end the syndemic...2020/04/27 · amber coyne, mph end the syndemic coordinator ending the hiv...
TRANSCRIPT
END THE SYNDEMICTENNESSEE
endthesyndemictn.org
An Integrated HIV, Sexually Transmitted Infections, Substance Use Disorder, and Viral Hepatitis Plan for TN
Amber Coyne, MPHEnd the Syndemic Coordinator
ENDING THE HIV EPIDEMIC ACROSS THE U.S.
EHE plans across the
nation
Phase one jurisdictions identified by the federal EHE plan
THE STORY OF SCOTT COUNTY, INDIANA
THE STORY OF SCOTT COUNTY, INDIANA
HIV AND HCV RAPID TRANSMISSION VULNERABILITY
Federal assessment showing the 220 counties most
vulnerable counties
• 31 vulnerable counties• 53 moderately vulnerable counties • 11 highly vulnerable counties
TN assessment of
vulnerability
WHAT IS A SYNDEMIC?
THREE CRITERIA OF A SYNDEMIC FRAMEWORK
THE HEART OF THE FRAMEWORK
THE HEART OF THE FRAMEWORK
HOW TENNESSEE RANKS NATIONALLY
QUICK FACTS ON THE SYNDEMIC – NATIONAL DATA
QUICK FACTS ON THE SYNDEMIC – TENNESSEE DATA, 2018
HIV & HCV VULNERABILITY ASSESSMENT FOR TN, 2019
• % of populat ion 20-44 years old• % of homes w ith > 1 vehicle• % of populat ion unemployed• Per capita income
• Primary care prov ider rate• Mental health prov ider rate• % of clients in treatment for
OUD
• Syphil is case rate• Teen birth rate• Number of premature deaths• HIV prevalence rate
• Mult iple prov ider episodes• Morphine Mill igram equivalent
“ MME”
ACCESS TO HEALTHCARE
HEALTH OUTCOMESOPIOID USE
SOCIOECONOMIC FACTORS
NUMBER OF REPORTED CASES OF STIs TN, 2013-2017
30,493 35,088
7,406
12,425
990
1,456
-
200
400
600
800
1,000
1,200
1,400
1,600
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2013 2014 2015 2016 2017
CHLA
MYD
IA&
GO
NO
RRHE
A
*Syphilis includes all stages of disease.
Chlamydia ↑ 15%
Gonorrhea ↑ 68%
Syphilis ↑ 47%
STD/HIV REPORTED CO-INFECTIONS TN, 2014-2017
87
176189
244
101
178
239
354
225
367
344
380
0
50
100
150
200
250
300
350
400
2014 2015 2016 2017
Num
ber
of C
o-In
fect
ed R
epor
ted
Case
s
CHL/HIV GC/HIV Syphil is/HIV
PrEP REFERRALS AMONG SYPHILIS CASES TN, 2018
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Only Syphilis (N=2,496) Eligible for PREP (N=895) Referred for PREP(N=367)
STD/HIV REPORTED CO-INFECTIONS BY AGE TN, 2017
36 45 9540 57
5693 148
163
75 104 660 0 0
% O
F CO
-INFE
CTED
CASE
S RE
PORT
ED
45+ 35-44 25-34
Case Counts of Newly Reported Confirmed and Probable Chronic HCV infection by Age and Sex, Tennessee 2014-218
STD/HIV CO-INFECTIONS BY METRO REGION TN, 2017
0
20
40
60
80
100
120
140
160
180
Davidson Hamilton Knox Madison Shelby Sull ivan
Num
ber
of C
o-In
fect
ed C
ases
Rep
orte
d
CHL/HIV GC/HIV Syphilis/HIV
STD/HIV CO-INFECTIONS BY RURAL REGION TN, 2017
8
13
7
3
7
37
7
0
5
10
15
20
25
30
35
40
Northeast East Southeast UpperCumberland
South Central MidCumberland
West
umbe
r of
Co-
Infe
cted
Cas
es R
epor
ted
CHL/HIV GC/HIV Syphil is/HIV
REALTIONSHIP BETWEEN VIRAL HEPATITIS AND HIV
HEPATITIS C AND HIV CO-INFECTION DATA
37%
28%
10%
9%
16%
HIV/ HCV & HIV/HBV/HCV Co-infections by HIV Expsosure Category - 2019 Year-to-date
MSM IDU MSM & IDU
Heterosexual Other
HEPATITIS B AND HIV DATA CO-INFECTION DATA
48%
9%9%
12%
22%
HIV/ HCV & HIV/HBV/HCV Co-infections by HIV
Expsosure Category - 2019 Year-to-date
MSM IDU MSM & IDU Heterosexual Other
THE RELATIONSHIP BETWEEN SUD AND HIV, STIS, & VH
DIVISION OF SUBSTANCE ABUSE OPIOID USE PATTERNS
Substance Use Rate Increases by Region, FY 2012 – FY 2019
Percentage Increase, Opioid Use Rate
Percentage Increase, Methamphetamine Use Rate
Percentage Increase, Use of Both Opioids and
Methamphetamine
Tennessee 27% 219% 286%
Region 1 6% 361% 398%
Region 2 -1% 448% 405%
Region 3 13% 141% 141%
Region 4 122% 303% 683%
Region 5 49% 198% 321%
Region 6 18% 122% 190%
Region 7 89% 162% 307%
WANT TO MAKE A DIFFERENCE? INTEGRATE & COLLABORATE
WANT TO MAKE A DIFFERENCE? JOIN END THE SYNDEMIC
COMMUNITY ENGAGEMENT PROCESS
COMMUNITY ENGAGEMENT PROCESS
ANATOMY OF THE PLAN
LINKS TO MORE INFORMATION • Syringe Services Programs- https://www.tn.gov/health/health-program-areas/std/std/syringe-services-
program.html• Ryan White Program- https://www.tn.gov/health/health-program-areas/std/std/ryanwhite.html• Viral Hepatitis Case Navigators:
https://www.nastad.org/sites/default/files/HD_Success_Stories/successstories_july2019_tennessee.pdf• PrEP Navigators: https://getpreptn.com/• Overdose dashboard: https://www.tn.gov/health/health-program-areas/pdo/pdo/data-dashboard.html• Regional Overdose Prevention Specialists: https://www.tn.gov/behavioral-health/substance-abuse-
services/prevention/rops.html• Medication-Assisted Treatment: https://www.tn.gov/behavioral-health/substance-abuse-services/treatment--
-recovery/treatment---recovery/opioid-treatment-programs.html• Behavioral Health Safety Net of TN: https://www.tn.gov/behavioral-health/mental-health-services/mental-
health-services-for-adults0/behavioral-health-safety-net-.html• Tennessee Recovery Navigators: https://www.tn.gov/behavioral-health/substance-abuse-services/treatment--
-recovery/treatment---recovery/tennessee-recovery-navigators.html• Substance Abuse and Mental Health Services Administration: https://www.tn.gov/behavioral-health.html• HIV surveillance Reports https://www.tn.gov/health/health-program-areas/statistics/health-data/hiv-
data.html• Viral Hepatitis Epidemiological Profile https://www.tn.gov/content/dam/tn/health/documents/viral-
hepatitis/2018%20Epi%20Profile_Final.pdf
A BIG THANK YOU TO THE FOLLOWING:
• The End the Syndemic Internal work group at TDH and TDMHSAS
• The HIV Prevention Team – especially Meredith Brantley • The Viral Hepatitis Team – especially Lindsey Sizemore,
Heather Wingate, and Jennifer Black• The STI Team – especially Leo Parker, Dyanne Herrera-Vasquez • The Office of Informatics and Analytics – especially Charlotte
Cherry and Ben Tyndall• The TDMHSAS – especially Anthony Jackson • Opioid Response Coordinator – Kristen Zak
END THE SYNDEMICTENNESSEE
endthesyndemictn.org
Thank you!Have questions or feedback?
Email: [email protected]