Download Trends in STIs in MSM in Ireland - Health Protection Surveillance

Trends in STIs in MSM in Ireland
Gillian Cullen
Health Protection Surveillance Centre
Gay Health Forum 13
5th June, 2015
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Trends in
 Gonorrhoea
 HIV
 LGV
 Syphilis
… among MSM in the context of trends internationally.
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London, September, 2014
In 2013…
 84% of syphilis cases & 65% gonorrhoea cases in
London were diagnosed in MSM
 Over 50% of new HIV diagnoses in London were
among MSM
 LGV occured almost exclusively in MSM
Public Health England, Sept. 2014. HIV & STIs in men who have sex with men in London.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/357451/2014_09_17_STIs_HIV_in_MSM_in_London_v1_0.pdf
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United States, December, 2014
In 2013…
 MSM accounted for 75% of all primary & secondary
syphilis cases
 51.6% of primary & secondary syphilis cases were coinfected with HIV (case-based reports)
 for the first time since 2000 the rate of reported
gonorrhoea cases among men was higher than the
rate among women
CDC Division of STD Prevention, December 2014. Sexually transmitted disease surveillance 2013. http://www.cdc.gov/std/stats13/surv2013-print.pdf
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In Ireland, mode of transmission is collected for the
following diseases:
 Gonorrhoea
 HIV
 LGV
 Syphilis
Note: Data for 2014 are provisional
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Notification rate of gonorrhoea cases by gender &
percentage of cases among MSM, 1995-2014
60
100
50
80
70
40
60
30
50
40
20
30
20
10
% cases in MSM where recorded
Notification rate / 100,000 population
90
10
0
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Year
% in MSM
Notification rate in males
Rate in females
Total notification rate
Sources: National aggregate STI database 1995-2012 and CIDR 2013-2014, HPSC
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1.8
1
1.6
0.9
0.8
1.4
0.7
1.2
0.6
1
0.5
0.8
0.4
0.6
0.3
0.4
Proportion of cases among MSM
Notifcation rate / 100,000 population
Notification rate of LGV cases by gender & proportion of cases
among MSM, 1995-2014
0.2
0.2
0.1
0
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Year
Proportion of cases among MSM
Males
Females
Total
Sources: National aggregate STI database 1995-2012 and CIDR 2013-2014, HPSC
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Notification rate of early syphilis cases by gender &
percentage of cases among MSM, 1995-2014
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100
90
Notification rate / 100,000 population
12
80
10
70
60
8
50
6
40
30
4
20
2
10
0
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Year
% MSM
Males
Females
Total
Sources: National syphilis database 2000-2011 and CIDR 2012-2014, HPSC
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Percentage of syphilis cases that are HIV positive &
syphilis re-infections among MSM, 2000-2014
Percentage of syphilis cases among MSM
35
30
25
20
15
10
5
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Year
% HIV positive
% re-infection
Sources: National syphilis database 2000-2011 and CIDR 2012-2014, HPSC
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Trend in new HIV diagnoses among MSM
MSM
MSM % of new diagnoses
180
60.0
50.0
Number of new diagnoses
140
120
40.0
100
30.0
80
60
20.0
40
10.0
Percentage of MSM among new diagnoses
160
20
0
0.0
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year of diagnosis
Sources: National HIV database 2003-2011 and CIDR 2012-2013, HPSC
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Trend in median age at diagnosis for HIV & Syphilis,
2003-2014
38
37
36
Median age
35
34
HIV
Syphilis
33
32
31
30
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Year
Sources: National HIV database 2003-2011, National syphilis database 2003-2011 and CIDR 2012-2013, HPSC
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Ireland, May 2015
 More than 70% of gonorrhoea cases in 2013 & 2014
were in MSM (based on limited data)
 49% of new HIV diagnoses in 2014 were in MSM
 LGV occurs almost exclusively in MSM
 64% of early syphilis cases were in MSM in 2014
… so pattern in Ireland is not that different
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As in London there are high rates of STIs among MSM.
So some of the same interventions and
recommendations should be considered in Ireland.
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Public Health Messages 1
 Encourage regular HIV & STI screening & treatment
 Expand & normalise HIV testing to ensure earlier
diagnosis and access to treatment
 Routine collection of mode of transmission to
improve understanding of the health of MSM
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Public Health Messages 2
 Avail of all health promotion opportunities to educate
and raise awareness among MSM of need for regular
HIV & STI screening and to adopt safe sex practices
 Good access to condoms
 Provision of personal, social and health education to all
children that addresses elf-esteem and builds confident
adults who take fewer risks
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Acknowledgements
The Health Protection Surveillance Centre (HPSC) would like to thank all
those who provided the data for this report, particularly the STI clinics,
the infectious disease surveillance staff within the departments of public
health, the laboratories and GP clinics.
Dr. Kate O’Donnell, HPSC, for providing HIV data for this presentation.
STI data were extracted from CIDR on 28th May, 2015,
and were correct at the time of publication.
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