Region II Infertility Prevention Project Advisory Committee May 31-June 1, 2006

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Region II Infertility Prevention Project
Advisory CommitteeMay 31-June 1, 2006

• CDC Update
• Personnel
• Budget and Program Changes
• Reorganization
• Ongoing Projects
• Azithromycin
• Performance Measures

2
PDSB Personnel

• Catherine Lindsey Satterwhite
• David Johnson
• Sheldon Black
• David Byrum
• Tracey Hardy
• Susan DeLisle
• Kathryn Koski

3
Budget 2006

• Flat Funding for STD Prevention
• 161 Million FY 2006
• 106 million to grantees
• 50 funding awards
• FY 2006 Final Budget
• 2.97 reduction in funds
• CSPS and Infrastructure
• 1 Katrina Relief

4
Program Changes

• Internal-
• Infrastructure Performance Measure(s)
• External-
• However, new language in the congressional
  committee report for FY06 indicates possible
  future directions for the Infertility Prevention
  Project

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109th Congress Committee

• The committee notes that CDC is charged
  legislatively with instituting programs to help
  prevent infertility. CDCs current program
  activities in this matter are undertaken by the
  division of HIV/STD/TB and are limited to the
  prevention of venereal diseases. The Committee
  understands that there are numerous additional
  causes of infertility beyond sexually transmitted
  disease, such as delayed child bearing, smoking,
  low or excessive body weight, exposure to
  hazardous environmental toxins, drug and alcohol
  abuse, and particularly for men, exposure to high
  temperatures. The Committee encourages CDC to
  consider expanding the scope of this program and
  provide greater support to public education on
  the risks to fertility.
• Senate Report 109-103 Calendar 163

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Reorganization

• CDC
• CoCID
• NCHHSTP
• DSTDP
• PDSB and THCB merged into the Program and
  Training Branch (PTB)

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Ongoing Projects

• Male Screening Consultation
• Questions of Interest
• What is the effectiveness of screening men in
  various venues to identify undiagnosed chlamydia
  infection?
• Can we identify behavioral or demographic
  characteristics such as age that can be used to
  target men at high risk for chlamydia infection?
• What do models and cost-effectiveness studies on
  male chlamydia screening tell us?
• What data are there on partner management
  practices for female partners of men found to
  have chlamydia?

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Ongoing Projects

• Partner Management
• Expedited Partner Therapy
• Dear Colleague Letter
• Catalogue of state and local statutes, rules, and
  regulations
• GC Screening
• National GC Screening guidelines using a
  prevalence threshold should be established
• Localize efforts in a geographic core
• GISP/GASP

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Ongoing Projects

• Infertility Prevention Workgroup Subcommittees
• Partner Services
• Client Counseling and Behavioral Interventions
• Diagnosis and Treatment
• Surveillance and Monitoring
• Screening
• 2 Page Outline
• Rationale for component
• Describe Status Quo
• Given existing evidence, what should we be doing?
• Identify critical issues and recommend strategies

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Ongoing Projects

• Broad Action Areas Identified
• Twenty-six prioritized to eleven
• Development of 3-5 page brief response paper
  using a common template
• Discussion meeting June 16
• Subsequent Prioritization
• 3-5 presented to Dr. Douglas for consideration

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Ongoing Projects

• Partnership for Prevention
• P4P is a national nonprofit dedicated to building
  evidence for strong disease prevention policies
• Proposed Work Plan
• Promote the use of high-impact adolescent
  preventive services, including chlamydia
  screening
• Develop an implementation guide to assist health
  systems and clinicians establish systems that
  encourage the delivery of chlamydia screening
  services
• Promote delivery of the new HPV vaccine,
  especially to vulnerable populations

12
Azithromycin

• FDA approval for generic AZ 11/11/05
• Greenstone (Pfizer)
• Teva
• Sandoz
• 340B sub-ceiling pricing for branded AZ (95/10
  doses) expires 6/30/06. Pfizer will not renew
  this contract with 340B
• Kansas IPP Coordinator
• Jennifer Vandevelde 785-296-6544

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Performance MeasuresActivities

• PM Consultation January 2006
• Established PM evaluation criteria
• Reviewed current measures and evaluated possible
  future measures
• Recommended guiding principles

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PM Activities (2)

• PM Consultation (cont)
• Made recommendations for each new measure
• Tabled
• Needs further discussion
• Proportion of family planning clinics adhering to
  regional chlamydia screening criteria
  (Infrastructure?)
• Pilot-ready
• Timeliness of treatment for maternal syphilis
  during pregnancy
• Screening coverage estimate among sexually active
  15-19 year old women in FP clinics
  (Infrastructure ?)
• Ready for Implementation

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PM Activities (3)

• PM Consultation (cont)
• Made recommendations for each new measure
• Ready for Implementation
• Gender of Sex Partner information
• Timeliness of treatment for gonorrhea and
  chlamydia in women who test positive in STD
  clinics
• Made recommendations for current measures

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PM Activities (4)

• Live Database March 6
• Continued development of Technical Assistance and
  Reports section
• January-June 2005 data final ß-est for data entry
• MOU and User ID requests
• Grantees
• IPP regional coordinators
• Three training Webinar for grantees
• Database available for aggregate July-December
  2005 data entry until April 30, 2006. Changes
  after 4-30-06 will be reviewed, approved, and
  entered by project area consultant.

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Performance MeasureIPP CS1

• Among clients of IPP Family Planning clinics, the
  proportion of women with positive chlamydia tests
  treated within 14 and 30 days of the date of
  specimen collection.

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IPP CS 1 (Chlamydia) Results
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IPP-CS1 Proportion of positive chlamydia cases
from family Planning clinics treated within 14
and 30 days U.S. and IPP median proportions
(2005)
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Performance MeasureIPP CS2

• Among clients of IPP Family Planning clinics, the
  proportion of women with positive gonorhea tests
  treated within 14 and 30 days of the date of
  specimen collection.

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IPP CS 2 (Gonorrhea) Results
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IPP-CS2 Proportion of positive gonorrhea cases
from family Planning clinics treated within 14
and 30 days U.S. and IPP median proportions
(2005)
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Performance MeasureCSPS MLS1

• Proportion of female admittees to large juvenile
  detention centers tested for chlamydia.

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CSPS MLS1 (JDC Screening) Results
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CSPS-MLS1 Proportion of female juvenile detention
center admittees that are screened for
chlamydia Median proportions in U.S. and IPP
regions (2005)
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Disclaimer

• "The findings and conclusions in this
  presentation are those of the author and do not
  necessarily represent the views of the Centers
  for Disease Control and Prevention."

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Questions