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Home My WebLink AboutMINUTES - 01082013 - C.187RECOMMENDATION(S): ACCEPT report from the Health Services Department, Public Health Division, on their efforts to prevent the spread of HIV infections and other diseases and the Needle Exchange Program, as recommended by the Family and Human Services Committee. FISCAL IMPACT: None. BACKGROUND: On December 3, 2012 the Family and Human Services Committee received a report from the Health Services Department, Public Health Division on their efforts to prevent HIV infections and other infectious diseases through the efforts of the Needle Exchange Program. The Committee accepted the report and asked that it be forwarded to the Board of Supervisors for their review and acceptance. CONSEQUENCE OF NEGATIVE ACTION: None CHILDREN'S IMPACT STATEMENT: None APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 01/08/2013 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: Dorothy Sansoe, 925-335-1009 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: January 8, 2013 David Twa, County Administrator and Clerk of the Board of Supervisors By: STACEY M. BOYD, Deputy cc: C.187 To:Board of Supervisors From:Family and Human Services Committee Date:January 8, 2013 Contra Costa County Subject:Update on the County's HIV Prevention Efforts and the Needle Exchange Program ATTACHMENTS Report Power Point November 2012Prepared for the Contra Costa Board of Supervisors by Contra Costa Health DepartmentNeedle Exchange Update NEEDLE EXCHANGE In 1999, the Contra Costa Board of Supervisors endorsed a State of Emergency with respect to HIV and AIDS to allow for the provision of needle exchange services. This report satisfies the legislative requirement for a biennial update to maintain needle exchange services in Contra Costa County. 2012 LegislationSB 41 (Yee) took effect in January this year and allows nonprescription syringe sales or distribution (NPSS) through licensed pharmacies, physicians and syringe exchange programs to individuals aged 18 and older. AB 604 (Skinner) also took effect this year and streamlines the process for initiating syringe exchange programs (SEP) in areas without local endorsement for exchange, and decreases reporting requirements to every two years in areas with established SEPs in California. HIV/AIDS in Contra Costa County yAs of December 31 2011, more than 1,900 individuals were reported living with AIDS or HIV in Contra Costa. yApproximately 81% are male and 19% are female. African Americans are 30% of those living with HIV or AIDS, Whites 47% and Hispanics nearly 19%. yPredominant transmission among those living with HIV or AIDS remains men who have sex with other men (MSM). Injection Drug Use is about 17% of the caseload. New HIV and AIDS Reports by Year01020304050607080901002005 2006 2007 2008 2009 2010 2011AIDSHIV HIV/AIDS Attributed to Injection Drug Use (IDU) by Gender024681012141618202005 2006 2007 2008 2009 2010 2011MaleFemale Children with HIV and AIDSInfant Exposure has not been tracked by Stanford University since 2009. Of the 3,058 AIDS cases ever reported in Contra Costa, 24 have been pediatric cases (1-12 years of age). Seventeen of those pediatric cases (0.56%) were born to women with HIV/AIDS, and six were infected through blood/blood products. Of 725 HIV cases ever reported in Contra Costa, there were eight pediatric cases. Five (0.69%) were born to women with HIV/AIDS, and three have undetermined transmission. Reported Chronic Hepatitis C Cases Over Time5756805508106101537660100200300400500600700800900F 06 F07 F08 F09 F10 F11 F12number Law Enforcement and First Responder Exposures02040608010012014005/06 06/07 07/08 08/09 09/10 10/11 11/12All ExposuresNeedlestick Needle Exchange and CHEyServices continue under HEPPACyOne-for-one exchange offered in East and West County: roughly 70% of those served were at East County sites.yApproximately 55% of participants are White, 31% African American, and 14% Latino.yMen are 64% of those served.yApproximately 3% of those served accept referrals to health and support services. Reported Contacts (Individuals) at Needle Exchange Sites Over Time05001000150020002500300035000405 0506 0607 0708 0809 0910 1011 1112 Number of Syringes Distributed By CHE Over Time0500001000001500002000002500003000003500004000000405 0506 0607 0708 0809 0910 1011 1112 Secondary Exchanges Reported By CHE Over Time0100020003000400050006000700080000405 0506 0607 0708 0809 0910 1011 1112 AODS Service Enrollment 0500100015002000250030000607 0708 0809 0910 1011 11122011/2012 Enrollment n= 3996African AmWhiteHispanic AODS IDU Service Enrollment IDU/Non IDU01000200030004000500060000607 0708 0809 0910 1011 1112IDUs are about 17% of All AODS Service UsersTotal ServedIDUIn FY 1112 the Total N was 3996 and 693IDUs were served. AODS Service Enrollment By Gender01000200030004000500060000607 0708 0809 0910 1011 1112In 2011/2012 Women were Approximately 36% of Those Served By AODS Total ServedFemalein FY 1112 the Total N was 3996, and 1455 women were served. Other Prevention Strategies to Reduce Transmission of HIV in IDUs>Partner counseling and Anonymous Partner notification and counseling services;>Hepatitis C testing for highest risk IDUs;>HIV and STD testing services in community and in Alcohol and Other Drugs Services programs;>New evidence-based interventions in three agencies;>Cross training of staff and agencies. Syringe Disposal OptionsAdults anywhere in California may now purchase up to 30 syringes without a prescription. A number of locations for safe disposal of syringes are now available in Contra Costa. A link to the full list is maintained by the Contra Costa Environmental Health Program, as is a list of frequently asked questions on syringe and needle disposal and links to syringe disposal mail back services. More information on disposal is located at http://www.cchealth.org/eh/medical_waste/ CONCLUSIONS1. Access to clean needles is making a difference in Contra Costa and remains an important component of the strategy to reduce transmission of blood borne diseases. The number of infections attributed to injection drug use has declined over time and the availability of needle exchange and pharmacy syringe sales has played a role in this trend. 2. Reported local law enforcement exposure to potential blood borne pathogens via needle stick injury remains at the same level as prior to implementation of needle exchange and pharmacy sales. Materials for Law Enforcement to document potential exposure and request assistance remain available on the website. 3. The Health Department is no longer required to provide an annual status report, but is required to provide a biennial report. No major impact is anticipated in Contra Costa.