2010 STD Prevention Conference

North Carolina Division of Public HealthCommunicable Disease Branch

A. Bernard DavisSafety Officer

Current Picture for North Carolina•Approximately 35,000 North Carolinians living with HIV disease.

•North Carolina averages 1,800 new reported cases of HIV each year.

•Experiencing a significant outbreak of syphilis. In 2009, North Carolina reported 937 new cases of syphilis. This is an 84 percent increase in cases over the 508 cases reported in 2008.

•Increases in syphilis morbidity were noted for almost all demographic groups including persons already infected with HIV. In 2009, 36 percent of early syphilis cases also had HIV.

•ADAP program is closed to new enrollees. *Currently, there are a total of 103 people on the ADAP waiting list. (*this number changes on an almost daily basis.)

•In 2008, North Carolina reported over 43,734 cases of chlamydia and over 14,811 cases of gonorrhea.

Partnership, Development and ImplementationPartnership

•We work with a media partner that helps us develop and produce our Get Real Get Tested commercials.

•For door to door community testing events, the local health department is our main partner. We make sure to notify the county health director immediately and work with the health educators, STD nurses and lab personnel.

•It’s also important for us to partner with local community based organizations. These are the “gatekeepers” for the community and assist with getting us into the right places to offer testing.

•This has been one of the keys in making our campaign a success. If we were to go into a community unannounced and uninvited, the testing event would not work.

Partnership, Development and ImplementationDevelopment

•We began working with our media partner – WRAZ/FOX 50 on the development and production of the Get Real Get Tested commercials.

•As the media portion of the campaign developed, we began working internally to develop a plan for local testing events in areas across the state. Every area is different and we could not develop a “cookie cutter” plan.

•The target populations were determined by using surveillance and epi data. This allows us to identify the populations most affected and the high morbidity areas around the state.

•The campaign messages were developed based on input from community based organizations, Division of Public Health and focus groups.

Partnership, Development and ImplementationImplementation

•We began to show the Get Real Get Tested television commercials which are aired on several stations around the state. These commercials air in prime time – not at odd hours.

•We set up a web page for Get Real Get Tested, along with a toll free telephone number for anyone who has questions about HIV/STDs or wants to know where they can get tested.

•We began to visit different cities across the state to plan and implement door to door community testing events. Neighborhoods would be canvassed by teams offering HIV and syphilis testing. We also set up stationary testing sites around the community for people to come to us to get tested.

•Incentives have played a key part in getting folks to come out and test.

“Get Real Get Tested” Commercials• Commercials are running across North Carolina –

We’ve used local community members that would be recognizable There are six different commercials running, including a Spanish commercial running on Univision.

• Commercials are shown in prime time slots, i.e.

“House, M.D.” and “American Idol ”. Also aired commercial during the Super Bowl 2007, NASCAR races in 2008 and show finales in 2009.

• These commercials are airing statewide in North Carolina.

“Get Real Get Tested” Commercials

Targeted Campaign – “Get Real Get Tested”• Targeted Campaign Coordinator – Constance Jones

Manages each targeted campaign event including staff and operations.

• Safety Officer – Bernard DavisManages the safety aspects of each “GRGT” event

• The GRGT team collaborates with the Surveillance and Field Services teams in order to select areas that are considered to have high morbidity rates. Cities visited in 2006-07 included Fayetteville, Raleigh, Durham, High Point, Greensboro, Rocky Mount, Goldsboro, Kinston and Charlotte.

• Locations for 2008 included Sanford, Cullowhee, Greenville, Raleigh, Henderson, Fayetteville and Winston-Salem.

• Locations for 2009 included Wilmington, Durham, Raleigh, Winston Salem and Elizabeth City.

HIV testing in North Carolina from 2006 and 2008

2006 2008Number of HIV tests processed at the State Lab 146,548

214,215

Number of HIV positive cases (new and previous) identified 837 1,079

Number of persons tested for HIV that were Medicaid eligible 66,973 85,582

Number of new positives by race:

African American/African 416 536

Asian and Pacific Islander 6 2Hispanic/Latino 55 60

Native American/Alaskan Native 1 6

White 129 128Unknown Ethnicity 35 45

Results from the “Get Real Get Tested” campaign 2006 - 2009

• From 2006 to 2009, HIV tests processed by the State Public Health Lab increased by 73% in North Carolina.

• In 2007, there were 7,422 rapid HIV tests administered at non-traditional testing sites (NTS) in North Carolina with 71 people testing positive for HIV.

• In 2008, there were over 13,000 rapid HIV tests administered at non traditional test sites and jails in North Carolina with 165 people testing positive for HIV.

• Over 4,500 people were tested during 2006-2009 Get Real,

Get Tested door to door community testing events.

• Targeted campaign conducted in 19 locales across North Carolina.

• During the door to door community testing events, we identified 38 people who tested positive for the HIV-1 antibody and 41 people who were positive for syphilis.

Moving Forward with GRGT• With resources being very limited, we are challenged

in finding ways that we can reach the communities in need effectively. We are having to plan very focused and targeted events.

• In an effort to address the increase in syphilis cases, we are working to set up testing events at clubs around North Carolina. This includes clubs that cater to the straight and MSM communities. We’re also brainstorming on different techniques that we can use to approach the MSM community.

• Integrating HIV and syphilis testing with urine based testing for gonorrhea and Chlamydia. This will be important for testing at stationary sites or college campuses.

• We are developing media messages which stress the importance of getting tested and educated on STDs.

Questions?Bernard DavisSafety Officer Get Real Get TestedBernard.davis@dhhs.nc.gov704-566-8990

Holly WatkinsCampaign CoordinatorGet Real Get TestedHolly.watkins@dhhs.nc.gov919-715-0136

http://www.epi.state.nc.us/epi/hiv/index.html