figure 1. hiv and syphilis co-morbidity, 2000 – 2009 *diagnosed within 2000 – 2009
TRANSCRIPT
12%
11% 15
%
29%
23% 28
% 32%
31%
32%
24%
0%
5%
10%
15%
20%
25%
30%
35%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year of TES diagnosis
Per
cen
t H
IV p
osi
tive
0
100
200
300
400
500
600
Nu
mb
er of T
ES
diag
no
ses
Percent of TES cases that were HIV positive Number of TES cases diagnosed
Figure 1. HIV and syphilis co-morbidity, 2000 – 2009
*diagnosed within 2000 – 2009
349 cases, 6.23
443 cases, 8.03
463 cases, 7.39
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
2007 2008 2009
Year
Rela
tive
risk
Figure 2. Relative risk* of TES syphilis morbidity by sex, 2007 – 2009
Of the 1,369 interviews conducted during this time, 36% were
identified as MSM.
*Reference is female.
Figure 3. Relative risk* of TES syphilis infection among racial and ethnic minorities, 2007 – 2009
9.64 9.80
Black (non-Hispanic)225 cases, 5.46
38 cases, 2.7024 cases, 2.06
Hispanic28 cases, 2.10
0.00
2.00
4.00
6.00
8.00
10.00
12.00
2007 2008 2009
Year
Rela
tive
risk
*Reference is white (non-Hispanic).
Figure 4. Relative risk* of TES syphilis infection by age, 2007 – 2009
Age 15-1932 cases , 0.58
42 cases , 0.79
51 cases , 1.13
Age 20-29130 cases , 1.16
202 cases , 1.84
238 cases , 2.57
Age 40-4997 cases , 0.80
97 cases , 0.83
108 cases , 1.08
0.00
0.50
1.00
1.50
2.00
2.50
3.00
2007 2008 2009
Year
Rela
tive
risk
*Reference is 30-39.
Figure 5. TES syphilis morbidity by region, 2007 – 2009
0
20
40
60
80
100
120
140
160
180
200Ce
ntra
l
East
ern
Nor
ther
n
Nor
thw
est
Sout
hwes
t
Cent
ral
East
ern
Nor
ther
n
Nor
thw
est
Sout
hwes
t
Cent
ral
East
ern
Nor
ther
n
Nor
thw
est
Sout
hwes
t
2007 2008 2009
Region
Mor
bidi
ty
Internet Partner Services (IPS)
Since 2-25-05, there have been 248 internet partners named:
219 were unable to locate12 were located and refused examination7 were epi treated0 were brought to treatment2 were closed as "Other"
data thru May 2010
Two Different Syphilis Outbreaks, Two Different Responses, Same Outcome
Syphilis Outbreak Response Cost Comparison
Cost* Duration
Danville ‘00 $ 279,070 12 months
Lynchburg ‘07 $ 34,300 2 months
Cities are similar in size, location, and population dynamicsBoth have previous histories of syphilis outbreaksOnly difference is WHEN the response effort occurred
*Costs include salary, travel related, supplies, and contracts
Issues
SuccessesCan deploy DIS rapidlyRate of increase slowingMonthly webinar for LHD staffCBO partnerships
ChallengesTimeliness of disease interventionIPS – low Tx yieldTraining needsHIV co-infectionDIS resourcesMedia campaign approval