590. Tackling HIV/AIDS in Brooklyn New York Within a Network of Federally Qualified Health Centers

Background

As of June 30, 2016, 122,945 New Yorkers had been diagnosed and were known to be living with HIV/AIDS. The Family Health Centers at NYU Langone (FHC) has for the past 27 years continued to build an evolving network of services which aim to tackle the epidemic through the principles of hot-spotting, elevating cultural competency, and applying the continuum of care model for the communities we serve.

Methods

FHC’s network covers a service area of six NYC Community Districts in Brooklyn. Utilizing best practices, FHC has built a network which addresses the cascade of care through EMR embedded screening, education on cultural competencies in the LGBTQ community, dedicated health navigators, and a comprehensive panel of providers to deal with biopsychosocial factors that prohibit access to healthcare delivery. Utilizing automated referral pathways within the EMR along with a daily review of all testing results performed within the network, care coordination teams and patient navigators are able to identify patients. Dedicated case management teams are then assigned to locate patients and link patients to treatment and assist in overcoming care access barriers.

Results

Within the FHC catchment area the incidence of new HIV infections was heavily concentrated among poor minorities. Among the FHC population, minority races compromised 79.3% of those PLWHA, with 58% of the population having the risk factor of MSM activity. For those patients who fall under >20% below Federal poverty level, New York’s HIV/AIDS death rate is at 74.7%. Despite national and regional trends, the FHC over the last 3 years has managed to not only to provide greater opportunities for access to care, but has increased the rate of viral load suppression among patients served (393 patients in 2014 to 416 patients in 2016 and VLSR of 92.4–95.6%.)

Conclusion

HIV/AIDS prevalence is still characterized by wide gaps in healthcare disparities and inequality, particularly among those communities who are poor, LGTBQ and/or minority background. By building an infrastructure that follows best practices in a culturally sensitive context, the FHC is able to provide greater access to care in a dwindling population while creating a medical home for quality care regardless of payer base, race, or gender.

Disclosures

All authors: No reported disclosures.

Superior sagittal sinus and torcula thrombosis in minor head injury

A 27-year-old man suffered a relatively minor trauma. He developed signs of raised intracranial pressure three days after injury. Investigations revealed superior sagittal sinus and torcular thrombosis.

Effect of mineralocorticoid activity on transtubular potassium gradient, urinary [K]/[Na] ratio, and fractional excretion of potassium

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Natural environment surpasses polluted environment in inducing DNA damage in fish

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Evaluation of DNA damage in the oral mucosa of tobacco users and non-users by 32P-adduct assay

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Increasing appointment compliance through telephone reminders: does it ring true?

This study evaluated the effectiveness of telephone reminders on appointment-keeping in young people treated for gonorrhea. Compliance with scheduled follow-up was recorded for a total of 339 patients during three two-week periods, namely, initial baseline phase, intervention phase during which attempts were made to remind the patients by telephone, and repeat baseline phase. There was no overall improvement in compliance with follow-up during intervention (31%), compared to baseline (32%). However, data from the intervention phase revealed a significantly higher rate of appointment-keeping for those patients who were contacted (44%) than for patients who were not reachable (20%). Furthermore, when we reanalyzed the data as a function of telephone ownership for all patients who did not receive a reminder, return rates were significantly higher for patients owning telephones (32%) than for those denying phone ownership (18%). Thus, we conclude that the likelihood for appointment compliance was related more to sociobehavioral factors reflected in telephone ownership than to the telephone reminders.

Carcinogenicity, perinatal carcinogenicity and teratogenicity of low dose metronidazole (MNZ) in Swiss mice

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Preliminary observations on interaction of 14C-metronidazole with macromolecules in vivo and in vitro

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