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MINNESOTA STATE REPORT. By Candy Hadsall. RVIPP Regional Meeting. June 9-10, 2010. Indianapolis. STDs in Minnesota in 2009. Total of 16,702 STD cases reported to MDH in 2009: 14,186 Chlamydia cases (2% decrease) 2,302 Gonorrhea cases (10% decrease) 214 Syphilis cases (all stages)
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MINNESOTA STATE REPORT By Candy Hadsall RVIPP Regional Meeting June 9-10, 2010 Indianapolis
STDs in Minnesota in 2009 • Total of 16,702 STD cases reported to MDH in 2009: • 14,186 Chlamydia cases (2% decrease) • 2,302 Gonorrhea cases (10% decrease) • 214 Syphilis cases (all stages) • New HIV diagnoses reported • 370 (80% increase in MSM ages 15-24)
IPP Funding 2010-14 • Formula (goal by 2014) • 60% to address disparities in CT rates (urban area) • 10% to targeted GC screening (urban area) • 30% to address CT increases in Greater MN
2010-2013 IPP TESTING LOCATIONS • Planned Parenthood Minnesota, North Dakota, South Dakota (16 sites in Gtr MN) • St. Paul-Ramsey County Department of Public Health (FP and STD clinics) • Teen Age Medical Services (TAMS) • Includes street outreach to African American males • Hennepin County STD clinic (“Red Door”) • Health Start: School-based clinics in 5 of 10 high schools, based on positivity rates
MDH Activities • Progress on GC Plan • Pilot, coalition, capacity building • Change DIS protocols to contact partners of CT and GC + = slow progress due to resistance • Provider report card • Timeliness of reporting and treatment • Focus on highest reporters and IPP sites • In large systems, individual clinics AND system aggregate • Using surveillance data 2007-09 • Breakout by gender, show trends • Provide TA to clinics
MDH Activities (cont) • Held webinar to announce 2009 stats, announce activities • Syphilis Elim = Media campaign launched 6/3 • Info on Facebook – search stopsyphmn • Twitter feeds weekly – sx, prevention msgs • Testing at Pride • 3rd Annual Hepatitis Symposium Aug 11-12 • All funding raised outside MDH (Amer Liver Fdn)
IPP Activities • Lab meeting – on hold • Managing contracts • Coordinating development of statewide partnership
MN CT Partnership activities • MDH staff developed plans for coalition • Steering Committee, including external partners formed, meeting frequently • Hired consultants to assist w/mtgs and Summit • Created marketing materials, webpages • Contacting MDH divisions, community groups and LPH
Future Partnership activities • August 3 in St. Paul; simultaneous meetings in multiple sites in Greater MN via video conferencing • Following Summit, partnership and workgroups develop 3-5 yr statewide strategy to reduce rates and prevent CT and GC • Presented strategy March 2011 • Stakeholders implement plan
Update on EPT • Provider survey available until 6/14 • Goals: • Who was already using EPT? • Who is planning to implement it? • If not going to implement, why not? • 48 out of 239 responded so far • Will use responses to expand Guidance (add FAQs) and offer capacity building • Some respondents = EPT not new!
Update on EPT pilot projectApril 2010 – April 2011 • 14 clinics enrolled, 8 started; one ED still considering participation; most distribute medications, 1 Rx • Original pt must have confirmed + tests so we have contact info from report forms • Allow providers to treat initial pts w/meds provided even if they are unable to deliver meds to partners • Student started f/up interviews: patients report how many partners received meds, know if they took meds • Outcomes: • Did pts give meds/Rx to partners? All partners? Why/why not? • More likely to take med if med was provided vs. Rx? • How many partners took meds? • Have sex after given treatment? • Ask clinics to evaluate their participation and outcomes in various ways via report to student; look at how hard it is to implement new protocols
Outcomes to date • Some systems had to go through IRBs even though MDH went through IRB • Originally provided CT-only pkts and combo tx pkts but some clinics requested GC-only pkts when confirmed CT neg, GC pos; others treating both even when CT neg • 2 chose not to participate due to discomfort w/MDH contacting pts. Already using EPT & have excellent results w/retesting at 3 mos – will share their data with MDH • Finding unreported/late report cases when compare report forms to pilot log • Considering teleconference to address persistent ?s
Questions/issues raised • Many providers need update on communicable disease reporting rules – many ?s • Need info on retesting and test-of-cure • Providers surprised to find out HD can contact pts as part of normal surveillance • Questions/concerns re: not using w/MSM • Concerned about adverse events, allergies • EDs: responsible to notify pts of results? • Can pts/partners be treated more than once? • Suggestion for HDs managing projects: clinical knowledge essential in conjunction w/data, epi
Suggestions • HDs managing projects: clinical knowledge essential in conjunction w/data, epi • Hold training/info session for all providers before clinics enroll • Create instructions for completing log form
Candy Hadsall, RN, MASTD Clinical ConsultantMinnesota Department of Health651-201-4015Candy.Hadsall@state.mn.us