2007 – 2008 std/hiv laboratory survey minnesota department of health std and hiv section
TRANSCRIPT
2007 – 2008 STD/HIV Laboratory Survey
Minnesota Department of Health
STD and HIV Section
Background
• Under Minnesota law health care providers and laboratories must report all lab-confirmed cases of HIV, chlamydia, gonorrhea, and syphilis to MDH within one working day.
• There have been significant changes in STD/HIV laboratory test technologies over the past decade.
• From September, 2007 to July, 2008 MDH sent electronic surveys to 120 laboratories as an assessment of STD/HIV testing and reporting practices.
Demographics
• Response Rate Chlamydia/Gonorrhea: 80% (96/120 labs)
Syphilis: 80% (96 / 120 labs)
HIV: 78% (94 / 120 labs)
• Laboratory Types*21 Non-profit Labs 1 City Lab
20 Community labs 2 State Labs
16 Non-profit Community Labs 4 Commercial Laboratories
1 HMO 3 Physician’s Offices
*Includes 10 Out-of-State Labs
Chlamydia/Gonorrhea Survey Results
Chlamydia/Gonorrhea Testing Practices
– 26% (25) tested for both Chlamydia and Gonorrhea
– 60% (58) did not test for either Chlamydia or Gonorrhea
– No lab reported testing only for Chlamydia– 13% (13) tested only for Gonorrhea
Percentage of Labs Using Chlamydia Screening Tests (n=96)
0
10
20
30
40
50
60
70
80
Culture NAAT NAH DFA EIA/ELISA Other NoScreening
MethodReported
Chlamydia Screening Tests Used
Per
cen
tag
e o
f L
abs
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs Using Gonorrhea Screening Tests (n=96)
0
10
20
30
40
50
60
Culture NAAT NAH DFA EIA/ELISA Other NoScreening
MethodReported
Gonorrhea Screening Tests Used
Per
cen
tag
e o
f L
abs
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs Accepting Chlamydia Specimen Sources (n=96)
0
5
10
15
20
25
30
Cervix Eye Oral Rectum Urethra Urine Vagina/VaginalVault
Chlamydia Specimen Sources Accepted
Per
cen
tag
e o
f L
abs
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs Accepting Gonorrhea Specimen Sources (n=96)
0
5
10
15
20
25
30
35
40
45
Cervix Eye Joint Fluid Oral Rectum Urethra Urine Vagina/VaginalVault
Gonorrhea Specimen Sources Accepted
Per
cen
tag
e o
f L
abs
Includes results from reference laboratories used by labs included in the survey
Oral/Rectal Testing
• Chlamydia Oral/Rectal Testing by Culture – Oral Testing 8%– Rectal Testing 7%– Neither Oral nor Rectal Testing 7%
• Gonorrhea Oral/Rectal Testing by Culture– Oral Testing 31%– Rectal Testing 30%– Neither Oral nor Rectal Testing 2%
Testing and Positivity Rates
• Chlamydia Testing Rates– Total Number of Chlamydia Tests Performed 658,879
– Total Number of Positive Chlamydia Tests 25,615
– Positivity Rate Range for Chlamydia Tests 0% - 11%
• Gonorrhea Testing Rates– Total Number of Gonorrhea Tests Performed 627,547
– Total Number of Positive Gonorrhea Tests 5,324
– Positivity Rate Range for Gonorrhea Tests 0% - 11%
Syphilis Survey Results
Syphilis Testing Practices
– 62% of labs (n = 60) reported no Syphilis screening done
– 86% of labs (n = 83) reported no Syphilis confirmation testing done
Percentage of Labs Using Syphilis Screening Tests (n=97)
0
10
20
30
40
50
60
70
RPR/USR/VDRL VDRL-CSF EIA No Syphilis Testing
Syphilis Screening Tests Used
Per
cen
tag
e o
f L
abs
Includes results from reference laboratories used by labs included in the survey
Includes results from reference laboratories used by labs included in the survey87% of labs reported no confirmatory testing done.
Percentage of Labs Using Syphilis Confirmation Tests (n=97)
0
1
2
3
4
5
6
7
8
FTA-ABS/TP-PA/MHA-TP
IgM IgG FTA-ABS DS RPR after EIAScreen
Syphilis Confirmation Tests Used
Per
cen
tag
e o
f L
abs
Syphilis Screening and Positivity Rates, 2007
Total Number of Screening Tests 326,847
Total Number of Positive Screening Tests 3,757
Range of Screening Tests Ran 0 - 192,973
Positivity Rate Range for Screening 0% – 3%
Includes results from reference laboratories used by labs included in the survey
Syphilis Confirmation Testing and Positivity Rates, 2007
Total Number of Confirmation Tests 5,436
Total Number of Positive Confirmation Tests 2,922
Range of Confirmation Tests Ran 3,278
Positivity Rate Range for Confirmation Tests 0% - 93%
Includes results from reference laboratories used by labs included in the survey
HIV Survey Results
HIV Testing Practices
– 61% (n = 57) perform HIV screens– 4% (n = 4) perform HIV confirmatory tests– 8% (n = 8) perform other HIV tests
Percentage of Labs Using HIV Screening Tests (n=96)
0
5
10
15
20
25
30
35
40
45
HIV-1/2 Group O HIV-1 HIV-2 Neither HIV-1 norHIV-2
HIV Screening Tests Used
Per
cen
tag
e o
f L
abs
13 labs performed Waived Testing, 14 labs performed Non-Waived TestingIncludes results from reference laboratories used by labs included in the survey
Percentage of Labs using Confirmation Tests (n=96)
0
2
4
6
8
10
12
HIV-1 HIV-2 Neither HIV-1 norHIV-2
HIV Confirmation Tests Used
Per
cent
age
of L
abs
Includes results from reference laboratories used by other labs included in the survey
For More Information
STD and HIV Section
Minnesota Department of Health
651-201-5414