 In this newsletter, you will find updates from the Division of HIV and STI Programs (DHSP). If you have any questions or feedback about the newsletter, please reach out to us at: MDHHS-SHOARS-Support@Michigan.gov.
The Division of HIV and STI Programs, in partnership with the Michigan HIV/AIDS Council (MHAC), is celebrating Pride Month by hosting a table at Pride events throughout the state.
DHSP and MHAC are participating in the outreach effort to promote MHAC and attract new members from the community. MHAC serves to represent the diversity of those affected by HIV/AIDS in Michigan, maintain collaboration and coordination among prevention and care services, and inform a statewide comprehensive plan for HIV/AIDS prevention and care. The council has both voting and advisory members. Voting members include people from local HIV/AIDS organizations, people living with HIV/AIDS, and at-large community members.
|
“Being at Pride is so important for the work we do,” said Mary Roach, HIV Prevention Unit manager. “The LGBTQ+ community has been disproportionately impacted by HIV and STIs, and so it’s important for us to attend Pride events to show our support and provide resources.”
|
MHAC members will be available at the Pride tables to speak with people in the community about joining the council and promote testing, treatment, and prevention for HIV and STIs. Division staff members are presenting information related to safe sexual practices and passing out a survey to get feedback from the community.
You can find these tables at upcoming Pride events in Battle Creek, Lansing, and Jackson. Please stop by and say hello. These tables have already drawn such noteworthy visitors as Gov. Gretchen Whitmer at a recent Pride event in Ferndale!
|
Latest from the HIV/STI Epidemiologists:
HIV/STI Testing Trends Post-COVID
STIs: MDHHS Bureau of Laboratories provides STI testing for a variety of sites throughout Michigan. About 80% of all tests are from Local Health Department STI and Family Planning clinics. The number of specimens submitted for testing decreased markedly at the onset of the COVID pandemic in March 2020. Testing has increased slightly the past two years but remains well below pre-pandemic levels.
The positive rate for chlamydia tests has fallen over time to 7-8% at both STI and Family Planning clinics in 2021. The positive rate for gonorrhea testing has fallen only slightly to 5.8% in 2021 at STI clinics and 1.9% at Family Planning clinics. Positive testing rates are even lower for early 2022 data.
These and more STI testing trend data will be available in our Trends report to be published in August.
HIV: HIV testing remains low at state funded testing sites, but HIV laboratory screenings have returned to normal. Overall, new HIV diagnoses remain on the low end of normal for 2021. There are likely still a surplus of undiagnosed PLWH due to the pandemic. This topic will be highlighted in our annual Trends report published in August.
STI Fact Sheet, 2021 (data as of April 2022)
Just in time for STI Awareness week in April, we released a fact sheet summarizing some trends in diagnoses of STIs and highlighting health disparities.
- Diagnoses of primary and secondary syphilis are up 3x higher than 10 years ago, and 25% higher than 2020.
- Increased syphilis transmission among heterosexuals and to women has led to increases in congenital syphilis: about 40 cases per 100,000 births in 2021.
- Gonorrhea increases have been observed in Michigan since 2015 but have gone down slightly in 2022. In jurisdictions across the state, gonorrhea case rates remain high.
- Health disparities in STI rates remain a high priority to intervene and reduce. In 2021, while Black residents made up about 14% of Michigan’s population, they were 54% of all STI diagnoses. Disparities result from historical and current inequalities in distribution of social and material resources.
HIV Care Continuum Report, 2021 (data as of April 2022).
The Continuum of Care was developed by the Centers for Disease Control and Prevention (CDC) to assess gaps in care. The report includes geographic and demographic breakdowns for people living with HIV. Here’s what’s new:
- Compared to 2020, care outcomes improved during 2021. However, the proportion of people living with HIV (PLWH) in care remains lower than 2019, especially for individuals not enrolled in Ryan White (slide 27).
- The largest care disparity is between those enrolled and not enrolled in Ryan White (slides 11, 26, 27). Population level viral suppression will only improve if care among non-Ryan White enrollees improves. Preliminary analyses not included in this slide deck indicate a large portion of non-Ryan White enrollees out of care are eligible for Ryan White. Additional disparity information has been added (slides 11-12).
- Care outcome goals have been updated to reflect the 2030 Ending the Epidemic goals (95-95-95) from 2020 baselines. Graphs display midpoint goals for 2025 (slides 9, 14).
- Telehealth ramped up during 2020. Based on new data from Ryan White, HIV labs (CD4s & viral loads) are still excellent proxies for care, and most patients using telehealth still receive HIV labs (slide 10).
- Age groups with low care rates appear to be changing – away from 15-29 year olds and into the 24-39 age groups as the cohort ages (slides 23, 24).
- The estimated undiagnosed is now Michigan specific (slides 6, 36). Previously the national average was used. Additionally, the Michigan vs. National Care Continuum was updated with 2018 figures (slide 36).
DHSP recently reorganized to form a new HIV/STI Prevention Section. The HIV/STI Prevention Section focuses on the prevention of HIV and STIs and includes the HIV Prevention and Intervention Unit, Ending the Epidemic Unit, STI Interventions Unit, and Gonorrhea Unit.
We are proud to share that Amy Peterson, former STI Interventions Unit Manager, has accepted the role of Section Manager for this new section. Amy brings a combined 14 years of working in HIV and 15 years of working in STIs to the role and has been working at MDHHS since 1996. More information on the Division's sections and units can be found on our website here.
|
The Pull Up Project is a mobile unit initiative that seeks to meet people where they are and provide services to people in the Palmer Park and Highland Park neighborhoods. This initiative will include various services such as gender affirming care, general health wellness checks, HIV/ STI testing, prevention, outreach, harm reduction, syringe services programs (SSP), and referrals to essential support services.
On June 9th from 3-7pm, the MDHHS Ending the HIV Epidemic (EHE) team and Detroit Health Department EHE team held the Community Day event for the Pull Up Project in Palmer Park. The purpose of this event was to introduce the mobile unit initiative to the community, establish and build trust, and to conduct surveys to identify most needed or wanted services to be implemented at the park on a rotating schedule. The day consisted of free health and wellness checks, HIV rapid testing, SSP and harm reduction kit distribution, Covid testing and vaccination, food trucks, games, and music. Individuals that completed the survey received a $15 food voucher to redeem items from the Zenith Foodz, a culinary food truck local to Detroit.
Overall, the Community Day held much success:
- Approximately 200 attendees
- 122 surveys conducted
- 100 food boxes distributed by Gleaners
- 22 tabling agencies
- 18 MDHHS volunteers from varying units (EHE, HIV Prevention, Care Special Projects Units, Surveillance)
- 6 mobile units on site
Over the coming weeks, MDHHS and DHD are working to analyze survey data from the Community Day and finalize mobile unit scheduling. It is anticipated that services for this initiative will be conducted 3 days a week and begin the week of June 27th. For more information regarding the Pull Up Project, please reach out to Tyffanie Walton (waltont5@michigan.gov) or Kyra Sanders (sandersk7@michigan.gov).
|
 The 2022 State of Michigan HIV & STI Conference brings together experts to promote innovation, provide useful tools, and inspire ideas. This year's theme is "Reimagining Connections". This conference will present creative ways to enhance quality of care and build a solid infrastructure in the areas of HIV & STI care and prevention. The conference will also offer an opportunity to network and build connections with colleagues in the field. Registration is now open at MIHIVSTI.com
MDHHS and local health departments monitor the health of the community and provide the basis of preventive action. This requires physicians, laboratory facilities, and other care providers to promptly report all HIV & STI labs to MDHHS/local health department within 24 hours and Case Report Forms within seven days of diagnosis or discovery to ensure timely investigations and follow up. Lab results can be reported electronically (preferable) or by fax.
-
HIV cases should be reported directly to MDHHS. Please complete the Michigan Adult Confidential HIV Case Report Form and fax to 313-456-1580.
-
STI cases should be reported electronically through the Michigan Disease Surveillance System (MDSS) or faxed to MDHHS at 313-338-3906.
All reports should include patient information, facility/provider information, and lab information, including the name of the disease being reported. Below is a breakdown of all information that must be reported:
Patient Information
- Full name
- Date of birth
- Residential address and phone number
- Gender
- Race & ethnicity
- Risk factor
- Pregnancy status
Diagnosing Facility Information
- Reporting facility name and contact information
- Reporting physician or medical professional and contact information
Laboratory Information:
- Name and onset date of disease, infection, or condition
- Collection date
- Lab test type and results
- Site of specimen for STIs
- Co-infection information
- Treatment information
If you have any questions about case reporting, contact the Surveillance Unit at 313-456-1586 or 517-245-3300. You can also view surveillance contact information here.
In April the Centers for Disease Control and Prevention (CDC) awarded funds to 36 community-based organizations (CBOs) under the program PS22-2203: Comprehensive High-Impact HIV Prevention Programs for Young Men of Color Who have Sex with Men and Young Transgender Persons of Color. Included in these 36 organizations are Community Health Awareness Group (CHAG) and Health Emergency Lifeline (Corktown Health) both serving the Detroit community.
Through this funding opportunity, CBOs will develop and implement high-impact HIV prevention programs for young men of color who have sex with men, young transgender persons of color, and their partners regardless of age, gender, and race/ethnicity. Community-based organizations have been vital to our nation’s HIV prevention efforts since the earliest days of the HIV epidemic. CBOs have unparalleled knowledge of and credibility and experience within the communities they serve and are uniquely positioned to extend the reach of HIV prevention efforts implemented by state and local health departments.
Congratulations to CHAG and Corktown Health!
Site visits will resume beginning August 2022. Notifications with details for preparation will be sent to all agencies in which a site visit will be conducted.
The Ryan White HIV/AIDS Program (including CAREWare) webpage has been updated with new and existing links for agency resources. New resources: consumer/ novice quality management trainings. Updated existing links: Appendix B, Biopsychosocial Assessment tool, Ryan White Part B manual, and the Quality Improvement Plan.
The Ryan White and Care Collaborative Meeting will be held July 12,2022 from 10:00 am – 2:00pm. The Ryan White and Care Collaborative is an event intended for agencies to come together and share updates and trainings. This virtual event allows for sub-recipients to discuss best practices and learn about how other Ryan White funded agencies are utilizing resources and providing comprehensive care for the population being served. Ryan White sub-recipients and front-line workers who provide direct care to People Living with HIV (PLWH) are encouraged to attend. Registration is open in SHOARS.
MDHHS CoC staff will be holding a Case Conference Training on Thursday, August 18, 2022 from 9:00am -12:00pm. This training is open to all interested agency staff. The objective of this training is to map out the structure and benefits of utilizing case conferences to address hard to reach clients and to improve health outcomes. Ryan White sub-recipients and front-line workers who provide direct care to People Living with HIV (PLWH) are encouraged to attend. Registration is open in SHOARS.
2022 National Ryan White Conference on HIV Care & Treatment will be held virtually on August 23-26, 2022. The National Conference theme this year is “The Time Is Now: Harnessing the Power of Innovation, Health Equity, and Community to End the HIV Epidemic.” To register, visit ryanwhiteconference.hrsa.gov.
|
Empowering Clients Through the Housing Process - August 31, 2022. This training will focus on various aspects of housing and how to empower clients through the housing process. Participants will learn about tenant housing responsibilities, developing strong landlord relationships, and how to have difficult conversations between clients and landlords. Information on financial responsibility and budgeting will also be provided. Registration opens July 31st in SHOARS.
Strategies for Getting and Keeping PLWH Housed - December 7, 2022. This training will provide participants with information about different types of housing programs available across Michigan and who is eligible. Additionally, models for getting clients housed, as well as how to ensure stable housing, will be discussed. Registration opens November 7th in SHOARS.
Incorporating Divers SOGIE into Your Work. SOGIE (Sexual Orientation, Gender Identity and Expression) trainings are back this year with an addition on how to collect SOGIE Data in Systems of Care. "Incorporating Diverse SOGIE Into Your Work" cultivates an understanding that LGBTQ identity impacts how a person navigates services and care. Participants will learn best practices to enhance interpersonal and professional relationships with clients and peers who identify as LGBTQ+ or have diverse/expansive S.O.G.I.E. SOGIE data collection will be covered as well as the process of asking about SOGIE with a person centered and trauma-informed approach. Included is an overview of gender affirming care and transitioning (socially, medically, and legally). These practices serve to increase safety, access to resources, and mental/emotional well-being for gender diverse people. Sessions planned for June, July, August, and September 2022 are currently full but stay tuned as more will be offered in the future.
The STI/HIV Operations and Resource System (SHOARS) was recently featured at the Salesforce Innovation Day Conference in Chicago! DHSP had the opportunity to share our mission and vision for SHOARS with dozens of public sector organizations across the country. There was a lot of excitement regarding this new system, and we hope to keep the momentum going. Our presentation not only inspired other groups but allowed us to learn more about what other organizations are doing and how we can improve our system/processes.
Not yet signed up for SHOARS? SHOARS allows our DHSP Partners to interact with us easily and efficiently. Many DHSP Partners have already registered and are enjoying the system! Learn more at Michigan.gov/SHOARS.
|
The Ruth Ellis Center in collaboration with DHSP and Henry Ford Health System, is in the process of building and opening a supportive housing project focused on serving LGBTQ+ individuals. The new Ruth Ellis Clairmount Center, expected to open in the summer, will provide numerous services, including health care, to Detroit area LGBTQ+ youth who are unhoused. There will be housing units on the upper floors along with a “street level clinic”, an onsite pharmacy, and a community space on the main floor.
Tahrima Khanom, who works at the existing Henry Ford clinic at Ruth Ellis, said the current clinic provides primary care, with a big focus on HIV prevention. “A big part of our work is HIV prevention, treatment, and care, which is another reason why the Clairmount Center is such an amazing, and, I don't use the word ‘revolutionary’ lightly, but I think it's going to be revolutionary, especially when we talk about HIV treatment" she said. "We have patients coming in diagnosed with HIV, and the biggest barrier to care is housing stability because we know when those basic needs are not met, people are not able to stay in care and access this life-changing medication."
The full news article can be viewed by clicking here.
|
