end the syndemic...2020/04/27 · amber coyne, mph end the syndemic coordinator ending the hiv...
TRANSCRIPT
![Page 1: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/1.jpg)
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
![Page 2: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/2.jpg)
ENDING THE HIV EPIDEMIC ACROSS THE U.S.
EHE plans across the
nation
Phase one jurisdictions identified by the federal EHE plan
![Page 3: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/3.jpg)
THE STORY OF SCOTT COUNTY, INDIANA
![Page 4: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/4.jpg)
THE STORY OF SCOTT COUNTY, INDIANA
![Page 5: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/5.jpg)
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
![Page 6: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/6.jpg)
WHAT IS A SYNDEMIC?
![Page 7: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/7.jpg)
THREE CRITERIA OF A SYNDEMIC FRAMEWORK
![Page 8: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/8.jpg)
THE HEART OF THE FRAMEWORK
![Page 9: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/9.jpg)
THE HEART OF THE FRAMEWORK
![Page 10: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/10.jpg)
HOW TENNESSEE RANKS NATIONALLY
![Page 11: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/11.jpg)
QUICK FACTS ON THE SYNDEMIC – NATIONAL DATA
![Page 12: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/12.jpg)
QUICK FACTS ON THE SYNDEMIC – TENNESSEE DATA, 2018
![Page 13: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/13.jpg)
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
![Page 14: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/14.jpg)
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%
![Page 15: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/15.jpg)
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
![Page 16: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/16.jpg)
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)
![Page 17: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/17.jpg)
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
![Page 18: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/18.jpg)
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
![Page 19: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/19.jpg)
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
![Page 20: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/20.jpg)
REALTIONSHIP BETWEEN VIRAL HEPATITIS AND HIV
![Page 21: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/21.jpg)
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
![Page 22: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/22.jpg)
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
![Page 23: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/23.jpg)
THE RELATIONSHIP BETWEEN SUD AND HIV, STIS, & VH
![Page 24: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/24.jpg)
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%
![Page 25: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/25.jpg)
WANT TO MAKE A DIFFERENCE? INTEGRATE & COLLABORATE
![Page 26: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/26.jpg)
WANT TO MAKE A DIFFERENCE? JOIN END THE SYNDEMIC
![Page 27: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/27.jpg)
COMMUNITY ENGAGEMENT PROCESS
![Page 28: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/28.jpg)
COMMUNITY ENGAGEMENT PROCESS
![Page 29: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/29.jpg)
ANATOMY OF THE PLAN
![Page 30: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/30.jpg)
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
![Page 31: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/31.jpg)
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
![Page 32: END THE SYNDEMIC...2020/04/27 · Amber Coyne, MPH End the Syndemic Coordinator ENDING THE HIV EPIDEMIC ACROSS THE U.S. EHE plans across the nation Phase one jurisdictions identified](https://reader035.vdocuments.net/reader035/viewer/2022071108/5fe32a30afce5509465c6fc0/html5/thumbnails/32.jpg)
END THE SYNDEMICTENNESSEE
endthesyndemictn.org
Thank you!Have questions or feedback?
Email: [email protected]