1. 2014 HIV.STD.TB.Viral Hepatitis Symposium

2. Program Staff Lindsey VanderBusch – Program Manager lvanderbusch@nd.gov; 328.4555 lvanderbusch@nd.gov Sarah Weninger – STD & Viral Hepatitis Coordinator sweninger@nd.gov - 328.2366 sweninger@nd.gov Dee Pritschet – TB Controller/HIV Surveillance djpritschet@nd.gov, 328.2377 djpritschet@nd.gov Gordana Cokrlic – Ryan White Part B gcokrlic@nd.gov, 328. 2379 gcokrlic@nd.gov Gino Jose – HIV Prevention and Quality Management gjose@nd.gov; 328-1058 gjose@nd.gov Christopher Wegner – Family Health Care Center cwegner@famhealthcare.org, 701.271.6373 cwegner@famhealthcare.org

3. Lunch N’ Learns  The HIV/STD/TB/Hepatitis Program in the Division of Disease Control conducts Lunch and Learn Webinars for health-care professionals. Sign-Up for monthly emails – contact sweninger@nd.gov. sweninger@nd.gov  Each month a new topic will be held from 12:00 p.m. to 1:00 p.m. CST on the fourth Wednesday of the month.  Nursing education credits will be available for these presentations. Registration and schedule of topics are available at: http://www.ndhealth.gov/HIV/events.htm.http://www.ndhealth.gov/HIV/events.htm  Upcoming Schedule: September 24: General Medicine Practices for HIV/AIDS Healthcare Providers October 22: Hepatitis C Burden of Disease

4. HIV/AIDS

5. 2009 - Present HIV/AIDS Cases in North Dakota

6. Living in North Dakota with HIV/AIDS, n=357

7. Living in North Dakota HIV/AIDS Cases by Gender, n=357

8. Number Living in North Dakota HIV/AIDS cases by Age, n=357

9. Living in North Dakota HIV/AIDS Cases by Race/Ethnicity, n=357

10. Living in North Dakota HIV/AIDS Cases by Risk Factor n=357

11. Number in Care 357 living in North Dakota 217 had labs reported in the last 6 months 61% “in care”

12. 2009 – Present HIV/AIDS Status at Time of Diagnosis in ND

13. 2009-Present HIV/AIDS by Gender

14. 2009 – Present HIV/AIDS: Risk Factor by Gender

15. 2009 – Present HIV/AIDS: Male Risk Factors by Race

16. 2009 – Present HIV/AIDS: Female Risk Factors by Race

17. 2009-Present Race/Ethnicity of HIV/AIDS Cases

18. 2009-2013: Disparity by Race, HIV/AIDS Cases

19. New ND Cases 2009 - Present

20. All HIV/AIDS Cases 2009 - Present

21. Program Staff Lindsey VanderBusch – Program Manager lvanderbusch@nd.gov; 328.4555 lvanderbusch@nd.gov Sarah Weninger – STD & Viral Hepatitis Coordinator sweninger@nd.gov - 328.2366 sweninger@nd.gov Dee Pritschet – TB Controller/HIV Surveillance djpritschet@nd.gov, 328.2377 djpritschet@nd.gov Gordana Cokrlic – Ryan White Part B gcokrlic@nd.gov, 328. 2379 gcokrlic@nd.gov Gino Jose – HIV Prevention and Quality Management gjose@nd.gov; 328-1058 gjose@nd.gov Christopher Wegner – Family Health Care Center cwegner@famhealthcare.org, 701.271.6373 cwegner@famhealthcare.org

22. Lunch N’ Learns  The HIV/STD/TB/Hepatitis Program in the Division of Disease Control conducts Lunch and Learn Webinars for health-care professionals. Sign-Up for monthly emails – contact sweninger@nd.gov. sweninger@nd.gov  Each month a new topic will be held from 12:00 p.m. to 1:00 p.m. CST on the fourth Wednesday of the month.  Nursing education credits will be available for these presentations. Registration and schedule of topics are available at: http://www.ndhealth.gov/HIV/events.htm.http://www.ndhealth.gov/HIV/events.htm  Upcoming Schedule: September 24: General Medicine Practices for HIV/AIDS Healthcare Providers October 22: Hepatitis C Burden of Disease

23. Ryan White Part B

24. ND Ryan White Part B Program  Ryan White Program Provides assistance to ND residents living with HIV with gross income at or below 300% federal poverty level ($35,010 for a single person).  Ryan White services vary based on available funding, and include core and supportive services.  RW core services: Aids Drug Assistance Program (ADAP), outpatient medical care assistance, health insurance premium assistance, oral and vision care, mental health services, medical case management.  RW supportive services: case management, emergency financial assistance, housing services, medical transportation assistance, adherence counseling, substance abuse counseling.

25. 2013 Ryan White Clients  177 clients served  69% Male  61% White  31% Black/AA Traditionally RW clients have been predominantly white, male and MSM, however, in recent years we are seeing an increase in Black/AA, women, and heterosexual clients. 25

26. 2013 Ryan White Clients  46 new clients (35 new clients in 2012) 26

27. ND Ryan White Part B Program 27 Number of RW clients that are Black/African American has increased from 15% in 2009 to 31% in 2013. Race for 2013 Ryan White Clients

28. 2014 Ryan White Clients New Clients  Currently there are 163 active clients  31 new clients since January  Most of the new clients are seen in Fargo area  54% of new clients are Black/African American  41% are White 28

29. 2014 Ryan White Clients Coverage  Out of 163 clients  20% have no insurance (decrease from 41% in 2013)  33% have private insurance  33% have Medicaid  26% have Medicare 29

30. 2013 Ryan White Clients 30 2013 Medical Coverage

31. 2014 Ryan White Clients 31

32. Continuum of HIV Care for HIV Positives MMWR (60), 2011; NASTAD HIV Medicine Update, Calvin Cohen, MD. Of all with HIV infection, 850,000 individuals do not have suppressed HIV RNA (72%) 100% 75% 50% 25% 66% 77% 80% 77% 89%

33. Continuum of HIV Care for Ryan White Clients – HRSA/HAB Retained in care: had at least one OAMC visit before September 1, 2012, and had at least 2 visits 90 days or more apart Viral suppression: had at least one OAMC visit, at least one viral load count, and last viral load test <200 Source: 2012 RSR data (preliminary) MSM & IDU Retained in Care & Virally Suppressed

34. ND Ryan White Part B Program Continuum of HIV Care--Nationally  82% of Ryan White clients nationwide are retained in care, compared to 41% of all HIV positive individuals.  75% of Ryan White clients are virally suppressed compared to 28% of all HIV positive individuals. 34

35. Program Staff Lindsey VanderBusch – Program Manager lvanderbusch@nd.gov; 328.4555 lvanderbusch@nd.gov Sarah Weninger – STD & Viral Hepatitis Coordinator sweninger@nd.gov - 328.2366 sweninger@nd.gov Dee Pritschet – TB Controller/HIV Surveillance djpritschet@nd.gov, 328.2377 djpritschet@nd.gov Gordana Cokrlic – Ryan White Part B gcokrlic@nd.gov, 328. 2379 gcokrlic@nd.gov Gino Jose – HIV Prevention and Quality Management gjose@nd.gov; 328-1058 gjose@nd.gov Christopher Wegner – Family Health Care Center cwegner@famhealthcare.org, 701.271.6373 cwegner@famhealthcare.org

36. Lunch N’ Learns  The HIV/STD/TB/Hepatitis Program in the Division of Disease Control conducts Lunch and Learn Webinars for health-care professionals. Sign-Up for monthly emails – contact sweninger@nd.gov. sweninger@nd.gov  Each month a new topic will be held from 12:00 p.m. to 1:00 p.m. CST on the fourth Wednesday of the month.  Nursing education credits will be available for these presentations. Registration and schedule of topics are available at: http://www.ndhealth.gov/HIV/events.htm.http://www.ndhealth.gov/HIV/events.htm  Upcoming Schedule: September 24: General Medicine Practices for HIV/AIDS Healthcare Providers October 22: Hepatitis C Burden of Disease

37. Sexually Transmitted Diseases

39. Reported Chlamydia by Sex North Dakota, 2012 -2013

40. Reported Cases of Chlamydia by Age Group North Dakota, 2012 -2013

41. Chlamydia Rates by Race/Ethnicity North Dakota, 2012 - 2013 *Person of Hispanic ethnicity may be of any race; 22% of Chlamydia cases have unknown race

43. Reported Gonorrhea by Sex North Dakota, 2012 - 2013

44. Reported Cases of Gonorrhea by Age Group; North Dakota, 2012 – 2013

45. Gonorrhea Rates by Race/Ethnicity North Dakota, 2012 - 2013 *Person of Hispanic ethnicity may be of any race For 2013, 9.5% of GC Cases have unknown race

46. Gonorrhea Rates by Race, 2009-2013

48. Program Staff Lindsey VanderBusch – Program Manager lvanderbusch@nd.gov; 328.4555 lvanderbusch@nd.gov Sarah Weninger – STD & Viral Hepatitis Coordinator sweninger@nd.gov - 328.2366 sweninger@nd.gov Dee Pritschet – TB Controller/HIV Surveillance djpritschet@nd.gov, 328.2377 djpritschet@nd.gov Gordana Cokrlic – Ryan White Part B gcokrlic@nd.gov, 328. 2379 gcokrlic@nd.gov Gino Jose – HIV Prevention and Quality Management gjose@nd.gov; 328-1058 gjose@nd.gov Christopher Wegner – Family Health Care Center cwegner@famhealthcare.org, 701.271.6373 cwegner@famhealthcare.org

49. Lunch N’ Learns  The HIV/STD/TB/Hepatitis Program in the Division of Disease Control conducts Lunch and Learn Webinars for health-care professionals. Sign-Up for monthly emails – contact sweninger@nd.gov. sweninger@nd.gov  Each month a new topic will be held from 12:00 p.m. to 1:00 p.m. CST on the fourth Wednesday of the month.  Nursing education credits will be available for these presentations. Registration and schedule of topics are available at: http://www.ndhealth.gov/HIV/events.htm.http://www.ndhealth.gov/HIV/events.htm  Upcoming Schedule: September 24: General Medicine Practices for HIV/AIDS Healthcare Providers October 22: Hepatitis C Burden of Disease

50. Hepatitis B & C

51. *Based on reported positive lab result

55. Reported Hepatitis C Cases* by Year North Dakota, 2009-2013 * Includes acute and “past or present” infections

56. North Dakota Hepatitis C Cases* by Gender, 2012 - 2013 * Includes acute and “past or present” infections

57. North Dakota Hepatitis C Cases* by Age Group, 2012 - 2013 * Includes acute and “past or present” infections

58. Tuberculosis

59. 2009 – 2013 United States and North Dakota Tuberculosis Rates

60. 2000 – Present Number of Active TB Cases in North Dakota/Incidence Rate

61. 2009 – Present TB: Number of Refugees

62. 2009 – Present TB Cases by Race

63. 2009 – Present Active TB Cases US Born vs Foreign Born