1. Overview of Gonorrhea Epidemiology and Program Prevention Efforts Melinda Salmon Program Manager STD Control Program Philadelphia Department of Public Health melinda.e.salmon@phila.gov

2. Reported Cases of Gonorrhea: Philadelphia, 1990 - 2008 Year Number of Cases

3. Rate of Gonorrhea per 100,000 Population: Philadelphia, 1990 - 2008 Year 2010 Objective (19 per 100,000) Rates for 1990 to 1999 calculated with 1990 Census denominator. Rates for 2000 to present calculated with 2000 Census denominator. Year Rate per 100,000 population

4. Rates of Gonorrhea per 100,000 Population, by Gender: Philadelphia, 1996 – 2008 Rates for 1995 to 1999 calculated with 1990 Census denominator. Rates for 2000 to present calculated with 2000 Census denominator. Year Rate per 100,000 population

6. Race/Ethnicity * among Gonorrhea Cases, by Sex: Philadelphia, 2008 N=2,528 Female Gonorrhea Cases N=2,422 Male Gonorrhea Cases * Race and ethnicity are combined. Persons identified as Hispanic, alone or in combination with any US Census race category, are included in the Hispanic category. Persons in all other race categories are non-Hispanic. * “Asian” category includes Asian / Pacific Islander / Native Hawaiian groups. * “American Indian” category includes American Indian and Alaska Native groups. * Distribution represent cases with a specified race/ethnicity. In 2008, 29.8% of Gonorrhea cases (22.6% male, 36.7% female) had neither race nor ethnicity specified in the disease report. Total N includes cases with unknown race/ethnicity.

7. Top ZIP codes by Case Counts: 19143: 454 cases 19121: 306 cases 19132: 297 cases 19139: 286 cases (Rate: 542.9/100,000) 19140: 277 cases (Rate: 447.9/100,000) Top ZIP codes by Rate: 19121: 815.8/100,000 19138: 814.2/100,000 (161 cases) 19132: 779.2/100,000 19143: 693.6/100,000 19123: 598.9/100,000 (56 cases)

9. 2008 GC Morbidity by Provider Type Provider Type# Cases% Morbidity STD Clinic1,11623% Hosp/EDs1,11623% Family Planning83417% Other – Screening54211% Other – Non-Screening50410% Corrections3697% PMD2214% High School/HRC1293% Prenatal1182% TOTAL4,950100%

10. GC Screening Program Treatment Verification

11. Philadelphia’s Gonorrhea Screening Program Started ~1972 1994 - expanded to include chlamydia screening (FP and STD Clinics) 1996 – CT testing expanded to all GC screening sites 1997 – DNA probe instituted 2000 – added the juvenile detention center, began including males in testing 2002 – expanded to adult prisons to include asymptomatic males and females

12. Philadelphia’s Gonorrhea Screening Program 2003 – High School STD Screening Program begins >95% of those who test positive through city-wide screening program have documented Rx (2877/2996 in 2008) 64% of city-wide morbidity is currently identified through GC screening program Participation in GISP since ~ 1990

14. Possible Areas for Program Expansion No treatment verification for those testing positive outside the screening program No active partner notification for GC except for those who test positive through HS screening Expedited Partner Therapy currently not legal in PA

15. Thank you!