MINNESOTA STATE REPORT RVIPP Regional Meeting Chicago By Candy Hadsall March 8-10, 2011

STDs in Minnesota in 2010 New stats will be announced April 6 via webinar. Preliminary: CT up again, GC continuing to go down

MIPP TESTING LOCATIONS Planned Parenthood Minnesota, North Dakota, South Dakota (16 sites in Greater MN) Title X St. Paul-Ramsey County Department of Public Health (FP and STD clinics – combining into 1 clinic) Title X Hennepin County STD clinic Health Start: School-based clinics in 10 high schools, funding 5 based on positivity rates

Change to MIPP contractor Teen Age Medical Services (TAMS) Was part of Children’s Hospital – now part of an FQHC (Cedar Riverside People’s Ctr) Still in transition, awaiting final approval by MDH Financial Mgmt MIPP data collection not in place so will not be reimbursed for screening until it is – when? Expect program components and target audience to remain the same Includes street outreach to African American males

Update on MDH Activities Progress on GC Plan Change DIS protocols to contact partners of CT and GC + and have DIS do field-delivered therapy = slow progress due to resistance Update on EPT provider survey Purpose: to identify support for and extent of use of EPT, barriers Use for data: improve EPT Guidance, training for providers, Cap bldg Results: 59 out of 248 responded (24.1%), 68% drs.; majority supportive; 58% use it, 30% will start or resume; 79% give Rx, 43% meds

Clinic Capacity Building Developed “Responding to the CT Epidemic: Tools for Enhancing Screening and Treatment in MN Clinics” (12 topics) Adapted clinic assessment and provider training assessment Discussed document at 5 IPP site visits & one non-IPP clinic, did assessments Working with system of 3 private provider clinics in county outside metro Will be expanding efforts in 2011

Topics in “Responding to Chlamydia” document Stats, description, consequences Sexual history – 5 Ps Screening, treatment recommendations Testing options Rescreening What about GC? EPT Minor Consent Reporting requirements Minnesota Chlamydia Partnership

EPT Pilot Project EPT pilot project (April Dec 2011) 13 clinics: 7 urban, 2 suburban, 4 in Greater MN (Planned Parenthood) Protocols: Could distribute meds or Rx – all are doing meds Clinics fill out logs of participants Original pt must have confirmed + tests Allow providers to treat initial pts w/meds provided even if they are unable to deliver meds to partners Allow tx of MSM when partners of both genders Student conducts phone interviews with everyone listed on logs - match with report forms

Update on EPT Pilot Project Interview questions: 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? Student conducting phone interviews with original patients. Results as of January: 375 accepted (79%) 101 refused (21%) 313 interviewed (66%) 26 refused (5%) 137 unable to reach (29%)

Results of interviews (cont) Spoke to all partners: 269 (87%) Spoke to some partners: 11 (4%) Did not speak to partners: 19 (6%) Certain that all partners completed tx: 207 (85%) Certain that some partners completed tx: 14 (6%) Certain that no partners completed tx: 8 (3%) Uncertain if partners completed tx: 15 (6%)

Provider Report Card MPH student collected data Number of days between dx and reporting, dx and tx Focused on highest reporters and IPP sites Used surveillance data Major findings: Problems w/reporting time, not treatment Some clinics days late despite multiple ltrs from MDH Surveillance working with most delinquent clinics Plan to use data in capacity building w/clinics STD clinic – went from bundling reports and submitting every 30 days to submitting daily after discussions with staff and changes in protocol. Had been unaware.

National Chlamydia Coalition Grant & MN CT Partnership Held Summit on CT: August 3, people attended in St. Paul; 130 people at 9 video conferencing locations in Grtr MN 19% PH & 8% private providers, 19% youth, 3% health plan, 24% non-profit, 8% education, 1% each: religious, tribal, research orgs & 1% fed Speakers provided epidemiological backgrd, motivation to get involved, personal stories, information on using social media Brainstorming in afternoon - World Café process generated ideas for what needs to be done

Feedback from Summit #1: Healthy sexuality information needed Consistent, positive messages everywhere Messages that cover lifespan, deal with sexuality issues as adolescent AND as adult Mandatory Comprehensive Sexuality Education in all types of schools; health ed in colleges #2: Testing for CT, GC should be routine #3: Need funding for testing, treatment, prevention, EPT, partner notification

Activities following Summit 5 workgroups formed, 4-16 participants each from across state Educating teens, parents, teachers Educating providers Building awareness in community Affordable testing and treatment Access to testing and treatment Workgroups met multiple times Sept – Jan submitted ideas/recommendations for actions in each area “MN CT Strategy” now being written, will incorporate recommendations

Activities after Summit (cont) Received additional funding to coordinate outreach materials: Cincinnati, MOAPPP, Medica Logo, dedicated website, design & print summary of plan Strategy to be announced April 12 via webinar, will be posted to website MCP members to take Strategy to communities across state in 2011

MDH Other STD Activities Syphilis Elimination Efforts: Media campaign launched June 2010, new phase launches July 2011 Info on Facebook – search Twitter feeds weekly – sx, prevention msgs Two provider trainings were offered on the management of syphilis and HIV co-infection (Tony Mills, Will Wong) 4 th Annual Hepatitis Symposium Aug All funding raised outside MDH (Amer Liver Fdn)

Ideas for IPP Supplemental Rescreening pilot project: enc clinics to stress rescreening, design posters, offer incentives to youth to come back for screening in one group, compare to group without incentives, use results Provide educational materials and training to Child and Teen Checkup coordinators to encourage private drs (esp. peds) to screen Outreach, testing targeted to specific neighborhoods using geo-coding, focus on disparities in AA pop 2 provider trngs to increase screening, PN and EPT Support dissemination of Strategy Assess CT screening in IHS hospital near reservation

Candy Hadsall, RN, MA STD Clinical Consultant Minnesota Department of Health