2007 – 2008 std/hiv laboratory survey minnesota department of health std and hiv section

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

glenise.johnson@state.mn.us