Suggestions for AIDS Problems in Erie County
Numerous areas in Erie County possess a problem with AIDS, as revealed through cumulative AIDS cases. Several zipcodes within the inner-city financial district exceed the national average for cumulative AIDS cases. A cluster comprised of zipcodes 14201, 14202, and 14203 all have AIDS rates 3-4 times that of the national average. Zipcodes 14208 and 14209, with AIDS rates of 840 and 854, possess rates more than 2 times that of the national average. In regard to correlations, blacks and Hispanics represent the groups at greatest risk for AIDS; the correlation coefficient between percentage of the black population and cumulative AIDS cases is 0.65, for Hispanics, 0.56, both of which exceed the 95% confidence level. In addition, zipcodes with the lowest median household incomes and the largest percentage of households receiving public assistance and below the poverty level represent the areas of Erie County with the highest risk factor; the correlation coefficient for median household income is -0.72; for percentage of households receiving public assistance, 0.77; and for percentage of households below the poverty level, 0.75, all of which exceed the 95% confidence level. Regarding mode of transmission MSM, IDU, and heterosexual contact, represent the primary means of transmitting AIDS. 41% of the transmission in Erie County is through MSM, which exceeds the MSM transmission for New York by 15%. IDU accounts for 21% of the transmission of AIDS, equal to the IDU transmission for the U.S.; heterosexual contact represents ¼, 25%, of the AIDS transmission, a 13% increase of the heterosexual transmission for New York State. Females also pose an increasing risk for AIDS, as perceived in the approximately 4% increase of female diagnosis; through 2004, 26% of AIDS cases were female and currently, 29.6% of newly diagnosed cases are female.
In order to address the high cumulative AIDS in the low income areas zipcodes, HIV prevention and education programs need to be targeted to the poor and minorities. Currently, three AIDS service exists in Buffalo, two in zipcode 14201 and one in zipcode 14209, and one HIV/AIDS service exists through the American Red Cross in zipcode 14209. However, as perceived in the high rates for numerous zipcodes, these services do not suffice. Rather than have four separate AIDS clinics, the two in zipcode 14201 and the two in zipcode 14209 should be consolidated into two large-scale clinics. With four individual clinics, resources, such as medical personnel and counselors, may be spread too thin; however, with two primary AIDS clinics, workers and services can be consolidated and therefore possibly provide longer hours for clients. Also, consolidation of clinics would allow for consolidation of costs. Establishing exemplary clinics in zipcodes 14201 and 14209 would be advantageous because such areas are tangential to zipcodes 14202, 14203, and 14209, all of which possess the highest AIDS rates in Erie County. Despite a reduction from four separate clinical locations to two, individuals within the cluster of zipcode 14201, 14202, 14203, 14208, and 14209 would still be able to reach the clinics with public transportation, which runs 49 different routes, the majority of which run primarily through the inner-city financial district. Because the current AIDS clinics in zipcodes 14201 and 14209 are located in the same zipcodes as two major urban hospitals, Erie County Medical Center and Gates Circle Hospital, the AIDS service sites can establish networks with local Buffalo hospitals comprised of a rotational basis with doctors, so that on a given day doctors work at either the AIDS clinic or hospital for a given number of hours. This would provide attendees of the clinic with primary care physicians. In addition to HIV testing, the sites can offer mental health counseling targeted to blacks and Hispanics. In an endeavor to reduce transmission through MSM and heterosexuals, the satellite clinics and the primary AIDS clinic should offer seminars comprised of cognitive-behavioral therapy and safe sex practices specifically for MSM, as well as skills training seminars for heterosexual women and men. To address the issue of AIDS transmission through drug users, needle exchange programs can be established at the clinic sites, and peer outreach can be provided for IDUs.
AIDS Clinic in Buffalo, NY
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