MINNESOTA STATE REPORT RVIPP Regional Meeting Indianapolis By Candy Hadsall June 9-10, 2010

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 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

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 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 3 rd Annual Hepatitis Symposium Aug 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 project April 2010 – April 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, MA STD Clinical Consultant Minnesota Department of Health