Single Source Procurement: Pre-Exposure Prophylaxis (PrEP) Program - End of AIDS - STD County Clinics

On June 29, 2014, Governor Cuomo made an important announcement, in which he detailed a three-point plan to "Bend the Curve" and move us closer to the end of the AIDS epidemic in New York State. The goal is to reduce the number of new HIV infections to just 750 (from an estimated 3,000) by 2020.

The three-point plan includes:

  1. Identifying persons with HIV who remain undiagnosed and linking them to health care;
  2. Linking and retaining persons diagnosed with HIV in health care and maintaining them on antiretroviral therapy to maximize HIV viral load suppression so they remain healthy and to prevent further transmission; and
  3. Facilitating access to Pre-Exposure Prophylaxis (PrEP) for high-risk HIV negative persons.

A PrEP implementation program is being established to achieve the third goal of the Governor's three-point plan. This program seeks to fund a number of strategies to implement PrEP as part of Health Care for high risk sexually active individuals.

The County DOHs are the State Department of Health's extension for purposes of providing public health services in the community. They are known in their community and work in conjunction with the State around STD surveillance and reporting. The county DOH's serve all people including the indigent population and provide STD services regardless of insurance coverage. Each of the counties in the table above either has their own STD clinic or sub-contracts the STD clinic services for their county.

STD clinics provide walk in services for persons who are concerned they have an STD. Anogenital STDs are identified as a 'high risk' for HIV infection. These clinics provide services to people who do not have access to health care or those who do not want to share this information with their primary care provider. STD clinics are uniquely situated in each community to identify persons at high risk for HIV, start the discussion regarding their sexual health and the possibility of adding PrEP as a prevention strategy, and provide a referral to a community medical provider for PrEP services.

Through the contracts to be approved with this waiver, DOH AIDS Institute plans to facilitate access to PrEP for high risk individuals, by targeting PrEP to clinics in high need areas. NYS Public Health Law Article 23 requires all counties to provide diagnosis and treatment for STDs with the responsibilities more specifically defined in regulation. Some counties staff an HIV clinic directly, while others provide services through a contractor. Many county clinics have very limited operating schedules and reach relatively few persons. The counties that were chosen for funding had the highest number of newly diagnosed HIV infections in MSM (Men who have Sex with Men). This criteria was used to fairly allocate limited funding in a manner which maximizes the state's return on investment by targeting counties with the highest rates of new infection. All health departments outside of NYC were ranked. NYC is funding STD clinics within NYC, therefore STD clinics located within NYC are not under consideration for this funding.

Procurement / Program Name Pre-Exposure Prophylaxis (PrEP) Program - End of AIDS - STD County Clinics
Contractor Name(s) Multiple – Please see attached.
Contract Period 10/1/2014 – 3/31/2019
Contract Number(s) C029985 – C029989