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STDs in Houston/Harris County

STDs in Houston/Harris County. Trends Interventions Emerging Issues. Why are STDs Important?. Facilitate Transmission of HIV Infection Cause Infertility Cause PID Adverse Outcomes on Pregnancy 17 Billion Dollar Cost Annually in USA. How Are We Doing in Houston?.

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STDs in Houston/Harris County

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  1. STDs in Houston/Harris County Trends Interventions Emerging Issues

  2. Why are STDs Important? • Facilitate Transmission of HIV Infection • Cause Infertility • Cause PID • Adverse Outcomes on Pregnancy • 17 Billion Dollar Cost Annually in USA

  3. How Are We Doing in Houston? In 2002, Houston Ranked: • 48th- Chlamydia (346.1/100,000) • 45th- Gonorrhea (153.9/100,000) • 31st- P&S Syphilis (3.3/100,000)

  4. Chlamydia EPIDEMIOLOGY

  5. Gonorrhea EPIDEMIOLOGY

  6. Syphilis EPIDEMIOLOGY

  7. HDHHSSTD Interventions • Screening • Treatment • Education • Counseling • Partner Services

  8. Screening • Syphilis, gonorrhea, chlamydia, hep C,HIV testing in 3 STD clinics • Family Planning (no hep C) • Prenatal (no hep C) • Outreach Contractors (no gc)

  9. Screening • Mobile Unit Outreach testing • Collaboration with CBOs in outreach • Bookstores, Bath houses, streets, bars • Mobile clinic planned for 2003 • Jail tanks • Key HIV providers encouraged to test • Contracts with 7 CBOs to do screening

  10. Treatment • 3 STD Clinics • Some treatment in Family Planning and Maternity Clinics except for syphilis • Facilitate treatment with private providers - provide some meds • Facilitate treatment with Harris Co. Jail

  11. Treatment • DOT for chlamydia • Recommend epi profile based preventive treatment around syphilis outbreak • Encouraging stat RPR testing around outbreak • Hope to provide on site treatment on mobile clinic in 2003

  12. Vaccine • Hepatitis B vaccine in STD clinics • Plans for Hep A vaccine in STD clinics

  13. Education • Health Educators trained in STDs • CDBG health ed in K-12; and in K-12 • HIV/STD Info-line • Contracts with 23 CBOs for education • Work with CPG to emphasize STDs • Provider alerts, media alerts, provider training • Expanding education to web sites, chat rooms

  14. Counseling • Clinicians • DIS • Contractors

  15. Partner Services • DIS provide partner referrals and notification for syphilis and HIV • Some chlamydia and gonorrhea • Clustering and social network outreach • Counseling and testing contractors

  16. Partner Services • Pursuing web based self-interview • Self-referral through internet/email • DIS Liaison with Key Providers • Working with CBOs on training DIS and DIS on training CBOs to improve and promote partner notification

  17. DIS Outcomes for Syphilis*2002 • 488/546 Interviewed (89%) 442 contacts 515 were located (80%) 453 examined 62 refused exam 81 (18%) new cases brought to TX 229 preventive TX 457 clusters 4 new cases brought to TX • *P&S, EL, Unk duration

  18. DIS Outcomes HIV2002 • Interviewed 303/349 (87%) • 90% successful referrals to EIP • 482 contacts • 331Located/Counseled (69%) • 81 previous positive (24%) • 34 newly positive (10%) • 183 (55%)negative • 33 (10%) refused a test • 323 clusters --- 30 positives = 9%

  19. Emerging Issues • Syphilis Outbreaks • HIV Co-Infection • Resurgence in Risky Behavior • Partner Services Innovation • Internet and STDs • Hepatitis

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