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WASHTENAW COUNTY EPI UPDATE – 6/16/17

·         2016 HIV: newly diagnosed cases in wide age range of men

·         2016 Gonorrhea and chlamydia at record high levels

·         New maps of chlamydia and gonorrhea in Washtenaw:  increase in cases in central Ann Arbor 

 HIV:  men of all ages diagnosed in 2016

Number of new HIV cases similar to last year.  27 adults in Washtenaw County were newly diagnosed with HIV infection in 2016, very similar to the number of annual diagnoses in the past two years.

 Fewer young men diagnosed with HIV.  In 2015, almost 70% of new HIV cases were in men under age 30, while in 2016 this decreased to 44% of cases.  The age range of new HIV cases is 18 to 69 years, with 10 individuals aged 40 years and older.  As in previous years, almost all of the cases (85%) are in men. 

 MSM at continued risk. The primary reported risk factor for new HIV cases is men who have sex with men (MSM) at 59% of all cases.  Of note, is that only two individuals reported IV drug use, so this does not appear to be a significant mode of HIV transmission in our community at this time. 

Pre-exposure prophylaxis (PrEP).  PrEP is an HIV prevention strategy for our HIV-negative clients.  The medication is Truvada which at-risk individuals take once a day.  Washtenaw County Public Health is a prescriber and has several clients doing very well using this prevention medication along with condoms.  Feel free to contact Cathy Wilczynski at 734-544-2963 if you have questions or go to the CDC guidelines: http://www.cdc.gov/hiv/risk/prep/

 Most individuals with HIV receiving care. Washtenaw County Public Health has been engaged in Linkage to Care services.  We are pleased to announce that 95% of individuals diagnosed with HIV in 2016 are in care and adhering to medication regimens.  Thank you to our clinicians and community organizations for all of the work in providing quality care to individuals living with HIV.  If you have a client who has fallen out of care, feel free to contact us at 734-544-2963 for assistance.

 Prevention of new cases.  Screening for HIV in high-risk groups and notification of sexual partners of HIV-positive individuals remain critical. Given that people are now living much longer with HIV, health care providers need to frequently re-assess the current sexual partners and practices of their patients to ensure that exposed new contacts are aware of their risk. The ultimate goal is to decrease spread of the virus in the community and to decrease the number of new cases.  If anyone is interested in partner services to help their clients notify their partners, please call Heather Wolf, Public Health Prevention Specialist, at 734-544-3063.

For more details on the new Washtenaw HIV cases in 2016, please see their website:

http://www.ewashtenaw.org/government/departments/public_health/Sexual%20Health%20Services/maps-and-trends/hiv-trends-washtenaw-2010-16

 Chlamydia reports at record high levels in 2016

 Chlamydia reports at all-time high. Chlamydia reached a record high of 1773 cases in Washtenaw residents in 2016. As in previous years, most of the individuals diagnosed are under 25 years and are female.  Individuals from the Ypsilanti area account for 50% of the chlamydia cases.

 Epidemiology of Washtenaw Chlamydia Cases in 2016:

  • Females: 66%
  • Age range: 13 – 73 years; Median age: 21 years
    • 10 – 14 year olds:  0.6%
    • 15 – 19 year olds:  28%
    • 20 – 24 year olds:  43%
    • 25 – 29 year olds:  16%
    • 30 and older: 13%

·         Race and gender

o   Black or African-American Women: 31% of total cases

o   White or Caucasian Women: 29%

o   Black or African-American Men: 15%

o   White or Caucasian Men: 14%

  • Emergency department diagnoses: 7%
  • Zip code of residence (top 5):

o   48197:  26%

o   48198:  23%

o   48104:  14%

o   48103:  11%

o   48108:  7%

 

Gonorrhea reports at record level in 2016

 Gonorrhea case reports at very high levels. In 2016, the number Washtenaw residents diagnosed with gonorrhea infection increased to 423 cases. This is the highest number recorded in 25 years.  Black/African-American women were the most frequently diagnosed followed by White/Caucasian men.

 Epidemiology of Washtenaw Gonorrhea Cases in 2016:

  • Age range: 12  – 54  years; Median age: 23 years
    • 10 – 14 year olds:  1%
    • 15 – 19 year olds:  18%
    • 20 – 24 year olds:  42%
    • 25 – 29 year olds:  23%
    • 30 and older: 17%

·         Race and gender

o   Black or African-American Women: 38% of total cases

o   White or Caucasian Men: 22%

o   Black or African-American Men: 19%

o   White or Caucasian Women: 13%

  • Emergency department diagnoses: 18%
  • Zip code of residence (top 5):

o   48197: 31% of cases

o   48198: 26%

o   48104: 16%

o   48103: 9%

o   48108: 7%

New maps:  chlamydia and gonorrhea infections concentrated in urban areas of Washtenaw

 Chlamydia cases have been at record high levels for the past several years in Washtenaw County.  Sexually active young people 15 to 24 years of age are at higher risk for both chlamydia and gonorrhea infections.  However, age is not the only risk factor.  Some areas of Washtenaw County, particularly the Ypsilanti area and central Ann Arbor, have a higher burden of disease than other parts of our community. 

 Analyzing cases by geography can help to better target outreach for prevention, testing and treatment.  For example, the new maps show increasing burden of infections in the university student neighborhoods in central Ann Arbor.   Many areas in the eastern part of the county continue to have a high rate of diagnoses in the residents living there.

 Maps are now available for three time periods:  2008 – 10 and 2011 – 13 and 2014 - 16.  Maps include:

  • Gonorrhea – All Ages
  • Chlamydia – All Ages
  • Chlamydia and gonorrhea in 13 to 18 year olds Countywide and in the Ypsilanti area

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