1. Sexually Transmitted Disease (STD) Surveillance Report, 2010
Minnesota Department of Health
Sexually Transmitted Disease (STD) Surveillance Report, 2010
Minnesota Department of Health
STD Surveillance System

2. Minnesota Department of Health
Introduction
Under Minnesota law, physicians and laboratories must report all laboratory-confirmed cases of chlamydia, gonorrhea, syphilis, and chancroid to the Minnesota Department of Health (MDH) within one working day.
The MDH does not maintain statistics for other, non-reportable STDs (ex: herpes, HPV/genital warts).
This slide set describes trends in reportable STDs in Minnesota by person, place, and time.
Analyses exclude cases reported from federal and private prisons.
STDs in Minnesota: Annual Review

3. Minnesota Department of Health
Introduction
STD surveillance is the systematic collection of data from cases for the purpose of monitoring the frequency and distribution of STDs in a given population.
STD surveillance data are used to detect problems, prioritize resources, develop and target interventions, and evaluate the effectiveness of interventions.
STDs in Minnesota: Annual Review

4. Interpreting STD Surveillance Data
Minnesota Department of Health
Interpreting STD Surveillance Data
Factors that impact the completeness and accuracy of STD data include:
Level of STD screening by healthcare providers
Individual test-seeking behavior
Sensitivity of diagnostic tests
Compliance with case reporting
Completeness of case reporting
Timeliness of case reporting
Increases and decreases in STD rates can be due to actual changes in disease occurrence and/or changes in one or more of the above factors.
STDs in Minnesota: Annual Review

5. Interpreting STD Surveillance Data
The surveillance system only includes cases diagnosed in conjunction with a positive laboratory test. Cases diagnosed solely on symptoms are not counted.
Surveillance data represent cases of infection, not individuals. A person with multiple infections in a given year will be counted more than once.
Caution is warranted when interpreting changes in STD numbers that can seem disproportionately large when the number of cases is small.
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

6. Minnesota Department of Health
National Context
STDs in Minnesota: Annual Review

7. Chlamydia—Rates by State, United States and Outlying Areas, 2009
Source: Centers for Disease Control & Prevention, Division of STD Prevention Surveillance Slides.

8. Gonorrhea—Rates by State, United States and Outlying Areas, 2009
Source: Centers for Disease Control & Prevention, Division of STD Prevention Surveillance Slides.

9. Primary and Secondary Syphilis—Rates by State United States and Outlying Areas, 2009
Source: Centers for Disease Control & Prevention, Division of STD Prevention Surveillance Slides.

10. Minnesota Department of Health
Overview of STDs in Minnesota
STDs in Minnesota: Annual Review

11. Minnesota Department of Health
STDs in Minnesota Rate per 100,000 by Year of Diagnosis,
* P&S = Primary and Secondary
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

12. STDs in Minnesota: Number of Cases Reported in 2010
Minnesota Department of Health
STDs in Minnesota: Number of Cases Reported in 2010
Total of 17,760 STD cases reported to MDH in 2010:
15,294 Chlamydia cases
2,119 Gonorrhea cases
347 Syphilis cases (all stages)
0 Chancroid cases
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

13. Minnesota Department of Health
CHLAMYDIA
STDs in Minnesota: Annual Review

14. Minnesota Department of Health

15. Minnesota Department of Health
Chlamydia Infections by Residence at Diagnosis Minnesota, 2010
Minnesota Department of Health

16. Minnesota Department of Health
Chlamydia Rates by Gender Minnesota,

17. Minnesota Department of Health
Chlamydia Rates by Age Minnesota,

18. Age-Specific Chlamydia Rates by Gender Minnesota, 2010

19. Minnesota Department of Health
Chlamydia Rates by Race/Ethnicity Minnesota, .

20. Minnesota Department of Health
Chlamydia Rates by Race/Ethnicity Minnesota,

21. Minnesota Department of Health
GONORRHEA
STDs in Minnesota: Annual Review

22. Minnesota Department of Health

23. Minnesota Department of Health
Gonorrhea Infections in Minnesota by Residence at Diagnosis, 2010
Minnesota Department of Health

24. Minnesota Department of Health
Gonorrhea Rates by Gender Minnesota,

25. Minnesota Department of Health
Gonorrhea Rates by Age Minnesota,

26. Age-Specific Gonorrhea Rates by Gender Minnesota, 2010

27. Minnesota Department of Health
Gonorrhea Rates by Race/Ethnicity Minnesota,
2010 rates compared with Whites:
Black = 34x higher
American Indian = 4x higher
Asian/PI = 0x higher
Hispanic = 3x higher
* Persons of Hispanic ethnicity can be of any race.
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

28. Minnesota Department of Health
Gonorrhea Rates by Race/Ethnicity Minnesota,

29. Minnesota Department of Health
SYPHILIS
STDs in Minnesota: Annual Review

30. Syphilis Rates by Stage of Diagnosis Minnesota, 2000-2010

31. Minnesota Department of Health

32. Minnesota Department of Health
Primary & Secondary Syphilis Infections in Minnesota by Residence at Diagnosis, 2010

33. Minnesota Department of Health
Primary & Secondary Syphilis Rates by Gender Minnesota,

34. Minnesota Department of Health
Primary & Secondary Syphilis Rates by Age Minnesota,

35. Age-Specific Primary & Secondary Syphilis Rates by Gender, Minnesota, 2010

36. Minnesota Department of Health
Primary & Secondary Syphilis Cases by Race Minnesota, 2010

37. Minnesota Department of Health
Primary & Secondary Syphilis Rates by Race/Ethnicity Minnesota,

38. CHLAMYDIA AND GONORRHEA AMONG ADOLESCENTS & YOUNG ADULTS
Minnesota Department of Health
CHLAMYDIA AND GONORRHEA AMONG ADOLESCENTS & YOUNG ADULTS
(15-19 year olds) (20-24 year olds)
STDs in Minnesota: Annual Review

39. Minnesota Department of Health
Chlamydia Disproportionately Impacts Youth

40. Minnesota Department of Health
Gonorrhea Disproportionately Impacts Youth

41. Minnesota Department of Health
Characteristics of Adolescents & Young Adults† Diagnosed With Chlamydia or Gonorrhea in 2010

42. Minnesota Department of Health
Characteristics of Adolescents & Young Adults† Diagnosed With Chlamydia or Gonorrhea in 2010

43. Minnesota Department of Health
Chlamydia Rates Among Adolescents & Young Adults† by Gender in Minnesota,

44. Chlamydia — Positivity Rates by Age and Gender MIPP† Clinics, 2002-2010

45. Minnesota Department of Health
Chlamydia Cases Among Adolescents and Young Adults† by Gender and Race, Minnesota, 2010

46. Chlamydia Rate Among Adolescents and Young Adults† by Race, Minnesota, 2010

47. Chlamydia — Positivity Rates Among 15-24 Year-olds by Race MIPP† Clinics, 2002-2010

48. Minnesota Department of Health
Gonorrhea Rates Among Adolescents & Young Adults† by Gender in Minnesota,

49. Gonorrhea — Positivity Rates by Age and Gender MIPP† Clinics, 2002-2010

50. Minnesota Department of Health
Gonorrhea Cases Among Adolescents and Young Adults† by Gender and Race, 2010

51. Gonorrhea Rate Among Adolescents and Young Adults† by Race, Minnesota, 2010

52. Gonorrhea — Positivity Rates Among 15-24 Year-olds by Race MIPP† Clinics, 2002-2010

53. Summary of Chlamydia and Gonorrhea Among Adolescents and Young Adults†, Minnesota, 2010
Adolescents and young adults accounted for 69% of chlamydia and 65% of gonorrhea cases diagnosed in Minnesota.
75% of chlamydia or gonorrhea cases diagnosed among adolescents and young adults were females.
Whites and Blacks accounted for 41% and 32% of chlamydia or gonorrhea cases, respectively.
34% of gonorrhea or chlamydia cases were in the Cities of Minneapolis and Saint Paul.
† Adolescents defined as year-olds; Young Adults defined as year-olds.
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

54. Minnesota Department of Health
Topic of Interest:
Early Syphilis Among
Men Who Have Sex With Men
in Minnesota
STDs in Minnesota: Annual Review
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

55. Minnesota Department of Health
Number of Early Syphilis† Cases by Gender Minnesota,

56. Minnesota Department of Health
Early Syphilis† Cases by Stage at Diagnosis Minnesota,

57. Early Syphilis† by Gender and Sexual Behavior Minnesota, 2001-2010
Minnesota Department of Health
Early Syphilis† by Gender and Sexual Behavior Minnesota,

58. Early Syphilis† Cases Among MSM by Age Minnesota, 2010 (n=185)

59. Early Syphilis† (ES) Cases Co-infected with HIV, 2006-2010

60. Characteristics of Early Syphilis† Cases Among MSM, Minnesota, 2010
Minnesota Department of Health
Characteristics of Early Syphilis† Cases Among MSM, Minnesota, 2010
Gay and bisexual men account for 89% of cases among men.
66% of cases among MSM are White, but a disproportionate number of cases (23%) are African American.
75% of cases live in Hennepin County, and 61% in the City of Minneapolis.
57% of cases are also infected with HIV.
Among cases interviewed by the MDH Partner Services Program:
Commonly reported risk factors were meeting partners on the internet, anonymous sex, and no condom use.
MSM=Men who have sex with men
† Early Syphilis includes primary, secondary, and early latent stages of syphilis.
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review

61. What’s Being Done in Minnesota?
Minnesota Department of Health
What’s Being Done in Minnesota?
The MDH Partner Services Program continues to follow up on early syphilis cases and their sex partners.
In 2004 the MDH implemented the Syphilis Elimination Effort (SEE). SEE activities include:
Developed a clinician toolkit for syphilis testing and treatment;
Created a new outbreak response plan; and
Increased awareness among gay/bisexual men through advertising in magazines, bars, and websites.
SEP website: - includes several archived provider presentations and links to current awareness campaign materials
Physicians are encouraged to screen men who have sex with men at least annually and to ask about sex partners.
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review
STDs in Minnesota: Annual Review

62. Minnesota Department of Health
SURVEILLANCE SUMMARY

63. Summary of STD Trends in Minnesota
Minnesota Department of Health
Summary of STD Trends in Minnesota
From , the chlamydia rate increased by 87% while gonorrhea decreased to the lowest reported rate for the past decade. Rates of reported syphilis greatly increased in 2010 compared to 2009.
Minnesota has seen a resurgence of syphilis over the past decade, with men who have sex with men being especially impacted.
Persons of color continue to be disproportionately affected by STDs.
STD rates are highest in the cities of Minneapolis and Saint Paul. However, chlamydia and gonorrhea cases in the Twin Cities suburbs and Greater Minnesota account for 61% of the reported cases in 2010.
Adolescents and young adults (15-24 years) have the highest rates of chlamydia and gonorrhea, making up 68% of new infections in 2010.
Between 2009 and 2010, the chlamydia rate increased by 6% while the gonorrhea rate fell by 9%. Primary/secondary syphilis cases increased by 98% among men who have sex with men, who comprised 89% of all male cases in 2010; cases among women remain low.
Data Source: Minnesota STD Surveillance System STDs in Minnesota: Annual Review