1. MHRA/IPP clinic contribution to Chlamydia cases reported in NYC Preeti Pathela Bureau of STD Control ppathela@health.nyc.gov

2. Objective Develop neighborhood profiles that quantify the contribution that IPP sites (NYC BSTDC and MHRA) make to the overall burden of disease estimates for chlamydia at the neighborhood level

3. Methods Review of data collected since the adoption of NAATs (early 2003 for most sites). Compared proportion of cases that came from BSTDC and MHRA sites compared to other sources (private sector physicians and hospitals).

4. Questions Are BSTDC and MHRA clinics serving the neighborhoods with the highest rates of disease? Are there neighborhoods in which private providers, CBOs, and other health facilities can take a more active role in providing Ct testing and treatment?

5. 2005 data 39,215 Ct cases citywide (12,242 male; 26,946 female)

6. Reporting Providers

7. 2005 Ct case rate map (females)

8. 2005 Ct case rate map (males)

9. NYC neighborhoods with highest Ct case rates Patient residenceNo. of cases Case rate/100,000 population Crown Heights33101043.2 Greenwich Village817976.0 East New York1643945.8 East Flatbush2821890.7 Central Harlem1320873.5

10. NYC neighborhoods with highest Ct case rates Patient residence No. of cases Case rate/ 100,000 population MHRA/IPP funded clinics? % MHRA/IPP- contributed cases Crown Heights33101043.2√20.9% Greenwich Village 817976.018.0% East New York1643945.817.1% East Flatbush2821890.718.3% Central Harlem1320873.5√35.8% Of all 42 NYC neighborhoods, Central Harlem had the largest proportion of cases reported by MHRA Title X / IPP Region II–funded sites

11. Conclusions The majority of cases contributing to the high rate in Greenwich Village come from a detention house located there. The majority of cases contributing to the high rates in the other top neighborhoods are reported by private providers.

12. Conclusions (cont.) Assumptions: –Since there are large numbers of cases in certain neighborhoods of Brooklyn, there are many more infected, undiagnosed persons in the surrounding Brooklyn neighborhoods (e.g., Downtown Brooklyn) with lower rates of reported disease. –Lower rates in these areas may not be due to less disease, but to less screening. As there is little to no presence of public health facilities in these areas, these are identified neighborhoods in which private providers, CBOs, and other health facilities can take a more active role in providing testing and treatment.

13. Next steps The Bureau of STD Control will begin to work with DOHMH District Health Offices to develop plans to target and educate health care providers in these neighborhoods with high Ct morbidity that are not served by an IPP clinic