made, whether attempts to access services are made, and whether appropriate services are available and affordable. This data brief highlights the need to explore these pathways using a health equity lens. BPHC works with other city and state agencies as well as Boston’s local hospitals to develop strategies to address the opioid epidemic.
“Advancing health equity is at the core of the work we do at BPHC. This latest brief highlights the capabilities of our team to analyze data in important ways in order to understand current and emerging health inequities among Boston residents. This type of analysis is important as we face the opioid epidemic,” said Monica Valdes Lupi, JD, MPH, Executive Director of BPHC.
The Research and Evaluation Office at BPHC is staying in close communication with colleagues at MDPH regarding the potential for continuing this important study as well as looking at other avenues, including collaborating directly with local hospitals in Boston, to assess potential for enhancing existing treatment referring capacity. MDPH anticipates extending an opportunity in the fall of 2019 to run additional analyses using more recent data (through 2017) via the PHD partner program.
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|  Did you know that nearly one in four people living with HIV in the United States is female? This means that more than 235,000 women and girls have been diagnosed with HIV. HIV and AIDS are still widespread public health issues, and women remain vulnerable to infection, especially African-American and Hispanic women.
Here are some facts that every woman and girl need to know about HIV and AIDS. The only way to know for sure whether you have HIV is to get tested. Anyone who has sex is at risk of HIV infection, no matter what her race, ethnicity, age, or sexual orientation. Adult women are more likely to get HIV during vaginal sex because the vagina has a larger area that can be exposed to HIV-infected semen. Also, semen can stay in the vagina for several days after sex, which means a longer exposure time for women. Having an untreated sexually transmitted infection (STI) makes a person more vulnerable to get HIV if they're exposed to it. If you chose to have sex, there are many ways to prevent HIV, such as using condoms; not having multiple sex partners; not engaging in sexual activities while under the influence of alcohol or drugs; which is linked to sexual risk-taking; and getting tested for STIs. Never share needles, syringes, or other injection equipment. Sharing equipment puts you at high risk of HIV infection. If you do not have HIV and your partner does, talk to your health care provider about taking pre-exposure prophylaxis (PrEP). PrEP is a daily pill that can lower your risk of getting HIV. Daily PrEP can reduce the risk of getting HIV from sex by more than 90% If you think you may have been exposed to HIV, seek medical treatment right away. For people who have a one-time risk of exposure to HIV, post-exposure prophylaxis (PEP) might be an option. PEP is an anti-HIV medicine that you can take within 72 hours of possible exposure to HIV to lower your chances of getting HIV. If you are pregnant and living with HIV, you can take HIV medicine and work with your healthcare provider to stay healthy. If you take medicine, the risk of passing HIV to your baby is less than one percent.
People with HIV need to take HIV medicine to stay healthy and to reduce their risk of spreading the infection to others. If HIV medicine is taken as prescribed, HIV-positive individuals can get and keep an undetectable viral load (the amount of HIV in the body) and have effectively no risk of transmitting HIV to their HIV-negative sexual partners.
Some women with HIV sometimes postpone medical care because of stigma, and their fear of rejection by family, violence from a partner, or feelings of depression.
Progress has been made in the battle to end HIV/AIDS, including among women and girls. However, we need to do more in battling back stigma. Getting on treatment early after infection and staying on treatment without interruption has proven to be an effective strategy in keeping people with HIV healthy and preventing its spread. We are proud to join with the community in recognizing National Women and Girls HIV/AIDS Awareness Day," said Jenifer Leaf Jaeger, MD, MPH, Director of the Infectious Disease Bureau at BPHC.
We can all help fight stigma by learning and talking more about HIV. Go to www.bphc.org/HIV for more information.
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| BOSTON (March 1, 2019) – The Boston Public Health Commission (BPHC) today alerted the public of a measles exposure. On February 26, 2019, an individual with confirmed measles traveled from New York City to Boston and subsequently to New Hampshire. Persons who were at any of the following locations may have been exposed: 4:00 PM – 8:30 PM Greyhound Bus (#2520) from New York City to Boston 8:30 PM – 12:00 AM South Station Bus Terminal, Boston 10:00 PM – 11:30 PM Boston Express Bus (#5178) from Boston Logan Airport to Manchester, New Hampshire (with stops in Tyngsboro, MA and Nashua, NH)
Persons who were at these locations could become ill between March 3 and March 19, 2019 (21 days following potential exposure). “Measles is a serious disease, particularly in children who have not been vaccinated. If you don’t know your immunity status and think you have been exposed, contact your healthcare provider immediately,” said Jen Leaf Jeager, M.D., M.P.H., Director of the Infectious Disease Bureau at BPHC.
Measles is a highly contagious virus that is spread through the air, usually through coughing and sneezing. The virus may remain in the environment for up to two hours after the infectious person has left the area. Exposure can occur even without direct contact with an infectious person.
Early symptoms include a high fever, runny nose, cough, and red eyes. A skin rash usually occurs three to five days later and begins as flat, red spots on the face. If experiencing these symptoms, people are advised to contact their health care provider by phone immediately for further instructions. Those who have had measles in the past or have received two doses of measles containing vaccine are unlikely to become ill even if exposed. When immunity status is uncertain, monitoring for symptoms and contacting a healthcare provider if any arise is recommended. BPHC is coordinating with the Massachusetts Department of Public Health and the New Hampshire Department of Health and Human Services. For additional information, please contact BPHC at 617-534-5611, MDPH at 617-983-6800 or NHHHS at 603-271-4496.
Fact sheets on measles is available online in English, Arabic, Chinese, Haitian Creole, Portuguese, Spanish and Vietnamese. Media Contact: Robert Goldstein, rgoldstein@bphc.org, 617-534-3127
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