History and Milestones
Precursors to STAR Program
- First pediatric and adult AIDS cases are diagnosed in Brooklyn.
- SUNY Downstate’s Division of Infectious Disease in the Department of Medicine established the multi-disciplinary AIDS Team at SUNY Downstate’s public hospital affiliate, Kings County Hospital Center (KCHC), providing the first clinic specifically for AIDS in Brooklyn.
- Expansion of Pediatric Immunology Clinic at SUNY Downstate — providing HIV counseling and testing as well as clinical trials for children.
- First year of the Perinatal HIV Transmission Study at SUNY Downstate.
- Clinical training to community-based physicians on HIV/AIDS begins.
- The Infant and Child Learning Center is established to provide early intervention services for HIV-infected infants and children.
- A 10 bed inpatient HIV unit is established at SUNY Downstate’s University Hospital of Brooklyn (UHB).
- Under the direction of Dr. DeHovitz, the AIDS Prevention Center is established, providing HIV counseling and testing to adults as well as education and outreach.
- First year of the Heterosexual AIDS Transmission Study.
- Development of the Adolescent Education Program – providing peer-led community-based HIV education to teens throughout Brooklyn.
- Development of the Brooklyn Group Support Project (now Supportive Counseling and Family Stabilization Services) – providing support groups for HIV infected individuals and their families.
- Development of the HIV Clinical Scholars Program – two year fellowship providing specialty training to clinicians in HIV disease.
STAR Program Established
- Dr. Jack DeHovitz and Dr. Howard Minkoff establish the STAR Program with the overall goal of integrating HIV-related care, research and clinical education.
- SUNY’s University Hospital of Brooklyn becomes a New York State AIDS Designated Center.
- Development of the STAR Clinic (now STAR Health Center) – first outpatient HIV clinic on SUNY Downstate campus – established with Ryan White Title III (now Part C) funding and institutional support.
- First year of the Women’s AIDS Cohort Study (WACS) – prospective study examining the manifestations of HIV disease in women under the direction of Dr. Howard Minkoff.
- Development of SUNY AIDS Clinical Trials Unit – first adult clinical trials unit in Brooklyn (emphasizing trials for women and minorities).
- Development of Central/East European HIV Education Center through funding from the World AIDS Foundation.
- The Health and Education Alternatives for Teens (HEAT) Program begins serving the needs of HIV positive and at-risk adolescents under the direction of Dr. Jeffrey Birnbaum.
- Development of The HIV Center for Women and Children, to help coordinate the activities of all HIV-related programs directed by SUNY Downstate faculty.
- Development of the HIV Clinical Education Initiative – providing on-site training to area health care providers in HIV disease through funding from the New York State Department of Health AIDS Institute.
- Development of the New York State International Training and Research Program, focused on building HIV and infectious diseases research capacity in Central Europe and in later years, Eastern Europe and Central Asia, through funding from the Fogarty International Center.
- The NIH funds the STAR Program as a site for the Women’s Interagency HIV Study (WIHS) under the direction of Dr. Howard Minkoff. The WIHS is a collaborative, multi-site, longitudinal study to investigate the natural history of HIV infection in US women, and represents one of the largest prospective cohort studies of HIV-infected and uninfected women in existence. Its six sites are located in California (Los Angeles, San Francisco), Chicago, IL, the Washington, DC area and New York City (Bronx and SUNY-DMC in Brooklyn).
- Development of the Co-Located HIV/Gynecologic Care Program – providing both HIV and gynecologic care to HIV infected women (now the SHC’s Family Centered Health Care program).
- Two clinical textbooks, HIV Infection in Women and Primary Care of Women and Children with HIV: A Multidisciplinary Approach, edited by HIV Center faculty are published.
- The Maternal and Pediatric Services of Brooklyn (MAPS) program is funded through HRSA’s Special Projects of National Significance program to develop a model system for the prevention of perinatal HIV transmission at three Brooklyn hospitals.
- The Health and Education Alternatives for Teens (HEAT) Clinic is selected as a Clinical Science Group site as part of the NIH-funded Adolescent Medicine HIV/AIDS Research Network.
- STAR Clinic consolidates with the in-patient HIV care unit at University Hospital of Brooklyn under the direction of Dr. DeHovitz.
- Adult clinical trials are offered to STAR Clinic patients.
- STAR Clinic is renamed the STAR Health Center, reflecting a renewed vision of providing first-rate interdisciplinary health care to all persons with HIV disease.
- The Special Treatment and Research (STAR) Program is awarded targeted Ryan White funding from a Congressional Black Caucus (CBC) initiative for a new outreach project entitled—Educating People at Risk (EPAR).
- The CDC funds SUNY Downstate’s first large-scale, randomized community-based HIV/STD behavioral intervention project.
- The STAR Health Center (SHC) receives funding for the development of the first clinic in Brooklyn for the treatment of people co-infected with HIV and hepatitis C.
- The SHC begins providing comprehensive mental health/substance use treatment through funding from the NYS Department of Health AIDS Institute.
- The HEAT Program is awarded Ryan White Title IV (now Part D) funding through HRSA to establish a comprehensive care network to identify, enroll, and retain HIV-infected youth in medical care, and establish a youth service provider network in Brooklyn.
- Dr. Tracey Wilson is awarded 3 years of funding from the CDC to conduct “Implementation of IDSA/CDC Guidelines for HIV Prevention,” a demonstration project to assess the effectiveness of guidelines to incorporate sexual and drug use risk reduction activities into the HIV medical care setting.
- The STAR Program is awarded funding from SAMHSA to develop and implement substance abuse, HIV and hepatitis prevention interventions for minority and reentry populations in Brooklyn.
- The American International Health Alliance (AIHA) awards funding to establish a partnership with the Centre for Health Systems Research and Development at the University of the Free State in Bloemfontein, South Africa, establishing an “HIV/AIDS Twinning Center” to build capacity in HIV and TB research – part of the President’s Emergency Plan for AIDS Relief (PEPFAR).
- The STAR Program is awarded CDC funding for a multicenter study, led by Tracey Wilson, PhD, of the effect of a clinic-wide intervention in HIV primary care.
- The SHC begins the provision of substance abuse treatment to both HIV+ and HIV- adults in Central Brooklyn through SAMHSA funding. Interventions included the use of buprenorphine, Seeking Safety and acupuncture.
- The SHC’s Treatment Adherence Program is established to increase HIV treatment knowledge and adherence among HIV seropositive patients, and reduce HIV-associated morbidity and mortality.
- Funding is received from the Fogarty International Center of the National Institutes of Health to train researchers to address the problem of cervical cancer among HIV seropositive and seronegative women in Central and Eastern Europe. This project built upon the research training infrastructure provided by the New York State International Training and Research Program (NYS-ITRP), a cooperative program of SUNY Downstate, the SUNY Albany School of Public Health, and the New York State Department of Health.
- The STAR Program is awarded funding from the NYS Department of Health AIDS Institute to serve as a state-wide Prevention and Substance Use Center under the Clinical Education Initiative (CEI), providing state-of-the-art education and training workshops on prevention and substance use to front-line clinicians throughout New York State.
- On December 1, 2009, SUNY Downstate commemorated a quarter century in the fight against HIV/AIDS with a special World AIDS Day program. The program, entitled “A Quarter Century of HIV Care, Prevention and Research,” featured opening remarks by John C. LaRosa, MD, SUNY Downstate’s President, who noted that “as part of Downstate’s 150th anniversary celebrations, we thought it fitting on World AIDS Day to look at what Downstate has accomplished in the fight against HIV/AIDS.” Ron Bayer, PhD, an expert on medical ethics in the treatment of AIDS, spoke about the first 25 years of the AIDS epidemic and moderated a panel discussion featuring Downstate healthcare professionals. Each discussed their experiences delivering HIV/AIDS care over the past quarter century.
- In collaboration with Family Medicine, the STAR Program implements Screening, Brief Intervention, and Referral to Treatment (SBIRT) to prevent substance use and HIV in populations age 50 and above.
The SHC implements the Care Coordination project which utilizes intensive medical case management, including home visits and DOT to encourage maintenance in care and adherence to treatment.
- The STAR Program receives funding through SUNY Stony Brook to develop a Brooklyn-based program to screen and treat first responders to the September 11 attacks at the World Trade Center.
- Through HRSA AETC funding, an HIV track in Categorical Medicine is established in collaboration with Downstate’s Internal Medicine Residency Program with the goal of training the next generation of physicians in the care and treatment of HIV.
- The Adolescent Education Program begins implementation of 2 evidence-based interventions to prevent teenage pregnancy.
- The US President’s Emergency Plan for AIDS Relief (PEPFAR) awards funding to SUNY Downstate Medical Center’s (DMC) NYS International Training and Research Program (NYS-ITRP) through the CDC, to support HIV prevention interventions in Ukraine.
- The Health and Education Alternatives for Teens (HEAT) Program receives funding from HRSA’s Special Projects of National Significance (SPNS) Program to identify, engage and retain HIV+ transgender youth in care.
- The STAR Program receives funding from the NYC Department of Health and Mental Hygiene to implement the Community Promise, Prevention with Positives, Pilot Program to evaluate the implementation of a clinically based program to reduce risk behaviors among people with HIV.
- The SHC receives Level 3 recognition by the National Committee for Quality Assurance (NCQA) as a patient-centered medical home (PCMH). Level 3 designation is the highest achievable recognition for a medical group, awarded only to programs that pass a rigorous review process. Attaining a high score of 94.75 out of a possible 100 points required a strong team effort and is a testament to the quality and scope of the SHC’s services.
- Funding is awarded by HRSA AETC for the development of an HIV Track in SUNY-DMC’s PA Program. Like the HIV Track in the Department of Medicine’s residency program, the goal is to expand the capacity of primary care providers to care for people with HIV.
- The NIH awards a 5th five-year cycle of funding to the Brooklyn site of the Women’s Interagency HIV Study (WIHS), now under the direction of Dr. Howard Minkoff and Dr. Deborah Gustafson, and adds four southern sites: Atlanta, GA; Chapel Hill, NC; Miami, FL and Birmingham, AL/Jackson, MS.
- Development of a social media project to reach MSM and MTF transgender young adults at risk for substance use and HIV.
- The SHC begins provision of new services including high resolution anoscopy for the detection of anal dysplasia and anal cancer; provision of PrEP for HIV negative partners of people with HIV; and hormone therapy for transgender patients.
- The SHC’s Supportive Counseling and Family Stabilization project expands services to include home-based supportive counseling to encourage maintenance in care.
- The SHC receives funding to support screening and newly approved treatment for Hepatitis C.
- Inauguration of the SHC’s LGBT Health Initiative to provide primary medical care and to address specific medical and mental health needs of LGBT populations.
- SHC begins collaboration with Yale University on the NIDA-funded Working with HIV Clinics to adopt Addiction Treatments using Implementation Facilitation (WHAT IF?) research project.
- The STAR Program was awarded funding from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to create the SUNY Downstate SBIRT Training Center. The new center will train resident physicians in the Departments of Medicine, Family Medicine, and Psychiatry in the College of Medicine and physician assistant and midwifery students in the College of Health Related Professions in the skills necessary to provide evidence-based screening, brief intervention, and referral to treatment (SBIRT) to patients who are at risk for a substance abuse disorder.
- The STAR Program’s Adolescent Education Program (AEP) was awarded funding to conduct the “AEP Youth Health Advocate” (YHA) Program. The AEP provides a wide range of HIV, STD, HCV, pregnancy and substance use prevention services to at-risk minority youth ages 13-24. The program will train 8 YHAs to outreach/engage youth living with HIV/AIDS (PLWHA) and those at highest risk for HIV/STD/HCV, and provide prevention interventions and linkage to care and services.
- The STAR Program was awarded funding to provide “Evidence-Based Interventions for Biomedical Prevention in Clinical Settings” via Pre-Exposure Prophylaxis (PrEP). The program will provide supportive services, care coordination, patient navigation, and clinical care. The program will be targeted to Black and Hispanic men and women in high prevalence neighborhoods; men who have sex with men (MSM) including young MSM (ages 18-29; transgender (TG) men and TG women who have sex with men; individuals engaging in transactional sex; and persons with HIV+ partners.
- The STAR Program was awarded funding to establish a Center of Excellence (COE) to provide post-exposure prophylaxis for HIV (PEP). The Brooklyn PEP COE will be targeted to the same populations as the PrEP Program (above), and clients will be identified through internal and external collaborations and through social media.
- The STAR Program was awarded funding to establish a Status-Neutral Care Coordination Program, to provide care coordination services to HIV negative individuals at risk for HIV infection.
- The STAR Program was awarded funding to provide harm reduction services to address the specific needs of HIV+ persons who struggle with recent and/or a history of addiction, allowing clients to receive support and education, structured around risk reduction. The program will target Black/African-American/Afro-Caribbean and Latino men and women, LGBT and gender non-conforming clients, young MSM of color, and clients over 50 years old.
- The New York State International Training and Research Program (NYS-ITRP) (DeHovitz, PI) was awarded an additional $1.5 million 5-year grant to develop and implement the “Ukraine HIV Research Training Program” to build capacity in implementation science research that addresses gaps in HIV care in Ukraine. This program aims to decrease the burden of HIV disease through the systematic HIV-related research training of investigators and by increasing in-country training capacity. Our key collaborating institutions in Ukraine are the National University of Kyiv Mohyla Academy School of Public Health (SPH NaUKMA) and the Ukrainian Institute for Public Health Policy (UIPHP).
- The STAR Program (Yager, PI) was awarded $550,000 over 5 years from the NYS Department of Health AIDS Institute’s Corrections to Community Care Continuum. The project, which started in August 2017, will provide comprehensive care to previously incarcerated HIV+ individuals coming home to Brooklyn. This grant is the first step in the development of Back to Brooklyn, a model of care to provide immediate access to comprehensive medical care, behavioral health care and support services to the previously incarcerated.