2007 – 2008 STD/HIV
Laboratory Survey
Minnesota Department of Health
STD and HIV Section
Background
• Under Minnesota law health care providers and
laboratories must report all lab-confirmed cases of HIV,
chlamydia, gonorrhea, and syphilis to MDH within one
working day.
• There have been significant changes in STD/HIV
laboratory test technologies over the past decade.
• From September, 2007 to July, 2008 MDH sent
electronic surveys to 120 laboratories as an assessment
of STD/HIV testing and reporting practices.
Demographics
• Response Rate
Chlamydia/Gonorrhea: 80% (96/120 labs)
Syphilis: 80% (96 / 120 labs)
HIV: 78% (94 / 120 labs)
• Laboratory Types*
21 Non-profit Labs
20 Community labs
16 Non-profit Community Labs
1 HMO
*Includes 10 Out-of-State Labs
1 City Lab
2 State Labs
4 Commercial Laboratories
3 Physician’s Offices
Chlamydia/Gonorrhea
Survey Results
Chlamydia/Gonorrhea Testing
Practices
– 26% (25) tested for both Chlamydia and
Gonorrhea
– 60% (58) did not test for either Chlamydia or
Gonorrhea
– No lab reported testing only for Chlamydia
– 13% (13) tested only for Gonorrhea
Percentage of Labs Using Chlamydia
Screening Tests (n=96)
80
Percentage of Labs
70
60
50
40
30
20
10
0
Culture
NAAT
NAH
DFA
EIA/ELISA
Other
No
Screening
Method
Reported
Chlamydia Screening Tests Used
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs Using Gonorrhea
Screening Tests (n=96)
Percentage of Labs
60
50
40
30
20
10
0
Culture
NAAT
NAH
DFA
EIA/ELISA
Other
No
Screening
Method
Reported
Gonorrhea Screening Tests Used
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs Accepting
Chlamydia Specimen Sources (n=96)
Percentage of Labs
30
25
20
15
10
5
0
Cervix
Eye
Oral
Rectum
Urethra
Chlamydia Specimen Sources Accepted
Includes results from reference laboratories used by labs included in the survey
Urine
Vagina/Vaginal
Vault
Percentage of Labs Accepting
Gonorrhea Specimen Sources (n=96)
45
40
Percentage of Labs
35
30
25
20
15
10
5
0
Cervix
Eye
Joint Fluid
Oral
Rectum
Urethra
Gonorrhea Specimen Sources Accepted
Includes results from reference laboratories used by labs included in the survey
Urine
Vagina/Vaginal
Vault
Oral/Rectal Testing
• Chlamydia Oral/Rectal Testing by Culture
– Oral Testing
– Rectal Testing
– Neither Oral nor Rectal Testing
8%
7%
7%
• Gonorrhea Oral/Rectal Testing by Culture
– Oral Testing
– Rectal Testing
– Neither Oral nor Rectal Testing
31%
30%
2%
Testing and Positivity Rates
• Chlamydia Testing Rates
– Total Number of Chlamydia Tests Performed
– Total Number of Positive Chlamydia Tests
– Positivity Rate Range for Chlamydia Tests
658,879
25,615
0% - 11%
• Gonorrhea Testing Rates
– Total Number of Gonorrhea Tests Performed
– Total Number of Positive Gonorrhea Tests
– Positivity Rate Range for Gonorrhea Tests
627,547
5,324
0% - 11%
Syphilis Survey Results
Syphilis Testing Practices
– 62% of labs (n = 60) reported no Syphilis
screening done
– 86% of labs (n = 83) reported no Syphilis
confirmation testing done
Percentage of Labs Using Syphilis
Screening Tests (n=97)
70
Percentage of Labs
60
50
40
30
20
10
0
RPR/USR/VDRL
VDRL-CSF
EIA
No Syphilis Testing
Syphilis Screening Tests Used
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs Using Syphilis
Confirmation Tests (n=97)
Percentage of Labs
8
7
6
5
4
3
2
1
0
FTA-ABS/TPPA/MHA-TP
IgM
IgG
FTA-ABS DS
Syphilis Confirmation Tests Used
Includes results from reference laboratories used by labs included in the survey
87% of labs reported no confirmatory testing done.
RPR after EIA
Screen
Syphilis Screening and Positivity
Rates, 2007
Total Number of Screening Tests
326,847
Total Number of Positive Screening Tests
3,757
Range of Screening Tests Ran
0 - 192,973
Positivity Rate Range for Screening
0% – 3%
Includes results from reference laboratories used by labs included in the survey
Syphilis Confirmation Testing
and Positivity Rates, 2007
Total Number of Confirmation Tests
5,436
Total Number of Positive Confirmation Tests
2,922
Range of Confirmation Tests Ran
3,278
Positivity Rate Range for Confirmation Tests
0% - 93%
Includes results from reference laboratories used by labs included in the survey
HIV Survey Results
HIV Testing Practices
– 61% (n = 57) perform HIV screens
– 4% (n = 4) perform HIV confirmatory tests
– 8% (n = 8) perform other HIV tests
Percentage of Labs Using HIV Screening
Tests (n=96)
45
Percentage of Labs
40
35
30
25
20
15
10
5
0
HIV-1/2 Group O
HIV-1
HIV-2
Neither HIV-1 nor
HIV-2
HIV Screening Tests Used
13 labs performed Waived Testing, 14 labs performed Non-Waived Testing
Includes results from reference laboratories used by labs included in the survey
Percentage of Labs
Percentage of Labs using
Confirmation Tests (n=96)
12
10
8
6
4
2
0
HIV-1
HIV-2
Neither HIV-1 nor
HIV-2
HIV Confirmation Tests Used
Includes results from reference laboratories used by other labs included in the survey
For More Information
STD and HIV Section
Minnesota Department of Health
651-201-5414
glenise.johnson@state.mn.us