Sexually Transmitted Diseases, Hepatitis C and HIV Epidemiology in North Dakota Sarah Weninger, MPH HIV.STD.Viral Hepatitis Prevention Coordinator Great Plains Area Indian Health Service Public Health Training Conference August 5, 2016 2014 MFMER slide-1
Chlamydia 2014 MFMER slide-2
Compared to 2014, Chlamydia Decreased by 6.8% in 2015. 4,000 3,500 3,000 2,912 2,944 3,417 3,183 2,500 2,451 Number of Cases 2,000 1,500 1,000 500 0 2011 2012 2013 2014 2015 Year 2014 MFMER slide-3
Each Year for the Past 5 Years, about 64% of all Chlamydia Cases were Female. 2014 2015 Male 36% Male 36% Female 64% Female 64% 2014 MFMER slide-4
6 in10 Chlamydia Infections are Between 15-24 yrs. 1000 900 886 Female Male 800 Number of Cases 700 600 500 400 300 200 100 0 21 1 553 145 477 336 304 149 114 61 54 21 20 14 21 1 6 Age Group 2014 MFMER slide-5
Chlamydia Rates Decreased by 18.6% from 2014 to 2015 in American Indians. 2500 2000 American Indian / Alaskan Native Black / African American Asian White 2260.2 Cases Per 100,000 1500 1000 500 0 2011 2012 2013 2014 2015 Year 1419.2 359.6 275.7 2014 MFMER slide-6
Sioux County Reported the Highest Chlamydia Rate in 2015. 2014 MFMER slide-7
Interesting Chlamydia Facts in ND Diagnosing Facility: Chlamydia cases in 2015 diagnosed at: 59% at a private clinic/hospital; 25% at family planning/pregnancy clinics and 9% tribal/ihs facilities and 7% at other facilities. Treatment: Tribal IHS: 42 of 284 (14.8%) Reported as Not Treated All CT Cases: 108 (3.4%) Not treated Interviewed: 61% chlamydia cases were interviewed at IHS. All ND Chlamydia Cases Interviewed: 56 % Reminder: The NDDoH only interviews pregnant women, those diagnosed with PID and cases under 14 yrs. HIV Testing: 32.4% were tested for HIV at time of chlamydia diagnosis across ND 61.3% of chlamydia cases at IHS are tested for HIV 2014 MFMER slide-8
Gonorrhea 2014 MFMER slide-9
Gonorrhea has Increased 174% Over the Past 5 Years. Number of Cases 800 700 600 500 400 300 200 100 0 686 687 493 340 251 2011 2012 2013 2014 2015 Year 2014 MFMER slide-10
Compared to Chlamydia, a Higher Proportion of Gonorrhea Infections are Diagnosed Among Males. 2014 2015 Male 45% Male 45% Female 55% Female 55% 2014 MFMER slide-11
In 2015, Most Gonorrhea Cases Reported Among those 20-29 Yrs. 140 120 130 Female Male Number of Cases 100 80 60 40 20 0 3 0 65 27 95 94 89 45 42 24 24 12 9 6 15 2 5 Age Group 2014 MFMER slide-12
73% of Gonorrhea Cases are Diagnosed in Those < 30 Yrs. 140 Male Female 120 100 Number of Cases 80 60 40 20 0 <10 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-54 55+ Age Group, Years 2014 MFMER slide-13
The Rate of Gonorrhea is 7X Higher Among Native Americans than the ND Rate. Cases Per 100,000 800.0 700.0 600.0 500.0 400.0 300.0 200.0 100.0 0.0 American Indian / Alaskan Native Black / African American Hispanic ( all races) Asian White 2011 2012 2013 2014 2015 Year 693.2 583.5 97.0 56.2 29.1 2014 MFMER slide-14
Rolette County has the Highest Rate of Gonorrhea in ND. 2014 MFMER slide-15
Interesting GC Facts in ND Diagnosing Facility: Gonorrhea cases in 2015 diagnosed at: 56% at a private clinic/hospital; 22% at tribal/ihs facilities, 18% at family planning/pregnancy clinics and 4% at other facilities. Treatment: Tribal IHS: 29 of 154 (18.8%) Reported as Not Treated All GC Cases: 96 (13.9%) Not treated Interviewed: IHS: 48% gonorrhea cases were interviewed. All ND Gonorrhea Cases Interviewed: 64 % HIV Testing: All ND Gonorrhea Cases Tested for HIV: 38.7% 61.3% of gonorrhea cases at IHS are tested for HIV 2014 MFMER slide-16
Syphilis 2014 MFMER slide-17
Syphilis Continues to be a Concern in ND. 60 50 Primary, Secondary, Early Latent All Stages 51 Number of Cases 40 30 27 35 28 43 20 14 17 10 8 3 4 0 2011 2012 2013 2014 2015 Year 2014 MFMER slide-18
More Cases were Reported Among MSM in 2015 Compared to 2014. 60 50 Male Female Number of Cases 40 30 20 10 0 20 12 9 2 31 31 1 18 12 7 2011 2012 2013 2014 2015 Year 2014 MFMER slide-19
American Indians and Black/African Americans have Syphilis Rates 10x Higher Than Whites. 90.0 80.0 American Indian / Alaskan Native Black / African American White Rate per 100,000 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 35.3 26.8 3.1 2011 2012 2013 2014 2015 Year 2014 MFMER slide-20
10 Counties in N.D. Reported At Least One Syphilis Case in 2015. 2014 MFMER slide-21
HIV 2014 MFMER slide-22
ND has seen an Increase in Reported HIV/AIDS Diagnosis Since 2010. 100 90 86 80 76 70 Number of Cases 60 50 40 30 20 15 23 14 16 12 14 22 22 19 15 17 21 14 15 16 17 22 22 19 19 25 26 28 39 25 36 44 58 AIDS HIV 10 0 2 6 Year Reported 2014 MFMER slide-23
The Incidence of HIV/AIDS in ND has Increased 154% since 2011. 30 28 26 25 23 Number of Cases by Gender 20 15 10 11 16 5 0 2011 2012 2013 2014 2015 Year 2014 MFMER slide-24
The Average Age of Those Newly Diagnosed with HIV/AIDS was 34 Yrs in 2015. 9 8 7 6 Number of Cases 5 4 3 2 1 0 <5 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-54 55+ Age Group, Years Age of HIV/AIDS Incident Cases Diagnosed in N.D. 2015 2014 MFMER slide-25
Rates of HIV/AIDS are Highest among Black/African Americans. 120.0 100.0 98.28 80.0 Rate per 100,000 60.0 40.0 58.81 73.89 60.36 American Indian / Alaskan Native Black / African American Hispanic (all races) Asian White Native Hawaiian / Pacific Islander 20.0 14.58 0.0 2011 2012 2013 2014 2015 Year 2014 MFMER slide-26
Half of Newly Diagnosed HIV/AIDS Cases were Born Outside of U.S. in 2015. 35 30 25 20 7 10 15 15 3 10 5 2 9 13 15 16 14 0 2011 2012 2013 2014 2015 Foreign Born US Born 2014 MFMER slide-27
Injection Drug Use is Not a Reported Risk Factor for Newly Diagnosed HIV/AIDS Cases. 30 25 20 Number of Cases 15 10 Other/NRI MSM/IDU IDU Heterosexual MSM 5 0 2011 2012 2013 2014 2015 Year 2014 MFMER slide-28
7 Counties Reported At Least One New Case of HIV/AIDS in 2015. 2014 MFMER slide-29
As of December 31, 2015, There are 424 Individuals Living in ND with HIV/AIDS. 2014 MFMER slide-30
Hepatitis C 2014 MFMER slide-31
Hepatitis C Cases have Increased by 96% since 2011. Number of Cases 1200 1000 800 600 400 543 681 831 966 1062 200 0 2011 2012 2013 2014 2015 Year * Includes acute, chronic and resolved infections 2014 MFMER slide-32
More Males than Females are Diagnosed with Hepatitis C in ND. 1200 1000 Number of Cases 800 600 400 239 319 378 402 483 557 579 200 315 411 438 0 2011 2012 2013 2014 2015 Year Male Female 2014 MFMER slide-33
Hepatitis C is Most Often Diagnosed in Young Individuals in ND. 1200 <25 25-34 35-54 55+ 1000 237 176 800 Number of Cases 600 85 123 283 176 266 346 341 400 226 200 218 296 344 398 447 0 25 28 30 39 38 2011 2012 2013 2014 2015 Year 2014 MFMER slide-34
Native Americans have the Highest Rate of Hepatitis C in ND. 700.0 American Indian / Alaskan Native Black / African American White Hispanic ( all races) 600.0 577.3 500.0 Rate Per 100,000 400.0 300.0 265.4 353.1 246.3 200.0 186.9 100.0 87.5 73.9 60.4 117.9 19.6 0.0 2011 2012 2013 2014 2015 Year 2014 MFMER slide-35
Sioux County Reported the Highest Rate of Hepatitis C in ND in 2015. 2014 MFMER slide-36
Program Contact Information Sarah Weninger, MPH HIV.STD.Viral Hepatitis Prevention Coordinator sweninger@nd.gov; 701.328.2366 Lindsey VanderBusch, MPH HIV.STD.TB.Viral Hepatitis Program Manager lvanderbusch@nd.gov; 701.328.4555 Dee Pritschet HIV Surveillance Coordinator djpritschet@nd.gov; 701.328.2377 2014 MFMER slide-37