MMWR News Synopsis for September 21, 2017
- HIV Care Outcomes Among Men Who Have Sex With Men With Diagnosed HIV Infection — United States, 2015
- Opioid Overdose Outbreak — West Virginia, August 2016
- Trends in Cervical Cancer Screening in Title X–Funded Health Centers — United States, 2005–2015
- Respiratory and Ocular Symptoms Among Employees of an Indoor Waterpark Resort — Ohio, 2016
HIV Care Outcomes Among Men Who Have Sex With Men With Diagnosed HIV Infection — United States, 2015
CDC Media Relations
HIV care outcomes improved among men who have sex with men (MSM) in recent years. CDC researchers analyzed HIV surveillance data from 37 states and Washington, D.C., to determine care outcomes among MSM in 2014 and 2015. Compared with earlier findings for 2010 based on data from 18 states and Washington D.C., HIV care outcomes have improved for MSM. Eighty-four percent of MSM with HIV diagnosed in 2015 were linked to care within three months of diagnosis, compared with 78 percent in 2010. Fifty-eight percent of all MSM living with diagnosed HIV infection were retained in care and 61 percent were virally suppressed in 2014, compared with 51 percent retained in care and 42 percent virally suppressed previously. HIV testing is the gateway to care for people who receive a diagnosis of HIV infection and, along with risk assessment, the gateway to pre-exposure prophylaxis (PrEP) for those who test negative.
Elizabeth A. Adkins
Cabell-Huntington Health Department
Office 304-523-6483 Ext. 258
Collaborative public health and public safety investigation of opioid overdose outbreaks provides agencies with essential information to improve healthcare and public safety interventions. Effective intervention might improve patient outcomes in battling the opioid epidemic. An investigation into a widely publicized 2016 opioid overdose outbreak in Huntington, West Virginia, found emergence of carfentanil and furanyl fentanyl in the illicit opioid supply in the community, highlighting the importance of improved surveillance and investigation of such outbreaks. The investigation has also identified opportunities to improve local health care facility and health department responses to the opioid epidemic by linking emergency care for opioid overdose patients to treatment for opioid use disorder.
Title X clinics, an important source of family planning and related preventive care primarily for socioeconomically disadvantaged women, are required to follow nationally recognized care standards and adapt screening protocols as recommendations are updated. A downward trend in cervical cancer screening, based on analysis of aggregate Title X administrative data, is consistent with current screening guidelines that recommend a starting age of 21 years and a screening interval of every three to five years, depending on the technology used. We believe the declines over time, and especially following major recommendation changes in 2009 and 2012, have resulted from less screening of younger (under age 21) women and less frequent (annual) screening of women ages 21 years and older. We encourage Title X agencies to do further analysis using disaggregated client-encounter data to assess whether clients they serve are being screened as recommended. Cervical cancer screening is critical to early detection and treatment of precancerous cells and cervical cancer. In 2015, 3.6 million women received care in 3,900 clinics funded by the Title X Family Planning Program; over 743,000 were screened for cervical cancer. In a new study, researchers examined cervical cancer screening trends, in relation to changing screening recommendations, in Title X-funded agencies. Between 2005 and 2015, the percentage of females screened for cervical cancer declined by 30 points, which is consistent with changes in evidence-based recommendations from 2009-2012 that raised the starting age for screening to 21 years and increased the screening interval to three or five years, depending on testing technology.
CDC Media Relations
To prevent recreational water-associated illness caused by disinfection byproducts, vigilant monitoring and maintenance of ventilation and water systems are needed. Indoor waterpark users should shower before entering the water, and operators need to monitor and maintain ventilation and water quality systems to prevent illness from chlorine disinfection byproducts. Indoor waterparks are popular recreational venues where air and water quality problems can result in illness. At an indoor waterpark resort in Ohio, waterpark employees were four times more likely to have work-related eye and respiratory symptoms than employees who worked in other resort areas. Air, water, and ventilation-system assessments suggested that the higher prevalence of work-related symptoms among waterpark employees was related to an improperly functioning ventilation system. The ventilation system led to temperatures below, and relative humidity outside, recommended ranges. Accumulation of chlorine disinfection byproducts formed when chlorine used to disinfect water reacted with substances from swimmers’ bodies.
Update to CDC’s U.S. Medical Eligibility Criteria for Contraceptive Use, 2016: Revised Recommendations for the Use of Hormonal Contraception Among Women at High Risk for HIV Infection
CDC Media Relations
Women at high risk for HIV should continue to have access to the progestin-only injectable contraceptive depot medroxyprogesterone acetate (DMPA), but they should be counseled about a possible, but uncertain, increased risk of getting HIV and how to reduce their risk. In an update to the U.S. Medical Eligibility Criteria for Contraceptive Use, 2016, CDC is revising its recommendation on the use of DMPA by women at high risk for HIV from a US MEC Category 1 (no restriction) to Category 2 (benefits outweigh theoretical or proven risks) based on new scientific evidence and the World Health Organization’s similarly revised recommendation. The injectable contraceptive DMPA can be used by women at high risk for HIV infection, because the advantages generally outweigh the theoretical or proven risks – including a possible, but uncertain, increased risk of HIV acquisition. An accompanying clarification notes that there is evidence of a possible increased risk of getting HIV among progestin-only injectable users, but it is not clear whether this is due to methodological issues with the evidence or a real biological effect. All women at risk for HIV infection – regardless of contraceptive choice – should be counseled about how to reduce their risk.
- Increase in Reported Hepatitis A Infections Among Men Who Have Sex with Men — New York City, January–August 2017
- Travel-Associated Melioidosis and Resulting Laboratory Exposures — United States, 2016
- Human Immunodeficiency Virus Disease Death Rates Among Women Aged 45–64 Years, by Race and Age Group — National Vital Statistics System, United States, 2000–2015