Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Trends in STIs in MSM in Ireland Gillian Cullen Health Protection Surveillance Centre Gay Health Forum 13 5th June, 2015 1 Trends in Gonorrhoea HIV LGV Syphilis … among MSM in the context of trends internationally. 2 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 3 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 4 In Ireland, mode of transmission is collected for the following diseases: Gonorrhoea HIV LGV Syphilis Note: Data for 2014 are provisional 5 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 6 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 7 Notification rate of early syphilis cases by gender & percentage of cases among MSM, 1995-2014 14 100 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 8 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 9 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 10 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 11 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 12 As in London there are high rates of STIs among MSM. So some of the same interventions and recommendations should be considered in Ireland. 13 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 14 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 15 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. 16