New Mexico STD Program Summary Slides 2013

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1 New Mexico STD Program Summary Slides 2013 Janine Waters, STD Program Manager Angie Bartok, Epidemiologist Lewis Smith, Surveillance Coordinator Margo Yee, Surveillance Coordinator

2 Cases per 100,000 population Historical Trends in Chlamydia Rates, New Mexico vs. US, NM Chlamydia Rate US Chlamydia Rate Year

3 Cases per 100,000 population Chlamydia Rates, NM vs. US NM Chlamydia rate US Chlamydia rate NM ranked 6th in the nation for chlamydia rates in 2012

4 Case Rate per 100,000 Popualtion Chlamydia Rates by Sex, New Mexico, , NM Male CT Rate NM Female CT Rate

5 Cases per 100,000 Population Chlamydia Rates by Age Group, New Mexico, < Age Group (years) Chlamydia predominantly affects adolescents and young adults, with rates of infection highest among year olds followed by year olds

6 Percent of All reported Cases Percent of Reported Chlamydia and Gonorrhea Cases by Age Group, New Mexico, % 40.00% 37.6% 32.4% 30.00% 20.00% 25.1% 15.8% 18.7% 18.9% 13.7% Chlamydia Gonorrhea 10.00% 0.00% 9.4% 7.5% 4.2% 4.5% 5.1% 2.0% 0.8% 1.7% 1.2% 0.3% 0.4% 0.1% 0.6% < % of reported chlamydia cases are among persons ages years 48% of reported gonorrhea cases are among persons age years

7 Cases per 100,000 Population Chlamydia Rates by Race/ Ethnicity, New Mexico, , American Indian/Alaska Native Asian or Pacific Islander Black/African American Hispanic White, non-hispanic Similar to national level data, chlamydia rates show health disparities: Chlamydia disproportionately affects African American, American Indian, and Hispanic populations in New Mexico

8 Rates per 100,000 by Quartile Chlamydia Rates per 100,000 by County, New Mexico, 2013

9 Percent of Chlamydia Cases by Diagnosing Provider Type, % 1% 3% 2% 1% STD Clinic 4% 6% 13% 13% 33% Private Physician/HMO Indian Health Service Emergency room/urgent Care Family Planning/Planned Parenthood Laboratory Correctional Facility Hospital - Other School-based Clinic Missing/ Unknown Other 22%

10 Cases per 100,000 Population Historical Trends in Gonorrhea Rates, New Mexico vs. US, NM Gonorrhea Rate US Gonorrhea Rate Year

11 Cases per 100,000 Population Gonorrhea Rates in New Mexico vs. US, NM Gonorrhea Rate US Gonorrhea rate New Mexico experienced a 2.7 % increase in gonorrhea cases from 2012 to 2013, similar to the 2.3% increase in gonorrhea cases from 2011 to 2012 Remaining at rates of infection previously seen in 2007

12 Case Rate per 100,000 Popualtion Gonorrhea Rates by Sex, New Mexico, NM Male GC Rate NM Female GC Rate

13 Cases per 100,000 Population Gonorrhea Rates by Age Group, New Mexico, < Age Group (years) Gonorrhea rates increased in age groups > years from 2012 to 2013 Rates in 2013 among women ages decreased by 4% compared to 2012 Rates in 2013 among men ages decreased by 4% compared to 2012

14 Cases per 100,000 Population Gonorrhea Rates by Race/ Ethnicity, New Mexico, American Indian/Alaska Native Asian or Pacific Islander Black/African American Hispanic White, non-hispanic Similar to national level data, gonorrhea rates show health disparities: Gonorrhea disproportionately affects African American, American Indian, and Hispanic populations in New Mexico

15 Rates per 100,000 by Quartile Gonorrhea Rates per 100,000 by County, New Mexico, 2013

16 Percent of Gonorrhea Cases by Diagnosing Provider Type, New Mexico, % 1% 2% 13% STD Clinic 4% 2% 4% 6% 9% 37% Private Physician/HMO Indian Health Service Emergency room/urgent Care Family Planning/Planned Parenthood Laboratory Correctional Facility Hospital - Other School-based Clinic Missing/ Unknown Other 21%

17 Rate per 100,000 Popualtion Historical Trends in Primary and Secondary Syphilis Rates, New Mexico vs. US, NM P&S Syphilis Rate US P&S Syphilis Rate Year

18 Cases per 100,000 popualtion Rates of Primary and Secondary Syphilis, New Mexico and US, NM P & S Syphilis Rates US P & S Syphilis Rates Rates of primary and secondary syphilis in New Mexico have varied over the past 3 years. Between 2011 and 2012 there was an case increase of 42%. Then, between 2012 and 2013 there was a case decrease of 23%. Will the downward trend continue into 2014?

19 Number of Cases NM Primary and Secondary Syphilis Case Numbers by Sex, New Mexico, NM Male P&S Cases NM Female P&S Cases % of all reported primary and secondary syphilis cases in 2013 were male

20 % of Cases Cases of Primary, Secondary, and Early Latent Syphilis Among Men, by Gender of Partner, New Mexico, % MSM Sex with Female Unknown 80% 60% 40% 20% 0% Of all male cases of syphilis in 2013, where gender of partner was known, 69% of cases were men with male sex partners (MSM). The percent that had sex with female(s) increased in 2013 by 6% over 2012.

21 Case Rate per 100,000 population Primary, Secondary, and Early Latent Syphilis Rates by Age Group, Males, New Mexico, < Compared to 2012, there was a large decrease in P,S, and EL syphilis rates among men age years old in 2013, as well as in the age group

22 Cases per 100,000 Population Primary, Secondary, and Early Latent Syphilis Rates by Race/Ethnicity, NM, American Indian/Alaska Native Asian or Pacific Islander Black/African American Hispanic White, non-hispanic

23 Rates per 100,000 by Quartile Primary, Secondary, and Early Latent Syphilis Rates by County, New Mexico, 2013

24 Percent of Primary, Secondary and Early Latent Syphilis Cases by Diagnosing Provider, New Mexico, % 0% 8% 6% 14% 2% 3% 12% 18% 36% STD Clinic Private Physician/HMO Indian Health Service Hospital Emergency room/urgent Care Facility Laboratory Hospital - Other Correctional Facility Family Planning/Planned Parenthood Other Unknown/ Missing

26 Percent of Tests Changes in Gonorrhea Testing Methods, New Mexico, % 90% 80% 70% 60% 50% 40% 30% 20% 10% GC NAAT GC Gram Stain GC Culture Unknown/Missing 0% Year

27 Percent of Tests Changes in Chlamydia Testing Methods, New Mexico, % 90% 80% 70% 60% 50% 40% 30% CT NAAT CTCulture CT Antigen CT Antibody Unknown/ Missing 20% 10% 0% Year

28 Percent of All tests Specimen Source, All Gonorrhea Tests in PRISM, Females, New Mexico, % 80% 60% 40% 20% Missing Other Unknown Cervix Vagina Urine Urethra Rectal Oropharyngeal 0% Year

29 Percent of All Tests Specimen Source, All Chlamydia Tests in PRISM, Females, New Mexico, % 80% 60% 40% 20% 0% Year Missing Other Unknown Cervix Vagina Urine Urethra Rectal Oropharyngeal

30 Percent of All Tests Specimen Source, All Gonorrhea Tests in PRISM, Males, New Mexico, % 80% 60% 40% 20% Missing Other Unknown Urine Urethra Rectal Oropharyngeal 0% Year

31 Percent of All Tests Specimen Source, All Chlamydia Tests in PRISM, Males, New Mexico, % 80% 60% 40% 20% Missing Other Unknown Urine Urethra Rectal Oropharyngeal 0% Year

32 Men with Male Sex Partners (MSM)

33 Percent of tests Positive (Positivity) GC Positivity among Men Tested at Alternate Sites, NMDOH, by Year 15% Oropharynx Rectum 10% 5% 9.2% 10.90% 13.30% 14.60% 13.30% 12.50% 12.20% 5.1% 6.8% 2.7% 0%

34 Percent of tests Positive (Positivity) CT Positivity among Men Tested at Alternate Sites, NMDOH, by Year 20% Oropharynx Rectum 15% 10% 14.5% 17.0% 15.30% 15.10% 13.20% 5% 0% 2.7% 3.2% 3.80% 3.10% 2.40%

36 Streamlining DOH Testing Efforts CT and GC Positivity and Testing Volume, Percent of tests Positive (Positivity) Total Number of Tests 14% CT Positivity GC Positivity Number of tests % 10% 8% % % 2% % CT Positivity 13.0% 11.0% GC Positivity 3.4% 3.3% Number of tests Testing ratios by sex were stable from 2012 to 2013 : from 66% female in 2012 to 66% female in 2013, stayed constant in males from 34% in 2012 to 34% in 2013 % of tests in women age 25 and under decreased slightly from 70% to 68%

37 Chlamydia and Gonorrhea Positivity by Sex, all NMDOH Testing Sites, Percent of Tests Positive (Positivity) 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% GC Positivity - Females 1.3% 1.3% GC Positivity- Males 7.5% 7.2% CT Positivity - Females 11.0% 9.5% CT Positivity - Males 17.0% 13.7%

38 Percent of tests Positivie Chlamydia Positivity by Clinic Type, Females, all NM DOH Test Sites, % 16% 14% 12% 10% 8% 6% Family Planning STD 4% 2% 0% < Family Planning 15.0% 10.0% 8.3% 6.2% 5.0% 4.1% 4.4% STD 7.7% 15.9% 14.8% 11.7% 7.5% 6.7% 5.4% Age Group (Years)

39 Percent of Tests Positive (Positivity) Chlamydia and Gonorrhea Positivity, Females 25 years, Tested in NMDOH Family Planning Sites, % 10% 10.2% 8.8% 8% 6% CT Positivity GC Positivity 4% 2% 0.6% 0.7% 0%

40 Percent Positive Tests (Positivity) Chlamydia Positivity by Race/ Ethnicity, all NMDOH Test Sites, % 16% 14% 12% 10% 8% 6% 4% 2% 0% American Indian/Alaska Native Black/African American Asian White Hispanic Hawaiian Other Unknown % 15.6% 6.6% 9.8% 11.3% 0.0% 10.0% 9.5%

41 Percent Positive Tests (Positivity) Gonorrhea Positivity by Race/ Ethnicity, all NMDOH Test Sites, % 7% 6% 5% 4% 3% 2% 1% 0% American Indian/Alaska Native Black/African American Asian White Hispanic Hawaiian Other Unknown % 6.7% 3.3% 3.2% 3.0% 0.0% 2.6% 3.5%

TRENDS IN PARTICIPATION RATES FOR WILDLIFE-ASSOCIATED RECREATION BY RACE/ETHNICITY AND GENDER:

TRENDS IN PARTICIPATION RATES FOR WILDLIFE-ASSOCIATED RECREATION BY RACE/ETHNICITY AND GENDER: 1980-2001 Allan Marsinko Professor Department of Forestry and Natural Resources Clemson University Clemson,