Dr. Demetre Daskalakis on Record Low HIV Diagnoses in NYC

Dr. Demetre Daskalakis. Photo by Eleni Sakellis

NEW YORK – Greek-American Dr. Demetre Daskalakis, the Deputy Commissioner for Disease Control at the New York City Health Department commented on the record low number of HIV diagnoses in the city for 2016 announced by the Health Department on Wednesday, Nov. 28.

He said of the 8.6% decrease in new cases from 2015, “I would even go so far to say that it’s good and big news. I’m pretty euphoric about the news, to be honest.” The number of new cases of HIV in 2016 was 2,279. The city first began following new HIV diagnoses in 2001 when the number was 5,906, as the Daily News reported.

Dr. Daskalakis told The National Herald, “When government and community work together to motivate a change, epidemics can come into tighter control. We are very enthusiastic about the ongoing and accelerating progress New York City is witnessing to drive HIV below epidemic levels. Even in the earliest stages of the new programs implementation in New York City, we are seeing changes that will energize us to push forward.”

“The drop was even starker among men who have sex with men: Among that population, diagnoses fell from 1,450 in 2015 to 1,236 in in 2016 — a 14.8% drop,” the Daily News reported.

The use of “pre-exposure prophylaxis, or PrEP” which has increased this year is likely the reason for the drop in new cases of HIV for men in that group, Dr. Daskalakis noted, as reported in the Daily News. The drugs are prescribed to people who are not HIV-positive but are at risk for infection, “and are increasingly being prescribed to men who have sex with men,” as the Daily News reported.

Dr. Daskalakis said as noted in the Daily News, “I’m excited because if this is what happened in 2016, I can only imagine what’s going to happen in 2017 in terms of accelerating the decline of new infections. We’ve launched so many new interventions that focus on getting people on new medicines.”

“The city estimates that 5% of men who have sex with men were on PrEP at the start of 2016 — but that grew to 30% by the end of the year,” the Daily News reported.

Charles King, director of Housing Works, an AIDS-service organization, said, as reported in the Daily News, the number of cases for that group had “seen no movement. And suddenly we’re seeing sudden movement.”

King also agreed that increased prescriptions for PrEP are the reason for the good news partly because a similar decrease is not evident for “groups that are less likely to be prescribed PrEP” and “in fact, infections among women rose in 2016,” as the Daily News reported.

“That’s the part that to me is the most concerning,” Dr. Daskalakis noted, as reported in the Daily News, adding that previously, “I would look at the (men who have sex with men) diagnoses and say, ‘oh we’ve plateaued. And now I look at the women diagnoses as we’ve gone down (elsewhere) and say, ‘oh we’ve plateaued.’”

The next step for the city in the coming year will be to increase awareness of the availability of PrEP to women who have an increased risk of HIV infection as well as their physicians.

Dr. Daskalakis observed, as the Daily News reported, “When the providers of care for women really buy into pre-exposure prophylactics and understand its role, all of a sudden they’re prescribing to their patients.”

He added that New York City reached out to “black and Hispanic men with information about PrEP in 2016,” since new diagnoses are still more likely among the black and Hispanic communities in spite of the decline in new diagnoses for  “black, Latino and white men in 2016,” as reported in the Daily News.

Efforts included “rebranding STD clinics to sexual health clinics and establishing a more advanced system for delivering PrEP to people who need it. Among those receiving PrEP from the city’s clinics, about 60% are black and Latino — a much higher share of the population on PrEP than nationally,” the Daily News reported.

“Among those who do have HIV, 76% have achieved ‘viral suppression’” with antiretroviral medicines that keep the viral load undetectable and once the viral load is undetectable “for at least six month [they] have effectively no risk of sexually transmitting HIV, according to the Health Department,” as the Daily News reported.

Daskalakis’ parents are both from Evrytania, his father from Megalo Chorio and his mother from Karpenisi.