Prepared by Bradley Stoner MD PhD Medical Director and Deloris Rother MPH Project Manager St Louis STDHIV Prevention Training Center for STD 101 March 12 2012 National Center for HIVAIDS Viral Hepatitis STD and TB Prevention ID: 734475
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Slide1
Current Epidemiology of Selected STDs
Prepared by Bradley Stoner, MD, PhD, Medical Director and Deloris Rother, MPH, Project ManagerSt. Louis STD/HIV Prevention Training Center for STD 101March 12, 2012
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of STD PreventionSlide2
What we’ll cover today
DiseasesChlamydiaGonorrheaSyphilisViral STDsHSV-2, HPV
Other STDsChancroid, trich
Special Populations
Adolescents
MSMSlide3
What is epidemiology?Distribution and determinants of disease within a population
Who, what, and wherePart of the core function of public healthAssessmentAssurancePolicy developmentWhy is this important?Lets us know where disease is occurring, and who is getting itLets us plan for control and prevention activitiesSlide4
Chlamydia
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide5
Epidemiology of Chlamydia
Incidence1,307,893 cases reported in 2010Largest no. of cases ever reported to CDC for any conditionMost frequently reported STD in USCase rate = 426.0 per 100,000 population5.1% increase over the previous yearRates 2.5x higher in femalesHigher screening rates in women
But male screening is increasing due to urine-based testingSlide6
Epidemiology of Chlamydia
High prevalence amongFamily planning clinics (8.0%)Prenatal clinics (7.2%)National job training program (11.4% women, 7.2% men)Adolescent corrections (14.5% women, 6.5% men)Slide7
Chlamydia—Rates by Sex, United States, 1990–2010
NOTE: As of January 2000, all 50 states and the District of Columbia have regulations that require the reporting of chlamydia cases.
Total
Women
Men
Rate (per 100,000 population)
Year
0
125
250
375
500
625
750
2010
2008
2006
2004
2002
2000
1998
1996
1994
1992
1990Slide8
Chlamydia—Rates by Region, United States, 2001–2010
South
Northeast
Midwest
West
Rate (per 100,000 population)
Year
0
100
200
300
400
500
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide9
Chlamydia—Rates by State, United States and Outlying Areas, 2010
NOTE: The total rate of chlamydia for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 422.6 per 100,000 population. Slide10
Chlamydia—Rates by County, United States, 2010
<
300.0
(n = 1,962)
Rate per 100,000
population
300.1–400.0
(n = 418)
>400.0
(n = 762)Slide11
Chlamydia—Rates by Age and Sex, United States, 2010
15–19
20–24
25–29
30–34
35–39
40–44
45–54
55–64
65+
Total
Men
Women
Rate (per 100,000 population)
Age
3,700
2,960
2,220
1,480
740
0
0
740
1,480
2,220
2,960
3,700
774.3
1,187.0
598.0
309.0
153.2
91.3
39.3
233.7
2.8
10.9
3,378.2
3,407.9
1,236.1
530.9
220.1
94.7
32.8
610.6
2.1
9.3Slide12
Chlamydia—Rates by Race/Ethnicity, United States, 2001–2010
Whites
Hispanics
Blacks
Asians/Pacific Islanders
American Indians/Alaska Natives
Rate (per 100,000 population)
Year
0
300
600
900
1200
1500
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide13
Chlamydia—Cases by Reporting Source and Sex, United States, 2001–2010
0
100
200
300
400
500
600
700
800
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
STD Clinic,
W
omen
STD Clinic, Men
Non-STD Clinic,
W
omen
Non-STD Clinic, Men
Cases (in thousands)
YearSlide14
Chlamydia—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics, by State, Infertility Prevention Project, United States and Outlying Areas, 2010
NOTE: Includes states and outlying areas that reported chlamydia positivity data on at least 500 women aged 15–24 years screened during 2010.Slide15
Chlamydia—Trends in Positivity Rates Among Women Aged 15–24 Years Tested in Family Planning Clinics, by U.S. Department of Health and Human Services (HHS) Region, Infertility Prevention Project, 2006–2010
* 2009 percent positivity for Region VI previously published in the 2009 Surveillance report has been corrected.Slide16
Gonorrhea
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide17
Epidemiology of Gonorrhea
Incidence309,341 cases reported in 2010Downward trend between 1975-1996, then plateau until 20062009 rate was lowest since national reporting beganCase rate = 100.8 per 100,000 population2.8% increase over the previous yearSlightly higher rates in femalesWomen highest rates age 15-24 year olds
Men highest rates 20-24Slide18
Epidemiology of Gonorrhea
Proportion of gonococcal infections caused by resistant organisms is increasingIncidence remains high in some groups defined by geography, age and race/ethnicity, or sexual orientationSlide19
Gonorrhea—Rates, United States, 1941–2010
Rate (per
100,000 population)
2006
2001
1996
1991
1986
1981
1976
1971
1966
1961
1956
1951
1946
1941
0
100
200
300
400
500
YearSlide20
Gonorrhea—Rates by Sex, United States, 1990–2010
Total
Women
Men
Rate (per 100,000 population)
0
100
200
300
400
Year
2010
2008
2006
2004
2002
2000
1998
1996
1994
1992
1990Slide21
Gonorrhea—Rates by Region, United States, 2001–2010
South
Northeast
Midwest
West
Rate (per 100,000 population)
0
50
100
150
200
250
300
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide22
Gonorrhea—Rates by State, United States and Outlying Areas, 2010
NOTE: The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 99.6 per 100,000 population.Slide23
Gonorrhea—Rates by County, United States, 2010
<
19.0
(n = 1,408)
Rate per 100,000
population
19.1–100.0
(n = 1,107)
>100.0
(n = 627)Slide24
Gonorrhea—Rates by Age and Sex, United States, 2010
15–19
20–24
25–29
30–34
35–39
40–44
45–54
55–64
65+
Total
Men
Women
Rate (per 100,000 population)
Age
750
600
450
300
150
0
0
150
300
450
600
750
253.4
421.0
241.3
146.5
85.1
64.2
34.1
94.1
2.4
11.0
570.9
560.7
226.3
107.5
48.2
23.8
9.0
106.5
0.5
1.9Slide25
Gonorrhea—Rates by Race/Ethnicity, United States, 2001–2010
Whites
Hispanics
Blacks
Asians/Pacific Islanders
American Indians/Alaska Natives
Rate (per 100,000 population)
Year
0
100
200
300
400
500
600
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide26
Gonorrhea—Cases by Reporting Source and Sex, United States, 2001–2010
0
40
80
120
160
200
STD Clinic, Women
STD Clinic, Men
Non-STD Clinic, Women
Non-STD Clinic, Men
Cases (in thousands)
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide27
Gonorrhea—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics, by State, Infertility Prevention Project, United States and Outlying Areas, 2010
* States/areas not meeting minimum inclusion criteria.NOTE: Includes states and outlying areas that reported positivity data on at least 500 women aged 15–24 years who were screened during 2010.Slide28
Gonococcal Isolate Surveillance Project (GISP)—Location of Participating Sentinel Sites and Regional Laboratories, United States, 2010Slide29
Gonococcal Isolate Surveillance Project (GISP)—Penicillin, Tetracycline, and Ciprofloxacin Resistance Among GISP Isolates, 2010
NOTE: PenR = penicillinase producing
Neisseria gonorrhoeae and chromosomally mediated penicillin-resistant
N. gonorrhoeae;
TetR
= chromosomally and plasmid mediated tetracycline-resistant
N.
gonorrhoeae
; and QRNG =
quinolone
-resistant
N.
gonorrhoeae
.
PenR
/QRNG
PenR
TetR
/QRNG
PenR
/
TetR
QRNG
PenR
/
TetR
/QRNG
TetR
Susceptible
72.8%
1.8%
6.9%
2.0%
2.9%
9.4%
3.5%
0.6%Slide30
Gonococcal Isolate Surveillance Project (GISP)—Drugs Used to Treat Gonorrhea Among GISP Participants, 1988–2010
NOTE: For 2010, “Other” includes no therapy (1.2%), azithromycin 2 g (1.7%), and other less frequently used drugs.
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
0
20
40
60
80
100
Ceftriaxone
125 mg
Spectinomycin
Ceftriaxone
250 mg
Cefixime
Penicillins
Ciprofloxacin
Tetracyclines
Ofloxacin
Other
Percentage
Year
Other
CephalosporinsSlide31
Gonococcal Isolate Surveillance Project (GISP)—Percentage of
Neisseria gonorrhoeae Isolates with Resistance or Intermediate Resistance to Ciprofloxacin, 1990–2010NOTE: Resistant isolates have ciprofloxacin minimum inhibitory concentrations (MICs)
>1 µg/ml. Isolates with intermediate resistance have ciprofloxacin MICs of 0.125–0.5 µg/ml. Susceptibility to ciprofloxacin was first measured in GISP in 1990.
0
5
10
15
20
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
Intermediate Resistance
Resistance
Percentage
Year
2010Slide32
SYPHILIS
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide33
Epidemiology of Syphilis
Incidence13,774 cases (primary and secondary) reported in 2010Annual increase from 2001-20092010 represents first decrease in 10 years (1.6%)Case rate = 4.5 per 100,000 population2.2% lower than 2009 rate21% decrease in women1.3% increase in menCongenital syphilis rates decreased 15% since 2008Slide34
Epidemiology of Syphilis (cont’d)Rates remain high in:
Some urban areas throughout the U.S.Rural areas in the SouthCommon co-occurrence of syphilis and HIV in men who have sex with men (MSM)Slide35
Syphilis—Reported Cases by Stage of Infection, United States, 1941–2010
Total Syphilis
Early Latent
Primary and Secondary
Cases (in thousands)
0
100
200
300
400
500
600
2006
2001
1996
1991
1986
1981
1976
1971
1966
1961
1956
1951
1946
1941
Y
earSlide36
Primary and Secondary Syphilis—Rates by State, United States and Outlying Areas, 2010
NOTE: The total rate of primary and secondary syphilis for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 4.5 per 100,000 population.Slide37
Primary and Secondary Syphilis—Rates by County, United States, 2010
NOTE: In 2010, 2,167 (69.0%) of 3,141 counties in the United States reported no cases of primary and secondary syphilis.
<
0.2
(n = 2,167)
Rate per 100,000
population
0
.21–2.2
(n = 383)
>2.2
(n = 592)Slide38
Primary and Secondary Syphilis—Rates by Region, United States, 2001–2010
South
Northeast
Midwest
West
Rate (per 100,000 population)
0
2
4
6
8
10
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide39
Primary and Secondary Syphilis—Rates by Age and Sex, United States, 2010
15–19
20–24
25–29
30–34
35–39
40–44
45–54
55–64
65+
Total
Men
Women
Rate (per 100,000 population)
Age
25
20
15
10
5
0
0
5
10
15
20
25
5.6
21.9
19.2
15.8
12.7
13.8
8.5
7.9
0.6
2.7
4.5
3.0
3.0
2.0
1.4
1.0
0.8
1.1
0.0
0.2Slide40
Primary and Secondary Syphilis—Rates by Race/Ethnicity, United States, 2001–2010
Whites
Hispanics
Blacks
Asians/Pacific Islanders
American Indians/Alaska Natives
Rate (per 100,000 population)
0
5
10
15
20
25
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide41
Primary and Secondary Syphilis—Reported Cases by Reporting Source and Sex, United States, 2001–2010
STD Clinic, Women
STD Clinic, Men
Non-STD Clinic, Women
Non-STD Clinic, Men
Cases (in thousands)
Year
0
2
4
6
8
10
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide42
Primary and Secondary Syphilis—Rates by Sex and Male-to-Female Rate Ratios, United States, 1990–2010
Male-to-Female Rate Ratio
Total Rate
Female Rate
Male Rate
Rate (per 100,000 population)
Rate Ratio (log scale)
Year
2008
2006
2004
2002
2000
1998
1996
1994
1992
1990
0
5
10
15
20
25
1:1
2:1
4:1
8:1
16:1
2010Slide43
Primary and Secondary Syphilis—Rates by Age Among Men Aged 15–44 Years, United States, 2001–2010
0
5
10
15
20
25
35–39
40–44
30–34
25–29
20–24
15–19
Rate (per 100,000 population)
Year
Age Group
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide44
Primary and Secondary Syphilis—Rates by Age Among Women Aged 15–44 Years, United States, 2001–2010
0
1
2
3
4
5
6
35–39
40–44
30–34
25–29
20–24
15–19
Rate (per 100,000 population)
Year
Age Group
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide45
STD Surveillance Network (SSuN)—Primary and Secondary Syphilis and HIV—Proportion of MSM* with Primary and Secondary Syphilis Who Are Co-infected with HIV, 2010
* MSM = men who have sex with men. NOTE: Includes sites that reported data on at least 5 MSM with P&S syphilis in 2010.
Percentage
0
10
20
30
40
50
60
70
80
90
100
Philadelphia
Baltimore
Richmond
New
Orleans
Chicago
Denver
Seattle
Los
Angeles
San
Francisco
New York
City
Hartford/
New
HavenSlide46
Primary and Secondary Syphilis—Reported Cases* by Stage, Sex, and Sexual Behavior, United States, 2010
* Of the reported male cases of primary and secondary syphilis, 18.3% were missing sex of sex partner information.† MSW = men who have sex with women only; MSM = men who have sex with men.
MSM
†
Women
Secondary
Primary
Cases
0
1,000
2,000
3,000
4,000
5,000
6,000
MSW
†Slide47
Primary and Secondary Syphilis—Reported Cases* by Sex, Sexual Behavior, and Race/Ethnicity,†
United States, 2010* Of the reported male cases of primary and secondary syphilis, 18.3% were missing sex of sex partner information; 2.0% of reported male cases with sex of sex partner data were missing race/ethnicity data.† No imputation was done for race/ethnicity.
‡ MSW = men who have sex with women only; MSM = men who have sex with men.
Blacks
Whites
Other
Hispanics
0
500
1,000
1,500
2,000
2,500
3,000
MSM
‡
Women
Cases
MSW
‡Slide48
Primary and Secondary Syphilis—Percentage of Reported Cases* by Sex, Sexual Behavior, and Selected Reporting Sources, 2010
* Of the reported male cases of primary and secondary syphilis, 18.3% were missing sex of sex partner information, and 2.7% of reported male cases with sex of sex partner data were missing source of information data.† HMO = health maintenance organization; MSW = men who have sex with women only; MSM = men who have
sex with men.
HIV Counseling and Testing Site
Correctional Facility
Percentage
STD Clinic
Private Physician/HMO
†
MSM
†
Women
MSW
†
0
5
10
15
20
25
30
35
40Slide49
Congenital Syphilis—Reported Cases Among Infants by Year of Birth and Rates of Primary and Secondary Syphilis Among Women, United States, 2001–2010
* CS = congenital syphilis; P&S = primary and secondary syphilis.
P&S Rate
CS Cases
CS* cases (in thousands)
P&S* rate (per 100,000 women)
0.0
0.2
0.4
0.6
0.8
0
1
2
3
4
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide50
GENITAL Herpes
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide51
Epidemiology of Genital Herpes
The majority of genital and perirectal herpetic outbreaks in the U.S. are caused by HSV-2Case reporting data are not availableTrend data based on estimates of initial visits to physicians’ officesSeroprevalence of HSV-2 (NHANES data – 14-49 yr. olds)1988-1994: 21.0%1999-2004: 17.0%2005-2008 16.2%Most persons with HSV-2 have not received a diagnosis of genital herpesSlide52
Genital Herpes—Initial Visits to Physicians’ Offices, United States, 1966–2010
NOTE: The relative standard errors for genital herpes estimates of more than 100,000 range from 18% to 30%.
SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.
0
50
100
150
200
250
300
350
400
Visits (in thousands)
Year
2008
2005
2002
1999
1996
1993
1990
1987
1984
1981
1978
1975
1972
1969
1966Slide53
Herpes Simplex Virus Type 2—Seroprevalence in Non-Hispanic Whites and Non-Hispanic Blacks by Age Group, National Health and Nutrition Examination Survey, 1976–1980, 1988–1994, 1999–2004, 2005–2008
* Age-adjusted by using the 2000 U.S. Census civilian, non-institutionalized population aged 14–49 years as the standard.NOTE: Error bars indicate 95% confidence intervals.
1976–1980
1988–1994
1999–2004
2005–2008
0
20
40
60
80
100
40–49
30–39
20–29
14–19
All Ages*
Percentage
Non-Hispanic Whites
Age
0
20
40
60
80
100
40–49
30–39
20–29
14–19
All Ages*
Non-Hispanic Blacks
Age
PercentageSlide54
Human papillomavirus
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide55
Epidemiology of HPV
Low-risk types (6 and11) are responsible for about 90% of anogenital wartsHigh-risk oncogenic types (16,18, and others) are associated with anogenital cancersOverall HPV prevalence among women 42.5% NHANES 2003-20065.6% of sexually active adults 18-59 years have self-reported history of genital wartsSlide56
Human Papillomavirus—Prevalence of High-risk and Low-risk Types Among Females Aged 14–59 Years, National Health and Nutrition Examination Survey, 2003–2006
* HPV = human papillomavirus.NOTE: Error bars indicate 95% confidence intervals. Both high-risk and low-risk HPV types were detected in some females.
SOURCE: Hariri S, Unger ER, Sternberg M, Dunne EF, Swan D, Patel S, et al. Prevalence of genital HPV among females in the United States, the National Health and Nutrition Examination Survey, 2003–2006.
J Infect Dis. 2011;204(4):566-73
50–59
40–49
30–39
25–29
20–24
14–19
Low-risk HPV*
Prevalence, %
High-risk
HPV*
Age
0
10
20
30
40
50
60Slide57
Genital Warts—Initial Visits to Physicians’ Offices, United States, 1966–2010
NOTE: The relative standard errors for genital warts estimates of more than 100,000 range from 18% to 30%.
SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.
0
100
200
300
400
500
2008
2005
2002
1999
1996
1993
1990
1987
1984
1981
1978
1975
1972
1969
1966
Visits (in thousands)
YearSlide58
STD Surveillance Network (SSuN)—Genital Warts—Prevalence Among Sexually Transmitted Disease (STD) Clinic Patients by Sex, Sex of Partners, and Site, 2010
* MSM = men who have sex with men; MSW = men who have sex with women only.
Philadelphia
Baltimore
Richmond
New
Orleans
Chicago
Denver
Seattle
Los
Angeles
San
Francisco
MSW*
MSM*
Percentage
Women
0
3
6
9
12
15
Birmingham
New York
City
Hartford/
New
HavenSlide59
Other stds
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide60
Chancroid—Reported Cases, United States, 1981–2010
0
1
2
3
4
5
Cases
(in thousands)
Year
2009
2007
2005
2003
2001
1999
1997
1995
1993
1991
1989
1987
1985
1983
1981Slide61
Trichomoniasis and Other Vaginal Infections—Women—Initial Visits to Physicians’ Offices, United States, 1966–2010
NOTE: The relative standard errors for trichomoniasis estimates range from 16% to 27% and for other vaginitis estimates range from 8% to 13%.
SOURCE: IMS Health, Integrated Promotional Services™, IMS Health Report, 1966–2010.
0
900
1,800
2,700
3,600
4,500
2008
2005
2002
1999
1996
1993
1990
1987
1984
1981
1978
1975
1972
1969
1966
Other
Vaginitis
Trichomoniasis
Visits (in
thousands)
YearSlide62
Pelvic Inflammatory Disease—Hospitalizations of Women Aged 15–44 Years, United States, 2000–2009
NOTE: The relative standard errors for acute and unspecified pelvic inflammatory disease (PID) cases ranges from 8%–18%. The relative standard error for chronic PID cases ranges from 12%–28%. Data only available through 2009.
SOURCE: 2009 National Hospital Discharge Survey [Internet]. Atlanta: Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/nchs/nhds/about/nhds.htm.
0
15
30
45
60
75
Chronic
Acute, Unspecified
Hospitalizations (in thousands)
Year
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000Slide63
Pelvic Inflammatory Disease—Initial Visits to Physicians’ Offices by Women Aged 15–44 Years, United States, 2001–2010
NOTE: The relative standard errors for these estimates are 21.6%–30%.
SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2010.
Visits (in thousands)
Year
0
50
100
150
200
250
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001Slide64
Ectopic Pregnancy—Hospitalizations of Women Aged 15–44 Years, United States, 2000–2009
NOTE: The relative standard errors for these estimates are 10%–23%. Data only available through 2009.
SOURCE: 2009 National Hospital Discharge Survey [Internet]. Atlanta: Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/nchs/nhds/about/nhds.htm.
0
10
20
30
40
50
Hospitalizations (in thousands)
Year
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000Slide65
STDs IN ADOLESCENTS ANDYOUNG ADULTS
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide66
Chlamydia—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics, by State, Infertility Prevention Project, United States and Outlying Areas, 2010
NOTE: Includes states and outlying areas that reported chlamydia positivity data on at least 500 women aged 15–24 years screened during 2010.Slide67
Chlamydia—Prevalence Among Women Aged 16–24 Years Entering the National Job Training Program, by State of Residence, United States and Outlying Areas, 2010
* Fewer than 100 women who resided in these states/areas and entered the National Job Training Program were screened for chlamydia in 2010.Slide68
Chlamydia—Prevalence Among Men Aged 16–24 Years Entering the National Job Training Program, by State of Residence, United States and Outlying Areas, 2010
* Fewer than 100 men who resided in these states/areas and entered the National Job Training Program were screened for chlamydia in 2010.Slide69
Gonorrhea—Positivity Among Women Aged 15–24 Years Tested in Family Planning Clinics, by State, Infertility Prevention Project, United States and Outlying Areas, 2010
* States/areas not meeting minimum inclusion criteria.NOTE: Includes states and outlying areas that reported positivity data on at least 500 women aged 15–24 years who were screened during 2010.Slide70
Gonorrhea—Prevalence Among Women Aged 16–24 Years Entering the National Job Training Program, by State of Residence, United States and Outlying Areas, 2010
* Fewer than 100 women who resided in these states/areas and entered the National Job Training Program were screened for gonorrhea in 2010.NOTE:
Many training centers use local laboratories to test female students for gonorrhea; these results are not available to CDC. For this map, gonorrhea test results for students at centers that submitted specimens to the national contract laboratory were included if the number of gonorrhea tests submitted was greater than 90% of the number of chlamydia tests submitted. Slide71
Gonorrhea—Prevalence Among Men Aged 16–24 Years Entering the National Job Training Program, by State of Residence, United States and Outlying Areas, 2010
* Fewer than 100 men who resided in these states/areas and entered the National Job Training Program were screened for gonorrhea in 2010.NOTE: Many training centers use local laboratories to test male students for gonorrhea; these results are not available to CDC. For this map, gonorrhea test results for students at centers that submitted specimens to the national contract laboratory were included if the number of gonorrhea tests submitted was greater than 90% of the number of chlamydia tests submitted
. Slide72
Chlamydia—Positivity by Age and Sex, Juvenile Corrections Facilities, 2010
NOTE: Positivity percentage is presented from facilities reporting more than 100 test results.
20
16
12
8
4
0
0
4
8
12
16
20
12
13
14
15
16
17
18
Total
Men
Women
Positivity
Age
2.4
3.8
6.1
7.8
8.8
10.0
6.9
7.2
1.5
10.1
13.3
16.2
17.0
15.0
16.3
15.3Slide73
Gonorrhea—Positivity by Age and Sex, Juvenile Corrections Facilities, 2010
NOTE: Positivity percentage is presented from facilities reporting more than 100 test results.
20
16
12
8
4
0
0
4
8
12
16
20
12
13
14
15
16
17
18
Total
Men
Women
Positivity
Age
0.2
0.6
0.8
1.3
1.3
2.1
1.1
2.8
0.1
3.4
4.1
4.4
4.2
4.2
5.1
4.2Slide74Slide75Slide76Slide77Slide78
STDs IN MEN WHO HAVE SEX WITHMEN (MSM)
Sexually Transmitted Disease Surveillance 2010Division of STD PreventionSlide79
STD Surveillance Network (SSuN)—Gonorrhea and Chlamydia—Proportion of MSM* Testing Positive for Gonorrhea and Chlamydia, by Site, 2010
* MSM = men who have sex with men.
0
5
10
15
20
25
30
Chlamydia
Gonorrhea
Percentage
Philadelphia
Baltimore
Richmond
New
Orleans
Chicago
Denver
Seattle
Los
Angeles
San
Francisco
Birmingham
New York
City
Hartford/
New
HavenSlide80
Gonococcal Isolate Surveillance Project (GISP)—Percentage of Urethral
Neisseria gonorrhoeae Isolates Obtained from MSM* Attending STD Clinics, 1990–2010* MSM = men who have sex with men.
0
5
10
15
20
25
30
Percentage
Year
2010
2008
2006
2004
2002
2000
1998
1996
1994
1992
1990Slide81
STD Surveillance Network (SSuN)—Proportion of MSM* Attending STD
Clinics with Primary and Secondary Syphilis, Gonorrhea or Chlamydia by HIV Status, 2010* MSM = men who have sex with men. †
HIV negative status includes persons of unknown status for this analysis.‡
GC urethral and CT urethral include results from both urethral and urine specimens.
HIV+
0
4
8
12
16
20
GC
‡
urethral
P&S syphilis
CT
‡
urethral
GC pharyngeal
GC rectal
CT rectal
HIV–
†
PercentageSlide82
STD Surveillance Network (SSuN)—Primary and Secondary Syphilis and HIV—Proportion of MSM* with Primary and Secondary Syphilis Who Are Co-infected with HIV, 2010
* MSM = men who have sex with men. NOTE: Includes sites that reported data on at least 5 MSM with P&S syphilis in 2010.
Percentage
0
10
20
30
40
50
60
70
80
90
100
Philadelphia
Baltimore
Richmond
New
Orleans
Chicago
Denver
Seattle
Los
Angeles
San
Francisco
New York
City
Hartford/
New
HavenSlide83Slide84