1. Maricopa County STD Update

2. Reportable STDs in Arizona (all within 5 working days) STD reporting forms available at: http://www.maricopa.gov/publichealth/Services/STD/reports.aspx http://www.maricopa.gov/publichealth/Services/STD/reports.aspx Chlamydia Gonorrhea Syphilis Genital Herpes Chancroid (H. ducrei) HIV http://www.azdhs.gov/phs/oids/downloads/cdr_form.pdf http://www.azdhs.gov/phs/oids/downloads/cdr_form.pdf

4. 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

5. Total Syphilis Cases Maricopa County

6. 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.

7. Syphilis Cases By Diagnosis 2010

8. Primary-Secondary Syphilis By Gender 2001-2010

9. Early Syphilis Cases By Sexual Preference

10. 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.

11. Congenital Syphilis Cases / Infant Deaths 1996-2010

12. Congenital Syphilis Cases By Race 2001-2010 * In 2008 and 2009 there was one Asian case each year

13. Maricopa County – Arizona Statute 36-693: “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

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

15. 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 406.3 per 100,000 population.

17. Chlamydia Cases By Age and Gender 2010

20. 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.

22. Gonorrhea Cases By Age and Gender 2010

23. Patient-Delivered Partner Therapy (Bill Passed April 2008) 2008 Arizona Senate Bill 1078: Amends A.R.S. 32-1401.27 and now allows providers to dispense antimicrobial treatment to persons in contact with someone with a communicable disease without a physical exam including STDs.

25. 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

26. Expedited Partner Therapy Amendment in effect since September 26, 2008 § ARS 32-1401 (27)(ss)(v)”Unprofessional Conduct” – (ss) Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section 32-1901 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 36-661 who is believed to have had significant exposure risk as defined in section 36-661 with another person who has been diagnosed with a communicable disease as defined in section 36- 661 by the prescribing or dispensing physician. – http://www.azleg.state.az.us

27. 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

28. Educational Materials Provider and Pharmacy Fact Sheets Partner fact sheets in English and Spanish Frequently asked questions Postcards to providers http://azdhs.gov/phs/oids/std/

29. ADHS STD Annual Report 2009 STD Annual Report 2009 STD Arizona Youth Report http://www.azdhs.gov/phs/oids/std/index.htm

30. 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

31. STD Clinic 1645 E. Roosevelt Phoenix, AZ 85006 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: