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Los Angeles County Department of Public Health STD Clinics

Los Angeles County Department of Public Health STD Clinics. SSuN Project Staff Sarah Guerry MD, Medical Director Michael Chien MPH, Epidemiologist Ali Stirland MBCHB MSC, Clinic Liaison. 1. Part 1 Description of STD Clinics. 2. Los Angeles County. Area: >4000 square miles

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Los Angeles County Department of Public Health STD Clinics

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  1. Los Angeles CountyDepartment of Public HealthSTD Clinics SSuN Project Staff Sarah Guerry MD, Medical Director Michael Chien MPH, Epidemiologist Ali Stirland MBCHB MSC, Clinic Liaison 1

  2. Part 1Description of STD Clinics 2

  3. Los Angeles County Area: >4000 square miles Population: 10 million STD clinics: 12

  4. Number of sessions/week Clinic visits 2008 27,500 new visits/yr 17,200 return visits/yr 3380 sessions/yr 67 sessions/wk 12 STD Clinics No.of Clinics 4

  5. STD Clinic Flow New visits (walk-in, free of charge) Registration Intake interview by PHI (DIS) or nurse Examination / wet mount micro by doctor (1 NP) Phlebotomy and other tests Doctor &/or nurse administers/dispenses meds Results Phone or return appointment 5

  6. Testing Routine GC/CT NAAT urine or cervical swab Syphilis (RPR/TPPA) HIV serology Wet mount micro Selected patients GC/CT NAAT rectal (CT/GC), throat (GC only) Liquid based Paps with HPV triage Hepatitis ABC serology (testing and pre-vax) HSV PCR and HSV-2 serology Urinalysis and pregnancy test 6

  7. Services STD diagnosis and treatment, including warts Emergency contraception Hepatitis A and B vaccination 7

  8. Challenges collecting data I Single form for multiple purposes • Clinical management • Data collection for: • Performance evaluation • Surveillance (STDP and SSuN) • Reporting (Office of Aids Program and Policy) Different variables & time periods SSuN & OAPP II Manual Process • Form completion in clinic • Data entry at STD Program from NCR copy 8

  9. Part 2STD Clinic Data1st Quarter 2009 9

  10. Populations of Interest • All STD New Clinic Clients • 6,498 total visits • MSM/MSMW Clients • 646 (9.9%) visits • Clients diagnosed with Genital Warts (GW) • 330 (5.1%) visits • Clients testing positive for HIV • 44 (0.7%) visits

  11. Gender

  12. Age

  13. Race/Ethnicity

  14. CT, GC, and HIV Prevalence

  15. Behavioral Risk Factors (past 90 days) among MSM (n=646) • 509 (78.8%) engaged in anal sex • 69 (10.7%) reported always using condom • 258 (39.9%) reported some drug or alcohol use • 21 (3.3%) methamphetamines • 168 (26.0%) marijuana • 33 (5.1%) ecstasy • 33 (5.1%) cocaine • 99 (15.3%) binge drinking

  16. Behavioral Risk Factors (past 12 months) among MSM (n=646) • 20 (3.1%) injection drug use or IDU sex partner • 44 (6.8%) incarcerated or incarcerated sex partner • 77 (11.9%) HIV positive sex partner • 196 (30.3%) anonymous sex partner • 50 (7.7%) sex at bathhouse or sex club • 74 (11.5%) casual sex partners from the internet

  17. MSM infected with CT, GC, or HIV vs. MSM testing negative for CT, GC and HIV

  18. Summary • Implementation has been smooth with no major challenges • High number of visits with sufficient volume for populations of interest

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