City of Milwaukee Health Department STD/HIV Program Overview & Activities STD Epidemiology Julie Katrichis BSN, RN Communicable and Infectious Disease Manager

Keenan Health Center 3200 N. 36th St, Milwaukee 53216

Clinical Services Walk-in Clinic Staffed with Public Health Nurses, Nurse Practitioner, On-site Lab 5,093 clients seen 65% Male, 85% African American, 45% Medicaid & 45% uninsured 43% of patients come in for symptoms 6,793 test for CT (includes oral and anal) (659/+) 10,444 test for GC (includes oral and anal) (1,641+)

Disease Interrupters Field Operations Staffed with Disease Intervention Specialists, Surveillance, CDC Federal Assignees Epidemiological Follow-up, Partner Services & Referrals CT/GC in City of Milwaukee 16 years and younger or pregnant Field Delivered Therapy HIV in Milwaukee County Syphilis in Southeastern Region of WI 266 total cases, 90.6% interviewed 320 partners initiated

Additional Activities Partnerships Diverse and Resilient ARCW PPWI Grants & Projects Strengthening U.S. Response to Antibiotic Resistant Gonorrhea (SURRG) Increase identification, testing and follow-up on GC and antibiotic resistant GC cases SURRG long term goals: Reduce the incidence of CT, GC, and syphilis and their respective sequelae; Improve the integration of STD services into clinical care across the healthcare system; Increase access to STD services for those populations most at-risk; Reduce the threats of antibiotic-resistant GC, other emerging STDs, and congenital syphilis. Outreach Condoms distributed ~90,000 per year Community Events ~3,000 people reached

STD Strategic Planning Strategic Planning Meeting Attendees Agenda Major take-aways Next steps

Disease 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016* Chlamydia 1518.2 1618.6 1535.9 1563.6 1549.7 1693.9 1668.9 1542.4 1488.8 1402.2 1485.5 1628.4 Gonorrhea 634.0 816.4 792.7 666.4 564.9 538.8 516.8 501.8 486.7 389.7 576.0 675.8

Primary and Secondary Syphilis Disease 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016* Primary and Secondary Syphilis 2.5 5.7 8.1 3.9 4.2 5.4 6.4 7.7 5.2 7.4

Comparison of 2015 STD and HIV Rates in the City of Milwaukee, Milwaukee County, Wisconsin, and the U.S.   City of Milwaukee Milwaukee County Wisconsin U.S.* Infection Cases Rate** Chlamydia 8,836 1,485.5 9,672 1,015 23,945 425 1,526,658 478.8 Gonorrhea 3,426 576.0 3,623 380 5,253 93 395,216 123.9 P&S syphilis 31 5.2 37 3.9 80 1.4 23,872 7.5 HIV 105 17.5 119 12.4 225 44,073 13.8 Data sources: Wisconsin PHIN AVR, accessed November 18, 2016; Wisconsin Department of Health Services (WI DHS), Sexually Transmitted Disease in Wisconsin 2015: Milwaukee County; WI DHS, Sexually Transmitted Disease in Wisconsin 2015: Reported Cases; WI DHS HIV/AIDS Surveillance Annual Review, 2015: Addendum: City of Milwaukee; Centers for Disease Control and Prevention (CDC) 2015 Sexually Transmitted Diseases Surveillance; CDC Diagnoses of HIV Infection in the United States and Dependent Areas, 2014; 2010 U.S. Census *The number of cases reported for the U.S. (which was used to calculate the U.S. HIV rate) is an estimated number created using statistical adjustment to account for reporting delays and missing transmission category. **All rates in Table 1 are defined as number of cases per 100,000 population. Please note that different data sources may have used different population data for the denominator of the rate.

Comparison of 2015 STD and HIV Rates in the City of Milwaukee, Wisconsin, and the U.S.

Data source: CDC STD Surveillance 2015 Data source: CDC STD Surveillance 2015. Please note that the “Milwaukee” MSA depicted in the graph above is the Milwaukee-Waukesha-West Allis MSA, which consists of Milwaukee, Ozaukee, Washington, and Waukesha Counties.

Thank you! Questions?