STD PREVENTION AND CONTROL IN SAN DIEGO COUNTY M. Winston Tilghman, - PowerPoint PPT Presentation

STD PREVENTION AND CONTROL IN SAN DIEGO COUNTY M. Winston Tilghman, M.D. County of San Diego Health and Human Services Agency Division of Public Health Services HIV, STD, and Hepatitis Branch CHEAC Annual Meeting – October 17, 2018 PUBLIC HEALTH SERVICES

SAN DIEGO COUNTY ▪ Population: 3.2 million people

Early Syphilis Cases and Rates by Year San Diego County, 1998-2017 Cases Rate per 100,000 population 1200 40.0 1130 35.0 981 1000 Rate per 100,000 Population 34.1 30.0 829 29.8 Number of Cases 800 25.0 668 25.1 578 576 515 600 20.0 519 20.5 456 454 15.0 399 364 400 314 10.0 11.2 11.0 11.0 220 10.6 9.3 8.9 200 152 8.6 7.6 5.0 6.3 72 48 46 45 38 4.6 3.7 0 0.0 1.3 1.0 0.9 0.9 0.9 Year

Cases – Early Syphilis in Women of Childbearing Age (15-49 y/o) & Pregnant Women, Congenital Syphilis, & Stillbirths San Diego County, 2013-2017 Women 15-49 y/o Pregnant Women Congenital Syphilis Stillbirths 50 45 45 40 40 Number of Cases 35 32 31 30 25 18 20 15 11 9 8 10 7 7 7 4 3 3 5 2 1 1 1 0 0 0 2013 2014 2015 2016 2017 Note: Early syphilis includes primary, secondary, and early latent stages of syphilis. Syphilitic stillbirths are included in the congenital syphilis case counts.

Gonorrhea Cases and Rates by Year San Diego County, 1998-2017 Cases Rate per 100,000 population 7000 250 5947 6000 200 Rate per 100,000 Population 179.7 4992 5000 Number of Cases 150 4000 3695 3391 151.8 2865 3000 26062767 2597 114.5 100 2385 2376 106.2 2016184320192166 21281972 90.9 17971875 78.9 85.7 90.3 2000 83.0 15871560 77.0 58.7 56.7 63.9 65.5 72.9 66.4 64.2 60.1 65.2 69.5 50 1000 0 0 Year

Chlamydia Cases and Rates by Year San Diego County, 1998-2017 Cases Rate per 100,000 Population 25000 1000 900 Rate per 100,000 Population 20801 20000 800 18904 Number of Cases 17418 700 165381604215626 1533615349 1407314266 15000 600 628.5 12692 574.8 11980 500 539.7 10225102491082211001 528.6 509.2 489.2 495.5 492.6 447.9 465.5 10000 400 8637 9168 390.8 409.9 7006 7576 350.1 344.9 359.5 361.9 300 306.9 320.1 259.2 275.4 5000 200 100 0 0 Year

STD & HIV Cases by Year San Diego County, 1997-2017

STD PROGRAM PRIORITIES Prevent congenital syphilis Prevent other complications of syphilis (neuro, ocular disease) Prevent complications of untreated gonorrhea & chlamydia Prevent the development/spread of antibiotic-resistant gonorrhea Integrate HIV prevention into STD case investigations Ensure availability of testing & treatment services Support & educate local healthcare providers

SURVEILLANCE Gonococcal Isolate Active STD Case Surveillance Surveillance Project (GISP) California Gonorrhea Surveillance System (CGSS)

DISEASE INTERVENTION Syphilis – Male Primary & Females of Secondary Childbearing Age Syphilis Male Rectal Gonorrhea (HIV-)

STD PREVENTION & OUTREACH STD Community Chlamydia Intervention Screening Project Project Don’t Think, MSM Community Know Engagement

STD CLINICAL SERVICES County Health Central Region Services Complex Public Health (Rosecrans) Center North Coastal South Region Public Health Public Health Center Center

STD CLINIC LOCATIONS

PROVIDER SUPPORT STD Consultation Syphilis Histories Pager Coming Soon: Clinical Training Public Health Detailing

REPORTS & COMMUNICATIONS

QUESTIONS?