msm sexual health summit august 20, 2012
DESCRIPTION
MSM Sexual Health Summit August 20, 2012. HIV/STD Prevention and Care Branch Texas Department of State Health Services. Newly Diagnosed HIV Cases, Deaths, and People Living with HIV in Texas: 1980-2011. Living with HIV. New HIV Cases. Deaths Among Cases. - PowerPoint PPT PresentationTRANSCRIPT
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MSM Sexual Health Summit August 20, 2012
HIV/STD Prevention and Care BranchTexas Department of State Health Services
80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 100
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
0
1,000
2,000
3,000
4,000
5,000
6,000
Year
Num
ber
Peop
le L
ivin
g w
ith
HIV
Num
ber
of N
ew
Dia
gnos
es/D
eath
s
Newly Diagnosed HIV Cases, Deaths, and People Living with HIV in Texas: 1980-2011
Newly diagnosed HIV infection includes all new HIV cases regardless of disease status. 2009-2010 death data are provisional.
Living with HIV
Deaths Among Cases
New HIV Cases
Public Awareness
Targeted Prevention
Full Diagnosis
Successful Linkage
Support Participation
in Care
Medical Adherence
Texas 2011 New Diagnosis Rate by Selected Characteristics
Tota
l Rat
eMale
Female
WhiteBlac
k
Hispan
icOth
er
MSM^0
100200300400500600
17 27 7 959 14 7
503
Case
s pe
r 10
0,00
0
^Denominator estimate based on: Lieb S, et al. Estimating Populations of Men Who Have Sex with Men in the Southern United States. Journal of Urban Health. 2009 Nov;86(6):887-901
2011 New Diagnosis Rate by Race Among MSM1
White Black Hispanic Other -
200 400 600 800
1,000 1,200 1,400 1,600 1,800
271
1,595
514 290
Case
s pe
r 10
0,00
0
1Denominator estimate based on: Lieb S, et al. Estimating Populations of Men Who Have Sex with Men in the Southern United States. Journal of Urban Health. 2009 Nov;86(6):887-901
6
Gonorrhea Cases:Texas, 1971-2011
01 0 ,0 0 02 0 ,0 0 03 0 ,0 0 04 0 ,0 0 05 0 ,0 0 06 0 ,0 0 07 0 ,0 0 08 0 ,0 0 09 0 ,0 0 01 0 0 ,0 0 0
7 1 7 3 7 5 7 7 7 9 8 1 8 3 8 5 8 7 8 9 9 1 9 3 9 5 9 7 9 9 0 1 0 3 0 5 0 7 0 9 1 1
Y e a r
Cases
7
STI/HIV ComorbidityProportion of HIV cases Co-Infected with STI 2005-2010
91.7%
8.3%
STDHIV/STD
8
GC/HIV ComorbidityBy Race/Ethnicity 2005-2010
GC Only HIV Only HIV/GC0%
10%
20%
30%
40%
50%
60%
16%
33%28%
53%
39%
53%
22%26%
17%
2% 1% 2%
WhiteBlackHispanicOther
9
GC/HIV ComorbidityBy Risk 2005-2010
HIV Only HIV/GC0%
10%
20%
30%
40%
50%
60%
70%
80%
54%
69%
15%8%7% 6%
24%17%
1% 1%0% 0%
MSMIDUMSM/IDUHeteroPediatricAdult Other
10
GC/HIV ComorbidityBy Age Group 2005-2010
GC Only HIV Only HIV/GC0%
10%
20%
30%
40%
50%
60%
70%
1% 1% 0%
63%
15%
22%24%
35% 36%
8%
32%26%
4%
18%15%
0-1415-2425-3435-4445+
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GC/HIV ComorbidityInterval Between Diagnoses 2005-2010
-7 to -12 -2 to -6 -1 to 1 2 to 6 7 to 120%
5%
10%
15%
20%
25%
30%
35%
40%
45%
17%15%
39%
14% 15%
Months From HIV Diagnosis to GC Diagnosis
12
12
Timing of Diagnoses2005-2010
-10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0% Chart Title
GCPSSTB
Axis Title
-12 -10 -8 -6 --4-2 0 2 4 6 8 10 12
Number of Months from HIV to Other DX
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Interdependent Capacity Building
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Interdependence, Unintended Consequences, Systems Adaptation
• Undetected and untreated disease driving GC and HIV– don’t ask don’t tell
• Not using all the laboratory weapons in our arsenal
• The unintended consequences of urine testing and how this may be fueling transmission of GC and also HIV in the MSM community
• Haven’t had a spotlight on the sexual transmission of HCV
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CDC Recommendations from STD Treatment Guidelines, 2010
Screening tests should be performed at least annually for sexually active MSM:• HIV serology, if HIV negative or not tested in the
previous year• syphilis serology• GC/CT screening for:
– urethral infection (urine testing) for men who had insertive intercourse
– Rectal infection (rectal swab) for men who had receptive anal intercourse
– Pharyngeal infection (throat swab) for men who had receptive oral intercourse
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CDC Recommendations
Sexual transmission of hepatitis C virus infection can occur, especially among HIV-infected MSM. Serologic screening for hepatitis C infection is recommended at initial evaluation of newly diagnosed HIV-infected persons. HIV-infected MSM can also acquire HCV after initial screening; therefore, men with new and unexplained increases in alanine aminotransferase (ALT) should be tested for acute HCV infection.
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Overall Goals of Engagement
• Reduce undetected and untreated GC/CT in MSM
• Reduce transmission of HIV in MSM
• Increase identification of HIV-positive MSM co-infected with HCV
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Summit Goals
• Increase awareness, urgency and action to implement consistent, appropriate and timely GC/CT detection for MSM and HCV screening for HIV-positive MSM
• Expand capacity to build protocols and provide education on this issue
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Summit Outcomes
• Develop next steps for your organization to implement extra-genital screening for MSM
• Build coalitions with partners in your area to implement consistent, appropriate and timely extra-genital GC and HCV screening for MSM