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Overview of Sexually Transmitted Disease Surveillance Data, Massachusetts, 1990-2017

A comprehensive overview of sexually transmitted disease (STD) surveillance data in Massachusetts from 1990 to 2017, including trends, descriptions of specific STDs, and in-depth analysis of gonorrhea cases in 2017. HIV/STD and sexual risk data are also presented.

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Overview of Sexually Transmitted Disease Surveillance Data, Massachusetts, 1990-2017

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  1. Massachusetts Department of Public Health Bureau of Infectious Disease and Laboratory Sciences Overview of Sexually Transmitted Disease Surveillance Data, Massachusetts, 1990-2017

  2. Outline • STD Trends and Descriptions: • General STD trends through 2017 • Chlamydia • Infectious syphilis • Gonorrhea • Descriptions of 2017 STD Cases • In-depth look at 2017 Gonorrhea Cases • HIV/STD and Sexual Risk

  3. Data Notes • STD and HIV specific laboratory and case management information are reported directly to the Department of Public Health and maintained in the Massachusetts STD surveillance and case management system, MAVEN • The majority (>85%) of laboratory test results are reported via electronic laboratory reporting • Case management information is reported via electronic medical record feeds, case reporting forms and collected by epidemiologists • Data are routinely reviewed, cleaned, and analyzed by surveillance epidemiologists • Routine reports are shared with internal and external stakeholders • All data are collected and maintained according to strict confidentiality and security requirements • If you have questions or to request more information: call the Massachusetts Department of Public Health, Division of STD Prevention, at 617-983-6940

  4. Data Notes • Case classifications (confirmed, probable or suspect) are based on CDC case definitions for nationally notifiable infectious diseases. • For full STI case classifications, see: https://www.cdc.gov/std/stats16/appendix-c.htm • All data in this report are accurate as of their analysis date, and are subject to change. Common reasons for data changes include amendments to reporting and routine data cleaning. • Transgender individuals are included in current gender identity categories. Non-binary gender identity is captured, but suppressed according to Massachusetts privacy and confidentiality rules. • Sexual risk categories for this report include: MSM = men who have sex with men, MSW = men who have sex with women, and WSM = women who have sex with men. These categories are based on patient and provider report and do not necessarily reflect an individual’s sexual identity in relation to gender (i.e. gay, bisexual, heterosexual, etc).

  5. Massachusetts STD Trends

  6. Confirmed Chlamydia Cases, Massachusetts, 1990 to 2017 Chlamydia cases have increased 38% from 2010 to 2017 Data are current as of 10/31/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention

  7. Confirmed Chlamydia Cases by Gender Identity,* Massachusetts, 2000 to 2017 From 2013 to 2017 male cases increased 40% and female cases increased 15% Data are current as of 10/31/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention *There were several cases reported as transgendered in 2014 through 2016. Transgender identity was not documented prior to 2014 and transgender individuals are included in the specified gender categories.

  8. Confirmed and Probable Infectious Syphilis Cases, Massachusetts, 1990 to 2017 Infectious syphilis cases have increased 56% from 2013 to 2017 Data are current as of 10/31/2018 and are subject to change. *Infectious syphilis is defined as primary, secondary and early latent stages of syphilis within one year of infection. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention

  9. Confirmed and Probable Infectious Syphilis by Gender Identity,* Massachusetts, 2000 to 2017 From 2010 to 2017 male cases increased 136% and female cases increased 114% Data are current as of 10/31/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention *There were several cases reported as transgendered in 2014 through 2016. Transgender identity was not documented prior to the MAVEN transition in 2014 and transgender individuals are included in the specified gender categories.

  10. Confirmed Gonorrhea Cases, Massachusetts, 1990 to 2017 Gonorrhea cases have increased 267% from 2010 to 2017 Data are current as of 10/31/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention

  11. Confirmed Gonorrhea Cases by Gender Identity,* Massachusetts, 2000 to 2017 From 2010 to 2017 male cases increased 329% and female cases increased 177% Data are current as of 10/31/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention *There were several cases reported as transgendered in 2014 through 2016. Transgender identity was not documented prior to the MAVEN transition in 2014 and transgender individuals are included in the specified gender categories.

  12. Description of 2017 STD Cases Geographic Distribution Age and Gender

  13. Confirmed Chlamydia Case Rates by City/Town, Massachusetts, 2017 N=29,202

  14. Confirmed Chlamydia Case Rates per 100,000 Population by Gender and Age, Massachusetts, 2017 N=29,202 Data are current as of 9/21/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention Due to small counts, transgender cases are not included as a gender category

  15. Confirmed and Probable Infectious Syphilis Case Rates by County, Massachusetts, 2017 N=1,091

  16. Confirmed and Probable Infectious Syphilis Case Rates per 100,000 Population by County, Massachusetts, 2017 N=1,091 Data are current as of 9/21/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention Due to small counts, transgender cases are not included as a gender category

  17. Confirmed and Probable Infectious Syphilis Case Rates per 100,000 Population by Age and Race/Ethnicity, Massachusetts, 2017 N=1,091 Data are current as of 6/25/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention Cases with unknown or other race/ethnicity were excluded. Due to small counts cases with races other than white or black were excluded.

  18. Confirmed Gonorrhea Case Rates by City/Town, Massachusetts, 2017 N=7,307

  19. Confirmed Gonorrhea Case Rates per 100,000 Population by Gender and Age, Massachusetts, 2017 N=7,307 Data are current as of 6/25/2018 and are subject to change. Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention Due to small counts, transgender cases are not included as a gender category

  20. Confirmed Gonorrhea Case Rates per 100,000 Population by County , Massachusetts, 2017 N=7,307 Statewide Gonorrhea cases increased 58% from 2016 to 2017

  21. HIV/STD and Sexual Risk

  22. Confirmed Chlamydia and Gonorrhea Cases Co-infected with Confirmed HIV • Chlamydia • 2% of cases were co-infected with HIV in 2017 • Gonorrhea • Between 2015 and 2017: • Co-infection with HIV decreased from ~ 10% to 7% • Among MSM, co-infection with HIV decreased from ~ 19% to 12% * HIV status is based on a full of year match with eHARS

  23. Confirmed and Probable Infectious Syphilis Cases with HIV Co-Infection, Massachusetts, 2015 to 2017 Data are current as of 9/21/18 and are subject to change * HIV status is based on a full year match with eHARS.

  24. Reported Infectious Syphilis Cases by Sexual Risk Category, Massachusetts 2015 to 2017 Data are current as of 9/21/2018 and are subject to change Data Source: Massachusetts Department of Public Health/Bureau of Infectious Disease and Laboratory Sciences/ Division STD Prevention

  25. Summary • Chlamydia cases increased by 38% between 2010 and 2017 • The 2017 Massachusetts state rate was 445.7 per 100,000 • Infectious Syphilis cases increased by 56% between 2013 and 2017 • The 2017 Massachusetts state rate was 16.66 per 100,000 • Between 2015 and 2017, approximately 40% of infectious syphilis cases were co-infected with HIV • Gonorrhea cases increased by 329% between 2010 and 2017 • This increase was primarily among men • In 2017, the Massachusetts state rate increased by 58% to 111.6 per 100,000

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