UNITED STATES: Sexually Transmitted Disease Rates Soar: CDC

Tue, 13 Jan 2009 - http://www.reuters.com

On Tuesday, CDC said new 2007 data on reportable STDs show overall rates of syphilis, chlamydia, and gonorrhea are unacceptably high. In 2007, cases of chlamydia reached their highest level ever with 1.1 million, up from roughly 1 million in 2006, representing an annual increase of 7.5 percent, said CDC’s report. More than 350,000 cases of gonorrhea were reported that year - essentially unchanged from 2006, the agency said. Approximately 11,466 syphilis cases were logged in 2007, representing a 15 percent rise from 2006. Syphilis has increased every year since the beginning of the decade - its rate is up 81 percent from a record low level in 2000, when officials thought it was on the verge of elimination. The unprecedented levels of chlamydia may reflect more testing and diagnoses rather than a rise in infections, said Dr. John Douglas, head of CDC’s STD division. Untreated, chlamydia and gonorrhea can cause pelvic inflammatory disease and infertility in women, among other health concerns. “Of all the causes of infertility, this is probably the most preventable - since these infections can be prevented, diagnosed, and treated,” he said. In men, untreated gonorrhea can cause infertility and can spread to the blood or joints and be life-threatening. The data show African Americans are disproportionately affected: Blacks comprise 12 percent of the US population but account for 70 percent of gonorrhea cases and nearly half of chlamydia and syphilis cases, CDC said. Black women ages 15-19 have the highest rates of chlamydia and gonorrhea, and gonorrhea rates for African Americans overall were 19 times higher than for whites, the report found. Gay and bisexual men accounted for 65 percent of syphilis cases in 2007, Douglas said. Many of the cases involve HIV-positive men who choose other HIV-positive men as sexual partners. “Within that relationship, they are less concerned about the transmission of other conditions. They’re not using condoms,” he noted. “They believe that their partner has already got the worst they can get - they’ve got an HIV infection.” According to CDC, when all STDs are factored in - including human papillomavirus and herpes - the United States logs almost 19 million new infections annually, with nearly half among those ages 15-24. Douglas said preventing STDs should be a priority. Teens can delay the start of sexual activity, and people can limit their number of sexual partners and use condoms. “Condoms have risk-reduction value for every sexually transmitted condition,” he stressed. The report is available online at http://www.cdc.gov/std/stats07/toc.htm.

SOUTH DAKOTA: Sexually Spread Diseases Up in South Dakota

Mon, 12 Jan 2009 - http://www.argusleader.com

The state Health Department’s 2008 infectious disease report shows some STDs hit record levels in South Dakota last year. Chlamydia cases climbed to an all-time high of 2,948, up from 328 in 2007, while gonorrhea reports reached 370 - the highest since 1988 and a 29.4 percent increase over 2007, the provisional data indicate. The number of HIV/AIDS cases returned 34, the same total as in 2006, after having dropped to 25 in 2007. State Epidemiologist Lon Kightlinger said the figures point to a failure in basic STD prevention. “[STDs] are a complex bag of prevention, treatment, and personal behavior. There needs to be more abstinence, monogamy, and, if that fails, safe sex,” he said. Those most affected by STDs in South Dakota are in the 15-24 age group, followed by persons ages 25-39, said Kightlinger. “People in this age group know what is going on,” he said. “It’s not like E. coli where there is something in the food and you’re an innocent bystander. There is a risk that people are taking.” Kightlinger noted the high number of chlamydia cases among Native Americans. He suggested an effective screening program with Indian Health Services on the reservations may be driving up those numbers. But at least one Native American health official disagreed, blaming the rise on a lack of sex education in schools. “The statistics are proof that young people need sex education to be able to protect themselves,” said Charon Asetoyer, executive director of Native American Women’s Health Education Resource Center in Lake Andes. “If you do not have the tools to protect yourself - the information - you are going to see an increase in the number of [STDs].”

CANADA: Most Grade Five Girls Given HPV Vaccine

Tue, 13 Jan 2009 - http://www.canada.com/edmontonjournal

Preliminary figures show approximately 65 percent of fifth-grade girls in Edmonton’s public and Catholic schools have been vaccinated against human papillomavirus (HPV). Firm provincial data are expected in late January or early February. Alberta Health committed $10 million (US $8.05 million) annually to provide the Gardasil vaccine for free to grade five girls beginning in September of last year. Gardasil protects against four strains of HPV linked to 70 percent of cervical cancers and 90 percent of genital warts. However, some Catholic leaders in the province opposed the vaccination program, fearing it could send “a message that early sexual intercourse is allowed, as long as one uses protection,” Calgary Bishop Frederick Henry and other Alberta bishops wrote in a position statement. The Edmonton Catholic School Board decided to offer the free vaccine, while other Catholic districts including Calgary, Elk Island, Grande Prairie, St. Thomas Aquinas, and Lakeland opted out. In Calgary Catholic schools, just 18.9 percent of targeted students were vaccinated against HPV at community clinics following the district’s decision not to let public health nurses give the shots on school property. Dr. Barbara Romanowski, a University of Alberta professor specializing in infectious diseases, called the Calgary Catholic school results “very, very disappointing.” “I think they’re a reflection of misinformation and inappropriate interference of the church in the health of the girls. Eighty or 82 percent of girls have absolutely no protection when they choose to become sexually active, which is very sad,” she said. Dr. Marcia Johnson, deputy medical health officer for Alberta Health Services Edmonton region, said she suspects many Catholic parents in Calgary were too busy to book vaccination appointments for their daughters outside school. “It’s my assumption the low uptake may be related to convenience factors and not just lack of interest in the vaccine,” she said.

GHANA: Changes in Sexual Risk Behavior Among Participants in PrEP HIV Prevention Trial

Mon, 01 Dec 2008 - http://www.stdjournal.com

The researchers introduced the study by noting, “One of the concerns raised regarding the introduction of any new HIV-prevention measure, such as PrEP [pre-exposure prophylaxis], is the potential for risk disinhibition or sexual risk compensation.” In this regard, the oral tenofovir HIV prevention trial has been the subject of international discussion. The current report documents the changes in sexual risk behavior among women in Ghana taking part in the oral tenofovir HIV prevention trial. In-depth interviews with participants were conducted to obtain qualitative data; these were then subjected to content-driven, thematic analysis. Self-reported sexual behavior data were collected monthly; growth curve analysis was the principal method used to document trends. The results indicate that sexual risk behavior did not increase during the trial. Across the 12-month period of study enrollment, the number of sexual partners and the rate of unprotected sex acts decreased. However, certain subgroups of women exhibited different growth curves. The data indicate that the HIV prevention counseling delivered with the trial was effective. “Counseling during the trial was effective,” the authors concluded. “Different types of counseling and messaging may be needed for different subgroups within a population. These findings also have implications for required sample sizes for future HIV prevention trials where seroconversion is the main outcome.”

MISSOURI: City Still Leads US in Two STDs, but Number of Cases Is Falling

Wed, 14 Jan 2009 - http://home.post-dispatch.com/

St. Louis has more cases of gonorrhea and chlamydia per capita than any other county or independent city in the country, according to the latest annual report from CDC. In 2007, 742 cases of gonorrhea and 1,265 cases of chlamydia were reported per 100,000 residents, totaling almost 7,000 new diagnoses of the STDs. That is about 500 fewer cases than the previous year. “We’re seeing the cases go down,” said Pamela Rice Walker, acting director of the St. Louis Department of Health. “I think what we’re doing is effective, it’s just going to take awhile to see even better results.” Dr. Bradley Stoner, an STD researcher and associate professor of medicine at Washington University, said the high STD rates in St. Louis are due to lack of health care access and public awareness. About two-thirds of the STDs in St. Louis occur in 15- to 24-year olds. “We still have a lot of disease to work with,” Stoner said. “I hate seeing us at the top of the list every year.” The health department provides free STD testing and counseling as well as STD prevention training to all the city’s high schools, middle schools and charter schools, according to Walker. “Our recommendations are [to] abstain, be monogamous, practice safe sex, but most importantly, get an annual physical,” Walker said. “Kids at that age group don’t need immunizations anymore and they tend to not go to the doctor.” A drop-in clinic for young adults, “the Spot,” sponsored by Washington University and other community partners, offers counseling, testing, and support groups. Chlamydia is the most common STD among clinic participants; 24 of 182 people tested so far have been positive.

LOUISIANA: HIV/AIDS Grants’ Distribution Tweaked

Wed, 14 Jan 2009 - http://www.timespicayune.com/

On Tuesday, Mayor Ray Nagin’s administration told the City Council it is aiming to award Ryan White funds to local AIDS service organizations (ASOs) by March 15. Fran Lawless, director of the Mayor’s Office of Health Policy, told the council’s Housing and Human Needs Committee she thinks the timeframe is “doable.” The US Department of Health and Human Services makes the allocations available on March 1. Last year, it took the city six months to execute contracts with selected providers - a delay that smaller ASOs said jeopardized their ability to stay open. Lawless blamed the delay on bureaucracy - six city departments must sign off on each contract before it goes to the mayor’s desk - and the fact that some larger ASOs failed to turn in invoices in a timely manner. Lawless told the committee the city’s Health Department has instituted a new policy to track the progress of contracts daily as they move through the approval process. The committee’s chair, Arnie Fielkow, said he wants to see the annual contracts “executed” by March 15, prompting Lawless to balk. Fielkow then asked if the city can at least have “full contracts completed at the start of the fiscal year [March 1].” To make that happen, council member Stacy Head urged the city to enter into provisional contracts ahead of the March 1 announcement and simply tie the exact value of each contract to the availability of future grants. The city counts on around $5 million in Ryan White funding annually thanks to a set formula, though an additional supplemental award varies from year to year. Last year, it received approximately $7.5 million for service providers in the seven-parish area.

UNITED STATES: More Data Sought for Merck’s Gardasil in Older Women

Fri, 09 Jan 2009 - http://www.reuters.com

Before deciding whether to grant its approval for the human papillomavirus vaccine Gardasil to be administered to older women, the Food and Drug Administration wants to see more long-term data on this group, drug maker Merck & Co. said Friday. In June, FDA rejected Merck’s request to approve the use of Gardasil by women ages 27 to 45. Merck’s initial application included data collected for an average of 24 months; FDA now wants to see the results of a 48-month study that is ongoing. Merck expects to respond in the fourth quarter. FDA’s action has no effect on its earlier approval of Gardasil for females ages nine through 26, or on Merck’s separate request that the vaccine be approved for use by males.

GEORGIA: Budget Woes Likely to Trump Social Issues in ’09 Session

Fri, 09 Jan 2009 - http://www.southernvoice.com/

Georgia lawmakers expect to slash some $2 billion from the state’s $20 billion budget in the current session of the Legislature. The state AIDS Drug Assistance Program for low-income patients is already slated for cuts, said Jeff Graham, executive director of the gay rights group Georgia Equality. “I don’t believe that there are any programs that will avoid scrutiny, and the ADAP program is one where the cuts have already been proposed by the Department of Human Resources,” he said. If the cuts are finalized, 120 to 130 ADAP clients may face disruption of their access to AIDS drugs, Graham said.

INDIANA: Indiana University-Purdue University Fort Wayne Student Treated for TB

Tue, 13 Jan 2009 -

The Fort Wayne-Allen County Department of Health is investigating the case of a commuter student at Indiana University-Purdue University Fort Wayne who is being treated for a suspected case of tuberculosis. “This student, who was taking one class, had minimal interaction with the campus community,” according to a campus-wide e-mail from Chancellor Michael Wartell. “It is important that everyone is informed that the risk of exposure is extremely low.” The health department is seeking those who might have had prolonged contact with the student; these people will be offered TB tests, said John Silcox, department spokesperson. In addition to the suspected case, the department has confirmed one TB case so far this year, Silcox said.