PATH stands for “Promoting Action Towards Health”. PATH is a research study conducted by Columbia University and Yale University, which gives newly diagnosed HIV-positive men who have sex with men (MSM) the opportunity to participate in an individual level counseling intervention.

The goal of PATH is to promote  positive health behaviors, avoid  future episodes of HIV
transmission, and increase selfawareness. PATH uses a one-onone counseling approach and offers financial compensation for  participants’ time.

Click here to download a brochure

Nidia Rodriguez chuckled and flipped through her phone, pausing at a snapshot of one of her own paintings: Betty Boop, lounging at the beach. “[Art] relieves a lot of stress. So I try to do as much as I can,” she mused, admiring her work.  “Right now I’m finishing a [painting of a] chef that I’m going to put in my kitchen... It says Nidia’s Kitchen.”

Don’t let the light subject matter of her art fool you; Nidia came to Harlem United during one of her darkest moments. A single mother of four, she was only one year clean from addiction (she quit cold turkey) and struggling with severe depression. Nidia recognized that she needed a support network. “I went to a clinic and my social worker kept searching for programs until we found the right one,” she said, explaining the winding path that led her to Harlem United, a place where she felt immediately at home. “I never knew what purpose I had [in life]…I’m thinking that Harlem United might be my destiny… it’s a program that really lets me be myself.”

Though Nidia has been involved with Harlem United’s Adult Day Health Care programming for just a little over a year, she has quickly made it her routine--and her haven. She arrives every day at 8am and stays until 3pm, signing up for the groups that she needs to feel better. The caring staff and her fellow group members have made her feel at ease, helping her work through her struggles. “I’ve learned to open up in a group [and] I feel more comfortable in myself…I realized I could communicate with people.”  Nidia isn’t the only one who has noticed a dramatic change. Omar Zurita, her social worker, is also amazed by how much she has blossomed in such a short period of time. “Since Nidia began the program, I’ve seen a remarkable change and progress in her.  She came to us feeling very depressed…she was very quiet and gave us small details about her life.  Looking at her now… her mood has significantly improved.”

In part, these improvements are a direct result of Harlem United’s creative programming. Thanks to El Faro’s Art Therapy program, Nidia has discovered a passion--and talent--for painting. The on-site art therapist, Hilda Meza, is well aware of the impact art has had:  "Through the process of art making, [Nidia] has been able to experience feelings of competence and satisfaction. Through months of attending the program consistently and utilizing the therapeutic groups, she slowly but surely became more confident and open towards learning.” To date, she has completed seven paintings, many of which are on display at El Faro.

Not only does Nidia have a great ability to focus on the positive--something that shines through in her artwork--she is also quite clear about her goals for the future. Her current aspirations include working for Harlem United, specifically, running a stress management group at El Faro. (There is no doubt that this mother of four/grandmother of six is a stress management expert). “When I go home that’s where the stresses are--all the little things I have to do. I just do one thing at a time.” Nidia’s best advice for juggling everyday stress? “Do something you like--maybe art!”

It is clear that Nidia is a woman of action, already making strides toward her goal. She is currently pursuing a GED, and was also elected by her community to be El Faro's Consumer Advisory Board Bi-Lingual Liaison. In her new role, Nidia looks forward to helping others love Harlem United as much as she does.

Rob Vassilarakis likes to say he went from running the streets to…running the streets.

A former crystal meth addict, Rob not only found a new beginning at Harlem United, but also a rather unexpected path as well.  “Harlem United helped me work a miracle in my life,” says Rob.  He now not only works here in intake and outreach, but also represented the agency and the Bronx in the Footlocker Five Borough Challenge a race within a race in the ING NYC Marathon 2011. 

“Since I found running, I have not been triggered to use again,” he adds, “I am no longer running from my issues; I’m running toward them.”   As part of Team Harlem United Rob has completed the NYC marathon twice and has also raised over $8,200 on behalf of the agency.  Part of his successful fundraising resulted from performances of his spoken word poetry throughout the city with El Grito de Poetas.  As one of the founders of the only Latino poetry troupe in the United States, Rob uses his poetry to raise awareness of HIV and open a dialogue about the social issues which are affecting the community.  “I really, really want to get the message to somebody – whether it’s another meth addict or whether it’s a kid who’s struggling with sexual identity – to know that it will be ok.  It took me 38 years to finally be okay, but I’ve arrived at this place, and it feels amazing.”

Please follow this link to view Rob’s poetry or visit www.harlemunited.org/teamharlemunited to learn more about Rob.

October 18, 2011

An Open Letter to the U.S. Food and Drug Administration and Gilead Sciences

RE: Timing the Review and Approval of Pre-exposure Prophylaxis for HIV Prevention

We, the undersigned, are non-profit organizations and coalitions who support the development of and access to new safe and effective HIV prevention options in the United States and globally. Data from multiple clinical trials in different populations showing that antiretroviral drugs for HIV treatment can also prevent HIV infection have accumulated to the point where FDA approval decisions could be made for this intervention. The approval issues for the different populations are not identical. For the reasons outlined below, we urge the FDA and Gilead Sciences to reconsider plans to combine the approval for a prevention indication for both men who have sex with men, including transgender populations (MSM) and heterosexuals into a single filing. The combination could unnecessarily delay approval for MSM, the group at greatest risk of HIV infection in the United States.

FDA has a duty to move forward on beneficial products by setting out best terms of use, and, by law, to “promote the public health by promptly and efficiently reviewing clinical research and taking appropriate action on the marketing of regulated products in a timely manner.” This duty is what’s in question today.

Results from three large clinical trials show that oral pre-exposure prophylaxis (oral PrEP) has the potential to prevent new HIV infections. Last year the iPrEx trial found that daily TDF/FTC (marketed as Truvada by Gilead) along with standard prevention reduced HIV infection risk by 42% in at-risk gay/bisexual men and transgender women who have sex with men (MSM).

The results preceded release of important infection data for MSM in the U.S. The U.S. Centers for Disease Control (CDC) estimates that MSM account for more than half of all new HIV infections in the U. S. For many MSM the HIV risk is growing. CDC found an estimated 34% increase in HIV infections in young MSM between 2006 and 2009, and a 48% increase in HIV among young black/African American MSM over the same period. MSM represent a population with demonstrable need for effective prevention tools.

Two additional trials have shown that oral TDF/FTC (or TDF alone as in one of the trials) as PrEP also reduces HIV infection risk by 62-73% in at-risk heterosexual men and women. But a fourth study of oral TDF/FTC as PrEP, which was conducted in a population of heterosexual women, was stopped before its anticipated end date after an interim data review found equal numbers of infections in the experimental and placebo arms. More recently, the oversight board of an ongoing PrEP trial comparing oral TDF alone to oral TDF/FTC and a gel containing TDF recommended discontinuing the use of oral TDF alone in a single arm of the study. That approach was deemed unable to show efficacy in the population of heterosexual women being studied. The other arms of the study continue to evaluate the other PrEP modalities. We do not yet know why this pattern emerged in these trials. Nevertheless, combined data show oral PrEP may be a vitally important prevention tool for some heterosexual populations.

Separate safety and effectiveness questions in data collected in heterosexual groups may unduly lengthen FDA review for MSM if the two approvals are bundled together. In addition to clarity surrounding the one trial that was stopped, FDA may have questions about:

• Offering oral PrEP to women who use hormonal contraceptives concurrently;
• Balancing risks to unborn children exposed to drugs in the absence of a known risk of exposure to HIV from an uninfected pregnant mother;
• The basis of using two-drug combinations vs single drugs in heterosexual populations.

The US DHHS perinatal guidelines for HIV recently withheld recommendations for oral PrEP based on these concerns. If approval for both MSM and heterosexuals is bundled together, it may take many months to answer the questions affecting one group more than the other.

Harms result when the benefits of FDA approval are delayed for a safe and effective intervention:

• Patients do not have the benefit of the safety and control measures that come with proper labeling, study- and FDA-regulated risk management;
• FDA regulatory requirements are not able to be integrated with or to facilitate other efforts to demonstrate real world effectiveness in a cohesive organized manner;
• FDA approval spurs insurance coverage from private and public sources needed to secure equitable access for disadvantaged populations;
• The drug manufacturer will be restricted from communicating important data to clinics because of restraints on unauthorized marketing;
• While PrEP should only be given to those who can truly benefit, a delayed approval means many of them will simply not get it at all. Whichever infections could have been averted will unfortunately occur.

These harms should not be imposed on either MSM or heterosexuals. FDA’s duty also requires the Agency to safeguard patients from uncertainty, and today, unfortunately, that uncertainty possibly weighs more heavily with one group more than the other. We must shore up that uncertainty promptly but not delay access to risk-reducing tools for MSM sooner if we can. Approval delayed, like justice, is approval denied.

FDA approval also influences the availability of PrEP in other countries hardest-hit by HIV/AIDS that look to the FDA for assurance that a new therapy is safe and effective. The largest international program for HIV treatment and prevention in developing countries, PEPFAR, considers FDA approval an important step in providing programming/access to PrEP.

Before the results of heterosexual PrEP studies were announced, the FDA and Gilead were reported to be ready to move forward on a review of PrEP for MSM. Now it looks like action on PrEP for MSM may take longer. Even six months of further delay could result in many preventable new HIV infections.

The FDA and Gilead should move quickly to ensure a thorough review of PrEP for MSM. It’s time. We also urge no delay to clear up data that will help heterosexual populations in need. Useful interventions often go through sequential approvals as was the case for Gardasil to prevent HPV related cancers and lesions in young women and men. Oral PrEP is not a magic pill but it adds to the available arsenal we have to prevent HIV.

Sincerely yours,

AIDS Action Committee of Massachusetts

AIDS Foundation of Chicago

AIDS Research Consortium of Atlanta

AIDS United

AVAC

Black AIDS Institute

Fenway Health

GMHC

Harlem United

International Rectal Microbicides Advocates

National Minority AIDS Council

Project Inform

San Francisco AIDS Foundation

HARLEM UNITED ANNOUNCES EXPANDED CLINIC HOURS

Responding to the increase demands on the clinic and the need for more evening and weekend hours, Harlem United is expanding our clinic hours to accommodate and better serve our clients.

The Willis Green Jr. Primary Care Health Center will be open late on Wednesdays. The new hours are:

• Monday 8:30 a.m. to 5:30 p.m.
• Tuesday 8:30 a.m. to 5:30 p.m.
• Wednesday 8:30 a.m. to 7:00 p.m.
• Thursday 8:30 a.m. to 5:30 p.m.
• Friday 8:30 a.m. to 5:30 p.m.

The Dental Clinic (at the Willis Green Jr. site) will be open late Monday and Wednesdays evenings. The new hours are:

• Monday 9:00 a.m. to 7:00 p.m.
• Tuesday 9:00 a.m. to 5:00 p.m.
• Wednesday 9:00 a.m. to 7:00 p.m.
• Thursday 9:00 a.m. to 5:00 p.m.
• Friday 9:00 a.m. to 5:00 p.m.
• Saturday 9:00 a.m. to 1:00 p.m. (Alternating Saturdays. Please call for an appointment.)

The El Faro Community Health Center new hours are:

• Monday 8:30 a.m. to 7:30 p.m.
• Tuesday 8:30 a.m. to 7:30 p.m.
• Wednesday 8:30 a.m. to 7:30 p.m.
• Thursday 8:30 a.m. to 7:30 p.m.
• Friday 8:30 a.m.to 4:30 p.m.
• Saturday 9 a.m. to 1 p.m. (Alternating Saturdays. Please call for an appointment)

Willis Green Jr. Primary Care Health Center
123-125 West 124 Street
New York, NY 10027
Tel: (212) 531-1300

El Faro Community Health Center
179 East 116 Street
New York, NY 10029
Tel: (212) 987-3707

To download a copy of the new expanded hours.

What interested you to come to Harlem United? Why did you decide to participate in the WIILOW & SHIELD Training?

I came to Harlem United because I heard so much about the women intervention programs through referrals from clients who participated in the program. I decided to participate because I wanted to learn more about learning how to become a peer within my community. I thought it was interesting that the interventions teach you how to be proud a woman and learn about characteristics of healthy and unhealthy relationships, and harm reduction.

When you first started the intervention from the beginning of the invention to the end of the intervention did you see and changes in yourself? And if so what was they?

I saw changes in myself by the end of the completion of both interventions. The intervention made me realized that I need to work on enhancing my strengths and work on my weaknesses.

What did you like about each of the Interventions?

I enjoyed the WILLOW intervention more specifically because of the role plays, group interaction, and learning from the other women like myself. I enjoyed the SHIELD intervention because of the mix group of women. I was able to learn the differences in perspective with HIV+ women as well as HIV negative women and learning how to be a peer in my community. Overall, the intervention SHIELD and WILLOW are excellent educational trainings; keep up the good work Harlem United!

Would you recommend the Interventions? And if so why?

Yes, I would recommend the intervention because I believe women can learn as much as I did from completing both interventions simultaneously.

I am thrilled to announce a new program at Harlem United!!

Through a competitive process, Harlem United acquired a 28-bed permanent congregate housing facility for adults living with HIV/AIDS located in east Harlem. Formerly operated by North General Hospital, Harlem United began oversight of the residence, July 1, 2011. This brings the total number of housing units at Harlem United to 586! We will work with familiar partners, the NYC Human Resources Administration (HRA) and Housing and Urban Development (HUD) to run this program with operating and support service contracts of approximately $1 million.

This program comes with almost a full complement of staff and twenty-five clients. During the next few weeks, we will be introducing the staff and clients to the depth and breadth of services Harlem United provides.

The building is conveniently located blocks from one of our Eastside Adult Day Healthcare Centers (El Faro). El Faro is a bi-lingual healthcare facility offering counseling and mental health services we are excited to link with this new facility to expand their services.

Thank you to the HIV/AIDS Treatment and Support Services team who has worked tirelessly to produce a proposal in a 24-hour period answering all questions quickly and effectively; and to everyone else affected by our need to accomplish this task in such a short amount of time. Thanks to everyone else involved in this process: Steve Bussey, President & CEO for negotiating the deal; Stephane Howze, Chief Operating Office, for her assistance with the proposal; Jacqui Kilmer, Director of Special Projects, for working on compliance; the Finance department for providing needed information quickly; Sara Gillen, Senior Vice President of Community Health Services, and her team for providing the welcome packet for the clients and staff; and Chantal Innocent, Director of Human Resources for orienting our new staff. And thank you, in advance, to the IT team who will be linking the building and new staff to the rest of the agency very shortly.

To ensure that this transition is as smooth as possible, Tamara Green, Associate Vice President of HATSS, will be re-locating her office to this new site.

Please join me in extending a Harlem United-style welcome to the new members of our family.

Kelsey Louie,
Senior Vice President of HIV/AIDS Treatment & Support Services

Additionally, Harlem United's Transitional Housing program added 13 new apartments at the end of 2010. Together with these 28 new congregate apartments; the Harlem United Housing program has expanded 8% in the last year. We provide a full continuum of housing programs including all permutations of scattered, congregate, permanent, and transitional housing; housing for women with children and women with mental illnesses; single and family housing, and mental health and substance abuse services. For more information on Harlem United's housing programs, please visit www.harlemunited.org.

Super Model Veronica Webb Teams with Harlem United

You may know Veronica Webb from her more than two decade career as a Super Model and TV personality; from the covers of Vogue, Essence, or Elle; from the runways of Victoria's Secret and Chanel; or even as the first African American woman to have a major cosmetics contract. Do you know her as an athlete, though? Or, as an advocate for HIV/AIDS? She's all of the above, and more.

Since the 90's Veronica's been involved with the HIV/AIDS community sitting on the board of LifeBeat.org. In 2009, she decided to take another step to aid in the fight—quite literally.

On her Team Harlem United marathon page, Veronica accounts how she, "always wanted to run the marathon," but found, "distance running was something [she] couldn't crack." Out to dinner with Sabine Feldman, Editor and Chief of Shape Magazine, she found the inspiration and courage to attempt the race. Then, in a moment of fate and "God putting you where you need to be," the next morning receiving a text message offering her a place on Harlem United Community AIDS Center's marathon team. She jumped at the chance. As she put it, "What could be more amazing than helping the population MOST in need of HIV/AIDS service providers while developing personal discipline, strength, and stamina at the same time?"

Veronica was set on her goal and, in 2009, completed her first ING New York City Marathon with Team Harlem United. Since then, she's run the marathon a second time as well as the NYC Half-marathon, amazing feats of dedication and endurance, and raised over $17,000 for the organization.

Her contributions haven't stopped there, though. Veronica continues to help Harlem United and the HIV/AIDS community. In June of 2010, Veronica helped Harlem United kick-off their new partnership with New World Ministries. Led by Rev. Terrance L. Kennedy, a ground breaking initiative of outreach was started to address a growing crisis. Out of the 1.1 million people living with HIV/AIDS in the U.S., approximately 280,000 to 350,000 don't know they have the disease. New World Ministries is working to decrease that number. Overcoming the taboos religion holds against AIDS—sex, homosexuality, testing, these ministers are addressing the problem. In 2009, 18 ministers were publically tested for HIV and in 2010, 12 became trained testers by Harlem United.

HIV/AIDS particularly has a disproportionate impact of communities of color with rates of new infection in Central Harlem more than twice as the rest of New York City. Ms. Webb put it best, "This initiative acknowledges that it takes a community to curb the spread of HIV and we are all going to need to work together." The event kicked-off Harlem United's testing events throughout the city in honor of National HIV Testing Day.

Leading up the 2010 New York City Half-marathon and her second marathon, Veronica found new ways to raise awareness and money for Harlem United. For her show Best of New York, she spotlighted the New York City Half-marathon and went on a run with Kelsey Louie, Senior Vice President of HIV/AIDS Treatment & Support Services and Team Harlem United Coach. On their run around Central Park, they discussed marathon training and the great things Harlem United does for the community. In the fall of 2010, again preparing for the marathon Ms. Webb pulled together some special items from her closet to donate to an exclusive auction on I-Ella.com. These items included the designer outfits she would be wearing during the upcoming Fashion Week, as well as a donated a pair of limited edition Louis Vuitton sneakers autographed by rapper Kanye West.

Ms. Webb is committed to the fight against HIV/AIDS with amazing dedication and innovative ideas. She has risen over $17,000 for Harlem United since 2009, and we are delighted to have such a beautiful (inside and out!) partner in advocacy and member of Team Harlem United.

In 2009, Harlem United provided over 8,000 HIV tests to the community adding to its almost three decades of high quality comprehensive care, prevention, and housing to clients regardless of race, socio-economic status, or sexual orientation. For more information on running the marathon for Team Harlem United and our services, please visit www.harlemunited.org/teamharlemunitedg.