Faculty Spotlight: Dr. Jason Zucker
Overcoming Obstacles to Sexual Health Prevention in Adolescents
Let’s get to know Dr. Jason Zucker! He is an Adult and Pediatric Infectious Disease physician and an Assistant Professor of Medicine in the Division of Infectious Diseases at Columbia University Irving Medical Center. Dr. Zucker focuses on sexual health for the adolescent community, both clinically and in research. His main goal is increasing availability of HIV and STI testing, treatment, and prevention services for anyone who may be vulnerable to infection.
In an interview with Dr. Zucker, he discussed how the adolescent community has the highest rate of HIV and STIs. Specifically, he says that “young adults are more likely to be single and more likely to be non-monogamous because that's the phase of the life they're in. That may be why STIs are highest in those 15 to 24 years of age, and intervening [in] that age group can have the highest impact on reducing sexually transmitted infections”. Because these rates are so high, he discusses the importance of PrEP, which is a medication that prevents HIV infection.
STIs are biomarkers for future HIV acquisition and everyone with a positive STI test should have routine [HIV] testing. HIV testing helps people with HIV by helping them know their diagnosis and allowing for linkage to care and starting on medication so they can stay healthy. However people testing negative for HIV can also be offered medication, PrEP, that can prevent HIV, which is amazing!
Despite the urgent need for HIV prevention awareness, many communities do not have access to these medications or to testing. Many adolescents go to the emergency room to seek treatments, but because of the busy atmosphere, they don’t always get the most information to fit their needs. Emergency Room (ER) physicians are often so busy that they can’t fully educate patients on STI and HIV treatments. This is where Dr. Zucker’s study comes into play! Along with Dr. Lauren Chernick, pediatric emergency medicine physician, and Co-PI of the study, they came up with the idea of STIckER, which stands for STI Check in the ER.
Patients who are sitting in the waiting room [will] complete this app, which will help them learn about [testing for] sexually transmitted infections, including extra-genital testing [e.g. testing of the throat], which many young people don't know about. We're going to assess their vulnerability to STIs by asking them some questions and using a 'risk score' to see what their need is for testing at that particular visit. And then we're going to offer them STI testing for which they can choose to accept it or not accept. It's up to them. But if they accept, then all they have to do is show the final screen to the ER provider and then they can order the labs. So we've really taken some of the pressure away from the ER provider, including the time of going through the education and testing with them, to make their job easier.
This program makes education and testing more accessible to young adults. They are given information that ER providers may not have the time to explain, which not only helps the patients, but also the providers. Also, this provides another way to get the message out, as people aren’t always educated by their parents or in school. Dr. Zucker believes that more options of STI education will spread awareness.
The more ways to get the message out, the better. And so I think it's really incumbent on us to give a lot of different ways for people to get the information so that they can receive it in the way that's best for them.
Overall, Dr. Zucker hopes that this project will improve sexual health in adolescent communities and lower the rates of HIV and STIs. He also wants to spread this platform to more healthcare settings, such as clinics. He says,
Our long term goal would be to find ways for people to use this [...] in other settings, like outpatient clinics and other settings where they might benefit from STI screening. This is just the pilot. So while right now it’s just designed for one time use in the ER we are hopeful that if it demonstrates an improvement in testing and we are able to successfully identify people with STIs [and] be able to expand what STIckER can do.
This is just the beginning of improving sexual health in adolescents! In addition to Dr. Zucker, many others in the Infectious Disease Department at Columbia are working on research in this field, and we’re excited to see what knowledge they discover!