1. Puerto Rico GC Overview Gonorrhea Control in Region II November 9, 2009

2. Objectives Present tendency of cases of GC in Puerto Rico Present the rates of GC Present cases by gender and age Future plans

3. GC Screening Timeline 1970’s- start VDI with partner notification and Rx verification 1980’s – PPNG follow-up 1992 – Privatization of Community Health Clinics 1996- IPP and use of DNA-probe starts 2006 –PN and Rx verification stopped because of Syphilis Elimination efforts and is the beginning of use NAAT 2008 – GC culture implementation in two clinics with Lab on site

4. Cases of Gonorrhea by year: Puerto Rico, 1981- 2008, Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health,

5. Cases of Gonorrhea by gender: Puerto Rico, 2000-2008 Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health,

6. Rates of Gonorrhea per 100,000 Population by Age and Gender: Puerto Rico, 2008 Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health

7. Rates of STD per 100,000 Population: Puerto Rico, 2000-2008 Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health

8. Rates of GC per 100,000 population in Puerto Rico 2008 Aguadilla Arecibo Ponce Bayamón Caguas Fajardo 0.0 - 5.0 5.1 – 10.0 10.1 – 15. 0 15.1 – 20.0 Mayaguez Metro Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health

9. Rates of CT per 100,000 population in Puerto Rico 2008 Aguadilla Arecibo Ponce Bayamón Caguas Fajardo 0 -100 101 – 200 201 – 300 Mayaguez Metro Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health,

10. Rates of Syphilis P & S per 100,000 population in Puerto Rico 2008 Aguadilla Arecibo Ponce Bayamón Caguas Fajardo 0 - 3 4 – 6 7 - 9 Mayaguez Metro Source: STD Surveillance Office, STD/HIV Prevention Division, Puerto Rico Department of Health

11. HIV Cases reported, Puerto Rico, June 2008 Aguadilla Arecibo Ponce Bayamón Caguas Fajardo 0 - 500 501 - 1000 1001 - 1500 Mayaguez Metro Source: VIH/AIDS Surveillance Office, Puerto Rico Department of Health

12. Gc Culture Report PRDOH Bacteriology Lab is in charge of processing and reporting the GC cultures All data is processed manually San Juan (CLETS) and Mayaguez clinics PeriodSamplesGender with more tests performed Sites most tested July to December 2008 29femaleRectal (6), Oral (6), Urethral (6) January to August 2009 127femaleOral (38), Rectal (35), Urethral (22)

13. Future plans Implementation of GC culture screening in additional STD Clinics Promote more screening in CLETS and Mayaguez Collect more data on GC culture screening Consideration of re-starting partner services for GC cases

14. Thanks Contact Information: Greduvel Durán Guzmán, MD, MPH Executive Director / Medical Services Director Central Office for AIDS Affairs and Transmissible Diseases ( OCASET) Puerto Rico Department of Health (787) 274-5536 / 3327 E-mail: gduran@salud.gov.prgduran@salud.gov.pr Bessie R. Lopez, MA Infertility Prevention Project Coordinator, STD/ HIV Prevention Division Puerto Rico Department of Health (787) 274-5572 / 33344 E-mail: bessielopez@salud.gov.prbessielopez@salud.gov.pr