Implementation of the Colorado Department of Public Health and Environment Gonorrhea Strategy, Incorporating Sexually Transmitted Infection and HIV Prevention Messages with Surveillance Activities

Background:  Limited funding and competing programmatic priorities have resulted in very limited DIS follow-up of Gonorrhea (GC) cases in Colorado.  Preliminary analysis shows that over 40 percent of HIV incident cases had been diagnosed with a sexually transmitted infection (STI) in the previous 24 months.

Objectives:  To describe the implementation of an integrated GC strategy in Colorado.

Project Description:  In January 2011, the STI/HIV Surveillance Program began to incorporate STI/HIV prevention messages with enhanced STI case ascertainment activities.

Findings:  In the first three quarters of 2011, of the 1773 persons reported with GC, 676 have been counseled by CDPHE STI/HIV registry staff.  Of these, 109 have identified themselves as a man who has sex with men (MSM) and 124 persons have been referred for treatment of their GC infection.  Preliminary results show a 14 percent increase in reported race, and adequate treatment was confirmed on an additional 994 of the 1,773 reported cases.

Conclusions: : Integrating STI related surveillance and prevention activities can be incorporated into existing structure with minimal impact on funding while increasing complete case ascertainment, ensuring adequate treatment and delivering STI/HIV prevention messaging to persons at increased risk for acquiring STI or HIV.

Implications for Programs, Policy, and Research:  Obtaining more complete case information, identifying MSM, ensuring adequate treatment, and delivery of STI/HIV prevention messages to high risk persons can be successfully achieved with minimal fiscal impact.  It is anticipated that these efforts will lead to a reduction in repeat GC infection, and will allow CDPHE to more effectively use limited resources to target STI and HIV testing and prevention efforts in Colorado.