Maricopa County STD Update

Reportable STDs in Arizona (all within 5 working days) STD reporting forms available at: Chlamydia Gonorrhea Syphilis Genital Herpes Chancroid (H. ducrei) HIV

Did you know? Up to 80% of persons with an STD do not experience symptoms 25% of young adults in the U.S. are infected with one or more STD’s A person is diagnosed with an STD every 26.8 minutes in Maricopa County Every day in America, 12,000 teenagers contract a sexually transmitted disease. A girl is four times more likely to contract an STD than she is to become pregnant

Total Syphilis Cases Maricopa County

Primary and secondary syphilis — Rates by county: United States, 2009 NOTE: The total rate of primary and secondary syphilis for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 4.6 per 100,000 population.

Syphilis Cases By Diagnosis 2010

Primary-Secondary Syphilis By Gender

Early Syphilis Cases By Sexual Preference

Congenital Syphilis—Infants—Rates by Year of Birth and State, United States and Outlying Areas, 2009 NOTE: The total rate of congenital syphilis for infants by year of birth for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 10.0 per 100,000 live births.

Congenital Syphilis Cases / Infant Deaths

Congenital Syphilis Cases By Race * In 2008 and 2009 there was one Asian case each year

Maricopa County – Arizona Statute : “A physician shall at the time of the first prenatal examination take a standard blood test for syphilis”. – Requests that all physicians and midwives providing obstetrical services in Maricopa County perform a third trimester blood sample for syphilis between 24 and 32 weeks gestation. – Require that all newborns in Maricopa County have blood drawn for syphilis testing. Current Syphilis Screening Recommendations for Pregnant Women in Maricopa County

Congenital Syphilis Transmission Weeks gestation First 0 (Conception) ~40 (Delivery) 1228 Second Third New Infection Screening

Chlamydia—Rates by State, United States and Outlying Areas, 2009 NOTE: The total rate of chlamydia for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was per 100,000 population.

Chlamydia Cases By Age and Gender 2010

Gonorrhea—Rates by State, United States and Outlying Areas, 2009 NOTE: The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 97.8 per 100,000 population.

Gonorrhea Cases By Age and Gender 2010

Patient-Delivered Partner Therapy (Bill Passed April 2008) 2008 Arizona Senate Bill 1078: Amends A.R.S and now allows providers to dispense antimicrobial treatment to persons in contact with someone with a communicable disease without a physical exam including STDs.

Use of EPT by Arizona Providers Survey of OB/GYN providers 142 completed surveys representing providers that delivered 32,768 (48%) of infants in Maricopa County 47% reported using EPT Barriers: – Inability to obtain medical/allergy history in partner – Concerns for liability/malpractice – Clinic policy of not prescribing to non-clinic patients

Expedited Partner Therapy Amendment in effect since September 26, 2008 § ARS (27)(ss)(v)”Unprofessional Conduct” – (ss) Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section to a person unless the licensee first conducts a physical examination of that person or has previously established a doctor-patient relationship. This subdivision does not apply to: – (v)Prescriptions written or antimicrobials dispensed to a contact as defined in section who is believed to have had significant exposure risk as defined in section with another person who has been diagnosed with a communicable disease as defined in section by the prescribing or dispensing physician. –

What to prescribe for EPT For partners of chlamydia cases: – Azithromycin 1 gram PO X 1 dose For partners of gonorrhea cases – Cefixime 400 mg PO X 1 dose Medication or prescriptions should be accompanied by partner information sheets

Educational Materials Provider and Pharmacy Fact Sheets Partner fact sheets in English and Spanish Frequently asked questions Postcards to providers

ADHS STD Annual Report 2009 STD Annual Report 2009 STD Arizona Youth Report

HIV and STDs Co-Infection Increased susceptibility; 2 to 5 times Increased infectiousness; 10x HIV semen concentration with gonorrhea Early detection and treatment of STDs

STD Clinic 1645 E. Roosevelt Phoenix, AZ Maricopa County Department of Public Health No appointment necessary Walk-In Clinic $20.00 fee includes lab testing, exam, and on site treatment. Clinic open 8 a.m. - 5 p.m. Monday through Friday Registration Hours: 7:30 a.m. - 4:00 p.m STDaz.com Visit our website: