Annual Summary: 2011 Minnesota Sexually Transmitted Disease Statistics

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Annual Summary: 2011 Minnesota Sexually Transmitted Disease Statistics (PDF: 79KB/9 pages)

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Overall Summary
Sources of Data
Limitations of Data
Chlamydia
Gonorrhea
Syphilis
Chancroid
Summary Points
Data Tables

Overall Summary:

The 2011 Sexually Transmitted Disease (STD) Statistics includes summary of surveillance data for Minnesota’s reportable STDs: chlamydia, gonorrhea, syphilis, and chancroid. In Minnesota, STDs are the most commonly reported communicable diseases and account for nearly 70% of all notifiable diseases reported to the Minnesota Department of Health (MDH). In 2011 the number of reported bacterial STDs increased to 19,547 cases, representing an overall increase of 8% from the previous year. The change in incidence rates varied by disease, with chlamydia increasing by 9%, gonorrhea increasing by 5%, and primary/secondary syphilis decreasing by 8%.

This report provides a comprehensive review of STD trends and current morbidity in Minnesota; data are also available in a slide presentation (PDF: 1.4MKB/64 slides). If you are interested in using one or more of these slides in a presentation, please contact Dawn Ginzl via e-mail or 651-201-4041.

Data Tables:

List of tables included in this report:
Table 1. Number of Cases and Rates (per 100,000 persons) of Chlamydia, Gonorrhea, Syphilis (All Stages) and Chancroid— Minnesota, 2007-2011
Table 2a. Chlamydia: Number of Cases and Rates (per 100,000 persons) by Residence, Age, Race/Ethnicity and Gender— Minnesota, 2011
Table 2b. Gonorrhea: Number of Cases and Rates (per 100,000 persons) by Residence, Age, Race/Ethnicity and Gender— Minnesota, 2011
Table 2c. Primary/Secondary Syphilis:  Number of Cases and Rates (per 100,000 persons) by Residence, Age, Race/Ethnicity and Gender— Minnesota, 2011
Table 3. Number of Chlamydia and Gonorrhea Cases and Rates (per 100,000 persons) by County—Minnesota, 2011

Sources of Data:

STD Case Reporting
Under state law (Minnesota Rule 4605.7040), both physicians and laboratories must report laboratory-confirmed infections of chlamydia, gonorrhea, syphilis, and chancroid to the MDH within one working day. Other common sexually transmitted conditions such as herpes simplex virus (HSV) and human papillomavirus (HPV) are not reported to the MDH. 

MDH Partner Services Program
All early syphilis cases, and any untreated chlamydia or gonorrhea cases reported to the MDH are referred to the Partner Services Program to ensure treatment of patients and their sexual partners. Additional surveillance data is collected through this process including information on sexual behavior and drug use.

Gonococcal Isolate Surveillance Project (GISP)
As part of the national Gonococcal Isolate Surveillance Project (GISP) funded by the Centers for Disease Control and Prevention (CDC), the MDH monitors antimicrobial susceptibilities of Neisseria gonorrhoeae. A Minneapolis STD clinic submits isolates on a monthly basis to the MDH. Sociodemographic and behavioral data for each case are also submitted. As of 2008, the MDH ceased routine susceptibility testing for GISP isolates, but still collaborates with the CDC to perform susceptibility testing.

Minnesota Infertility Prevention Project (MIPP)
Minnesota participates in the national Infertility Prevention Project funded by the CDC. Through MIPP, the MDH funds clinics across the state – including STD, family planning, adolescent, and community clinics – to provide testing and treatment for chlamydia and gonorrhea to men and women ages 15-24. Participating clinics submit to MDH demographic and clinical data on every test performed. With information on positive as well as negative tests, prevalence (or positivity) rates for chlamydia and gonorrhea can be calculated and monitored.

Limitations of Data:

Several factors impact the completeness and accuracy of the MDH’s STD surveillance data, including compliance with and completeness of case reporting among healthcare providers and laboratories. Clinically diagnosed cases, presumptively treated cases, and asymptomatic cases with no STD-related illnesses may be under-reported through the STD surveillance system. Furthermore, STD cases reported by laboratories lacking subsequent provider reporting may be excluded from the STD surveillance database. The majority of laboratory reports originate from facilities that do not routinely collect demographic and clinical information required for STD surveillance. In 2002, the MDH implemented an active surveillance process whereby providers are reminded to submit demographic and clinical information missing from cases reported solely through laboratories. Additional factors affecting validity of the STD surveillance data include STD screening coverage, individual test-seeking behavior, and accuracy of diagnostic tests. Thus, changes in STD rates may be due to one or more of these factors or due to actual changes in the incidence of STDs in the population.

Population counts used to calculate incidence rates by residence (i.e., state, counties, Minneapolis, and Saint Paul), by age, by gender, and by race/ethnicity were obtained from the U.S. Census Bureau. Incident rates (number of reported cases per 100,000 persons) were calculated using yearly case data and population counts from the decennial census. Population counts for 1991 to 1999 were estimated by interpolation between the 1990 and 2000 census data. Rates for 2011 were calculated using population counts from the 2010 Census, the most recent year for which counts by race, age, gender, and residence were available at the time of calculation and preparation. This 2011 data release includes rates calculated using revised population estimates for the calendar years between the 2000 and 2010 U.S. Censuses, resulting in changes to previously published rates back to 2001. 

Chlamydia:

Chlamydia is the most commonly reported communicable disease in Minnesota. From an all-time low of 115 cases per 100,000 in 1996, the incidence of chlamydia has more than doubled to 319 per 100,000 in 2011. Over these years, increases were seen across all gender, age, race and geographical groups. The rates more than tripled among men (54 to 193 per 100,000) and more than doubled among females (175 to 443 per 100,000). Among 30-39 year-olds, the incidence rate more than quadrupled. Rates doubled among American Indians, Blacks, and Hispanics and almost tripled among Whites and Asian/Pacific Islanders. In addition to an increase of disease in the population, other factors may have contributed to the increases seen during these years including increased reporting by providers, use of improved STD diagnostic tools, improved screening practices by clinicians and the addition of an active surveillance component to the MDH’s STD surveillance system.

In 2011, the chlamydia rate increased by 9% overall and remained highest among women (443 per 100,000), Blacks (1.727 per 100,000), and 20-24 year-olds (1,907 per 100,000). The rates increased by 15% among males and 6% among females. Adolescents (15-19 year-olds) and young adults (20-24 year-olds) have the highest rates and comprise the majority of cases, rates among males increased the most among those 20-24 years (29%), and among females for those 10-14 years (32%). Across geographic areas, the City of Minneapolis had the highest incidence rate (848 per 100,000). However, the Suburban area (seven-county metro excluding the cities of Minneapolis and St. Paul) experienced the greatest increase in chlamydia rates between 2010 and 2011 (15%), followed by Greater Minnesota (11%), St. Paul (8%), and finally Minneapolis (4%). The American Indian population showed the largest increase in chlamydia rates from 2010 to 2011 at 20%.   From 2010 to 2011 Whites saw an increase of 14%, followed by Asian/Pacific Islanders with an increase of 11%, Hispanics with an increase of 7%, and Blacks with an increase of 7%. Racial disparities in chlamydia continue to persist in Minnesota with the incidence rate among Blacks being 11 times that among Whites. Other racial/ethnic groups are disproportionately affected by chlamydia; incidence rates among American Indians, Asian/Pacific Islanders and Hispanics were 4.4, 1.9, and 2.7 times higher than the rate among Whites, respectively.

Gonorrhea:

In 2011, Minnesota experienced an increase in the rate of reported gonorrhea, after rates declined from 2008-2010. From 2000 to 2011, the incidence of gonorrhea in Minnesota decreased from 65 to 43 per 100,000 persons (34%). However, as with chlamydia, the incidence of infection was higher among some segments of the population compared to others. Rates during the past decade have decreased by 24% among males and 17% among females. The rates also decreased among all racial/ethnic groups, with the largest drops among Blacks and Asians (46% and 57%, respectively). However, during this period Blacks continued to have gonorrhea incidence rates far higher than other race groups.

In 2011 the incidence rate of gonorrhea increased by 5% from 41 to 43 per 100,000 persons. As with chlamydia, gonorrhea rates were highest among females (48 per 100,000), Blacks (410 per 100,000), and 20-24 year-olds (227 per 100,000). Adolescents and young adults continue to account for a disproportionate amount (65%) of all gonorrhea cases. The Cities of Minneapolis and Saint Paul accounted for the highest rates of infection (211 and 132 cases per 100,000 persons, respectively). The greatest increase from 2010 to 2011 (35%) was seen in St. Paul whereas gonorrhea rates in Minneapolis increased by 8% during this same time. Compared to chlamydia, greater racial disparities in gonorrhea infections continue to persist in Minnesota with an incidence rate among Blacks being 26 times that among Whites. These racial disparities are also evident among American Indians and Hispanics, whose rates are 6.0 and 2.3 times those of Whites.

The emergence of quinolone-resistant Neisseria Gonorrhea (QRNG) in recent years has become a particular concern. Due to the high prevalence of QRNG in Minnesota as well as nationwide, quinolones are no longer recommended for the treatment of gonococcal infections.

Syphilis:

Incidence rates of primary/secondary syphilis in Minnesota remained stable from 1998 until 2002 when an outbreak was observed among men who have sex with men (MSM) and the overall rate increased from 0.2 to 1.2 per 100,000 persons. Since 2002, primary/secondary syphilis rates have fluctuated but remained elevated. In addition, the number of early syphilis cases (primary, secondary, and early latent stages) increased from 83 in 2002 to 260 in 2011, with MSM accounting for 88% of all cases among males in 2011. The disparity in early syphilis rates between males and females has remained large and reflects the greater burden within the MSM community.

In 2011, the overall incidence rate of primary/secondary syphilis decreased from 2.8 to 2.6 cases per 100,000 persons. The number of cases among males decreased from 141 in 2010 to 134 in 2011 while among females, the number decreased from 9 to 5. Decreases in cases were observed across all geographic areas except Greater Minnesota, which increased from 11 in 2010 to 13 in 2011; however the City of Minneapolis remains to account for the majority of cases (42%). The incidence of primary/secondary syphilis infection decreased in every age group, except among persons 25-29 years of age, and among those under the age of 15 (no cases of primary/secondary syphilis in this age group in either 2010 or 2011). Whites comprised the majority (71%) of cases in 2011, while Asian/Pacific Islanders saw an increase of primary/secondary syphilis of 440% from 2010 to 2011. Also, Blacks comprised compromised 17% of all primary/secondary syphilis cases in 2011 and have a rate of primary/secondary syphilis that is almost 4 times higher than that among Whites.

The number of early syphilis cases increased in 2011 (260 versus 224 in 2010). The number of cases among women decreased from 14 cases in 2010 to 13 cases in 2011, with 38% of cases at the primary or secondary stage in 2011 compared to 64% in 2010. Early Syphilis cases among men increased from 207 to 247 (19%). Of all early syphilis cases reported in 2011, 95% were among males and 88%of these were MSM.

Chancroid:

Chancroid remains extremely rare in Minnesota. The last case reported in Minnesota was in 1999.

Summary Points:

  • Over the past decade (2001-2011), Minnesota’s chlamydia rate showed an overall increase of 90% while the rate of gonorrhea has fluctuated but has overall shown a decrease of 20%.  Rates of primary/secondary syphilis have increased 271%.
  • Minnesota has seen a resurgence in syphilis since 2002, with men who have sex with men being especially impacted.
  • Racial disparities in STDs continue to persist in Minnesota with communities of color having the highest rates.
  • Between 2010 and 2011, the chlamydia incidence rate increased by 9%, while the gonorrhea rate increased by 5%. Cases of primary/secondary syphilis decreased by 7%.  The greatest growth was seen among early latent syphilis cases, which increased by 16%.
  • In 2011, incidence rates of chlamydia increased by 16% among males and 6% among females; gonorrhea increased by 12% among males and 2% among females.
  • STD rates continued to be highest in the City of Minneapolis. However, the Twin Cities suburbs and Greater Minnesota accounted for a large percentage of STD cases.
  • Adolescents and young adults (ages 15-24) accounted for 69% of chlamydia and 65% of gonorrhea cases reported in 2011.
  • In 2011, men who have sex with men account for 88% of all male early syphilis cases, and rates of primary/secondary syphilis increased 440% among Asian/Pacific Islanders.     

Data Tables

Table 1. Number of Cases and Rates (per 100,000 persons) of Chlamydia, Gonorrhea, Syphilis (All Stages)
and Chancroid — Minnesota, 2007-2011

2007 2008 2009 2010 2011
Disease Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate
Chlamydia 13,480 259 14,414 275 14,369 272 15,509 292 16,898 319
Gonorrhea 3,479 67 3,054 58 2,328 44 2,149 41 2,283 43
All Stages of Syphilis 186 3.6 263 5.0 215 4.1 351 6.6 366 6.9
~ Primary/Secondary Syphilis 59 1.1 116 2.2 71 1.3 150 2.8 139 2.6
~ Early Latent Syphilis 55 1.1 47 0.9 46 0.9 74 1.4 121 2.3
~ Late Latent Syphilis 72 1.4 100 1.9 97 1.8 126 2.4 106 2.0
~ Other Syphilis (1) 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
~ Congenital Syphilis (2) 0 0.0 0 0.0 1 1.4 1 1.5 0 0.0
Chancroid 0 0.0 1 0.0 0 0.0 0 0.0 0 0.0
NOTE: Data exclude cases diagnosed in federal or private correctional facilities;
U.S. Census 2010 data is used to calculate rates.
(1) Includes unstaged neurosyphilis, latent syphilis of unknown duration, and late syphilis with clinical manifestations.
(2) Congenital syphilis rate per 100,000 live births.

Table 2a. Chlamydia: Number of Cases and Rates (per 100,000 persons) by Residence, Age, Race/Ethnicity and Gender — Minnesota, 2011
  Chlamydia
Males Females Total (VI)
Group Case % Case % Case % Rate
Residence (1)
Minneapolis 1,186 23% 2,059 17% 3,246 19% 848
St. Paul 648 13% 1,514 13% 2,165 13% 759
Suburban (2) 1,722 34% 4,186 35% 5,909 35% 271
Greater Minnesota 1,282 25% 3,567 30% 4,850 29% 198
Age
< 15 yrs 21 0% 141 1% 162 1% 15
15-19 yrs 1,006 20% 4,084 35% 5,094 30% 1,385
20-24 yrs 1,992 39% 4,792 41% 6,784 40% 1,907
25-29 yrs 996 20% 1,684 14% 2,681 16% 719
30-34 yrs 489 10% 608 5% 1,097 6% 320
35-39 yrs 244 5% 281 2% 527 3% 161
40-44 yrs 143 3% 130 1% 273 2% 77
45-49 yrs 103 2% 51 0% 154 1% 38
50-54 yrs 43 1% 36 0% 79 0% 20
55+ yrs 30 1% 17 0% 47 0% 4
Race/Ethnicity
White 2,035 40% 5,456 46% 7,494 44% 166
Black 1,765 35% 3,084 26% 4,851 29% 1,768
American Indian 84 2% 390 3% 475 3% 780
Asian/PI 169 3% 522 4% 692 4% 320
Other (3) (4) 206 4% 641 5% 847 5% x
Unknown (4) 808 16% 1,731 15% 2,539 15% x
Hispanic (5),(6) 319 6% 768 6% 1,087 6% 434
TOTAL 5,067 100% 11,824 100% 16,898 100% 319
NOTE: Data exclude cases diagnosed in federal or private correctional facilities;
U.S. Census 2010 data is used to calculate rates.
(1) Residence missing for 728 cases of chlamydia.
(2) Suburban is defined as the seven-county metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington Counties, excluding the cities of Minneapolis and St. Paul).
(3) Includes persons reported with more than one race.
(4) No comparable population data available to calculate rates.
(5) Persons of Hispanic origin may be of any race.
(6) Total includes 7 cases of chlamydia diagnosed in transgendered persons

Table 2b. Number of Cases and Rates (per 100,000 persons) of Gonorrhea by Residence, Age, Race/Ethnicity and Gender — Minnesota, 2011
  Gonorrhea
Males Females Total (1)
Group Case % Case % Case % Rate
Residence (2)
Minneapolis 410 41% 398 31% 809 35% 211
St. Paul 154 16% 222 17% 376 16% 132
Suburban (3) 272 28% 382 30% 655 29% 30
Greater Minnesota 109 11% 243 19% 352 15% 14
Age
< 15 yrs 2 0% 19 1% 21 1% 2
15-19 yrs 155 16% 428 33% 585 26% 159
20-24 yrs 321 32% 486 38% 807 35% 227
25-29 yrs 206 21% 186 14% 392 17% 105
30-34 yrs 112 11% 76 6% 188 8% 55
35-39 yrs 63 6% 53 4% 116 5% 35
40-44 yrs 49 5% 22 2% 71 3% 20
45-49 yrs 50 5% 11 1% 61 3% 15
50-54 yrs 17 2% 9 1% 26 1% 6
55+ yrs 13 1% 3 0% 16 1% 1
Race /Ethnicity
White 347 35% 378 29% 726 32% 16
Black 492 50% 659 51% 1,152 50% 420
American Indian 12 1% 51 4% 63 3% 103
Asian/PI 12 1% 21 2% 33 1% 15
Other (4)(5) 33 3% 64 5% 97 4% x
Unknown (5) 92 9% 120 9% 212 9% x
Hispanic (6) 48 5% 44 3% 92 4% 37
TOTAL 988 100% 1,293 100% 2,283 100% 43
NOTE: Data exclude cases diagnosed in federal or private correctional facilities;
U.S. Census 2010 data is used to calculate rates.
(1) Total includes 2 cases of gonorrhea diagnosed in transgendered persons.
(2) Residence missing for 91 cases of gonorrhea.
(3) Suburban is defined as the seven-county metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington Counties, excluding the cities of Minneapolis and St. Paul).
(4) Includes persons reported with more than one race.
(5) No comparable population data available to calculate rates.
(6) Persons of Hispanic origin may be of any race.

Table 2c. Number of Cases and Rates (per 100,000 persons) of Primary/Secondary Syphilis by Residence, Age, Race/Ethnicity and Gender -- Minnesota, 2011
  Primary & Secondary (P&S) Syphilis
  Males Females Total
Group Case % Case % Case % Rate
Residence
Minneapolis 56 42% 2 0% 58 42% 15.2
St. Paul 13 10% 1 0% 14 10% 4.9
Suburban (1) 52 39% 0 0% 52 37% 2.4
Greater Minnesota 11 8% 2 0% 13 9% 0.5
Age
< 15 yrs 0 0% 0 0% 0 0% 0.0
15-19 yrs 3 2% 0 0% 3 2% 0.8
20-24 yrs 25 19% 1 0% 26 19% 7.3
25-29 yrs 25 19% 1 0% 26 19% 7.0
30-34 yrs 15 11% 1 0% 16 12% 4.7
35-39 yrs 19 14% 2 0% 21 15% 6.4
40-44 yrs 11 8% 0 0% 11 8% 3.1
45-49 yrs 18 13% 0 0% 18 13% 4.4
50-54 yrs 12 9% 0 0% 12 9% 3.0
55+ yrs 6 4% 0 0% 6 4% 0.5
Race/Ethnicity
White 96 72% 2 0% 98 71% 2.2
Black 21 16% 3 0% 24 17% 8.7
American Indian 1 1% 0 0% 1 1% 1.6
Asian/PI 6 4% 0 0% 6 4% 2.8
Other (2)(3) 9 7% 0 0% 9 6% x
Unknown 1 1% 0 0% 1 1% x
Hispanic (4) 10 7% 0 0% 10 7% 4.0
TOTAL 134 100% 5 0% 139 100% 2.6
NOTE: Data exclude cases diagnosed in federal or private correctional facilities;
U.S. Census 2010 data is used to calculate rates.
(1) Suburban is defined as the seven-county metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington Counties, excluding the cities of Minneapolis and St. Paul).
(2) Includes persons reported with more than one race.
(3) No comparable population data available to calculate rates.
(4) Persons of Hispanic origin may be of any race.

Table 3. Number of Chlamydia and Gonorrhea Cases and Rates (1) (per 100,000 persons) by County of Residence -- Minnesota, 2011
 
Chlamydia
Gonorrhea
  
Chlamydia
Gonorrhea
County
Cases
 Rate Cases
Rate
County
Cases
Rate
Cases
Rate
Aitkin 13 80 1 - Marshall 4 - 0 -
Anoka 1024 310 93 28 Martin 32 154 2 -
Becker 42 129 5 15 Meeker 10 43 2 -
Beltrami 141 317 18 41 Mille Lacs 54 207 4 -
Benton 62 161 4 - Morrison 43 130 4 -
Big Stone 3 - 0 - Mower 116 296 17 43
Blue Earth 277 433 8 12 Murray 6 69 0 -
Brown 45 174 1 - Nicollet 28 86 5 15
Carlton 88 249 2 - Nobles 50 234 2 -
Carver 137 150 5 5 Norman 4 - 0 -
Cass 65 228 9 32 Olmsted 439 304 31 21
Chippewa 16 129 5 40 Otter Tail 73 127 4 -
Chisago 116 215 3 - Pennington 22 158 2 -
Clay 123 208 6 10 Pine 42 141 0 -
Clearwater 7 81 1 - Pipestone 7 73 0 -
Cook 7 135 0 - Polk 62 196 5 16
Cottonwood 15 128 0 - Pope 15 136 0 -
Crow Wing 110 176 16 26 Ramsey 2732 537 421 83
Dakota 1039 261 104 26 Red Lake 3 - 0 -
Dodge 55 274 3 - Redwood 16 100 2 -
Douglas 45 125 6 17 Renville 25 159 4 -
Faribault 11 76 3 - Rice 86 134 3 -
Fillmore 23 110 2 - Rock 14 145 0 -
Freeborn 73 234 3 - Roseau 14 90 0 -
Goodhue 96 208 2 - St. Louis 627 313 49 24
Grant 4 - 0 - Scott 258 199 18 14
Hennepin 5718 496 1172 102 Sherburne 158 179 7 8
Houston 13 68 2 - Sibley 17 112 1 -
Hubbard 14 69 0 - Stearns 422 280 50 33
Isanti 47 124 4 - Steele 59 161 6 16
Itasca 78 173 7 16 Stevens 10 103 1 -
Jackson 9 88 0 - Swift 9 92 0 -
Kanabec 23 142 1 - Todd 26 104 0 -
Kandiyohi 90 213 4 - Traverse 7 197 0 -
Kittson 1 - 0 - Wabasha 41 189 0 -
Koochiching 19 143 1 - Wadena 13 94 0 -
Lac qui Parle 5 69 0 - Waseca 19 99 0 -
Lake 13 120 0 - Washington 412 173 27 11
Lake of the Woods 5 124 0 - Watonwan 24 214 0 -
Le Sueur 45 162 4 - Wilkin 7 106 0 -
Lincoln 5 85 1 - Winona 132 257 7 14
Lyon 63 244 3 - Wright 177 142 12 10
McLeod 44 120 2 - Yellow Medicine 13 125 2 -
Mahnomen 13 240 2 -        
NOTE: Data exclude cases diagnosed in federal or private correctional facilities;
County data missing for 728 chlamydia cases and 91 gonorrhea cases.
(1) Rates not calculated for counties with fewer than 5 cases.
U.S. Census 2010 data is used to calculate rates.


Data Archive

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Updated Thursday, 11-Apr-2013 08:13:25 CDT