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2. USVI’s Gonorrhea Surveillance Or, What is going on down there in America’s Paradise? 2

3. We Are Here 3

4. Historical Challenges Territorial Government heavily dependent on tourism industry Three islands with population 110,000 Infrastructure challenges Lack of meaningful surveillance system for any disease, including GC Local population 4

5. Who has the Gonorrhea? 200420052006200720081->6/2009 Males8.8% of 368 9.1% of 262 5.6% of 220 6.0% of 355 7.1% of 497 6.7% of 226 Females2.5% of 4085 1.7% of 2945 1.9% of 2232 3.0% of 2414 2.9% of 2852 3.0% of 972 Data provided by Cicatelli Associates 5

6. And, where are we finding our +GCs? Males ______ Females 200420052006200720081->6/ 2009 total Private Practices 0% of 11 _______ 0% of 3 CHC-s0% - 6 ______ 1% - 1272 20% - 5 ______ 1% - 1228 0% - 1% _______ 1% - 527 50% - 2 _______ 2% - 174 0% - 2 ______ 2% - 216 None ______ 0% - 7 13% - 16 ______ 1% - 3424 Data provided by Cicatelli Associates 6

7. Here Males ------------ Females 200420052006200720081->6/ 2009 Total Prenatal0% - 1 --------- 4% - 204 25% - 4 ----------- 3% - 333 0% - 5 ---------- 2% - 609 0 ---------- 2% - 12 0 ---------- 2% - 797 0 ----------- 2% - 121 10% -10 ------------ 2% - 2699 Family Planning 13% -8 ----------- 2% - 2108 21%-24 ------------ 2% - 1065 0% -18 ----------- 2% - 801 8%-12 ---------- 4% - 1213 0%-9 ---------- 3% - 1298 0%-3 ----------- 3% - 597 9%-74 ---------- 2% - 7082 STD/HIV TB clinics 9% - 336 ----------- 7% - 415 7%-220 ----------- 3% - 253 6%-190 ----------- 3% - 244 6%-334 ----------- 3% - 332 7%-480 ----------- 5% - 503 7%-209 ----------- 5% - 234 7%-1769 ------------ 4% - 1981 Data provided by Cicatelli Associates 7

8. How we addressed our GC 6/2008 Identified an IPP coordinator 12/2008 Cut down # IPP sites to 6 Crafted strategies for CHCs and Prenatal to get own funding for Genprobes 1/2009 First STD conference 2/2009 First serious attempt to get Quest Labs to comply with mandated reporting to DOH 8

9. And, we also Promoted the NJDOH Labs to anyone, everyone in the Territory Cross trained our HIV Prevention Outreach Workers to be DIS Partnered with HIV Prevention to buy Genprobes for outreach into high GC areas Partnering AGAIN to produce a 2 nd STD/HIV conference 2/2010 9

10. Continued Challenges Reporting by computer! Getting private MDs to test Collecting private MDs data Highly valued staff is leaving Cuts in budget for Genprobes Competing grant funders 10

11. But, hope springs eternal H1N1 has brought highly talented CDC surveillance support, and they love our dog 11

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13. Thank you, and you, and you, and Bon Voyage Cicatelli New York City Prevention Training Center New Jersey State Labs, especially JoAnn and Melissa Dr. Hall 13