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
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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
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Public Awareness
Targeted Prevention
Full Diagnosis
Successful Linkage
Support Participation
in Care
Medical Adherence
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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
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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
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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
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STI/HIV ComorbidityProportion of HIV cases Co-Infected with STI 2005-2010
91.7%
8.3%
STDHIV/STD
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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
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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
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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
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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