STD Testing in Kentucky

Kentucky STD Data

STD data & statistics in Kentucky

As per the year 2017-18 STD surveillance data, Kentucky ranked 40th among all US states in chlamydia rates, with 435 cases. This is way lower than the national chlamydia rate. But, it is worth noting that the number of chlamydia cases in the state has risen about 10% over the past five years. In 2012, Kentucky reported 394 cases, which increased to 389 in 2013, 400 in 2014, and 435 in 2017-18. Despite that, Kentucky has the 2nd lowest chlamydia rate among other Southern states.

Gonorrhea prevalence in the state is fairly low and puts the state in the middle nationally. After population adjustment, Kentucky’s gonorrhea rate was 167.2 per 100,000 people in 2017. But, reportedly, gonorrhea rates have increased over 70% across the state since 2012. In 2012, Kentucky reported 97 cases/100,000 people, which increased slightly to 98 in 2013, and 98.6 in 2014 but jumped to over 167 by 2017-18. Still, Kentucky ranked in the bottom quarter in the Southern region.

A similar trend is noted in syphilis cases. Its prevalence in the state varies widely, especially since the past six years. But, it is still among the 25 states with the lowest primary/secondary syphilis rates. Kentucky has the third-lowest rate overall in the country, with 5.9 cases reported in 2018. It is reported that the rate of syphilis infections in Kentucky has almost doubled compared to the rate in 2012. Syphilis rates reportedly increased by 62% from 2014 to 2017. The rates were highest in Jefferson County during 2017-2018 with 46 cases/100,000 people, twice more than the statewide average of 16 cases. Jefferson County also recorded the highest number of gonorrhea cases, with 361/100,000 people.

HIV Rates in Kentucky

In Kentucky state, a disparity is noted in heterosexual black females compared to white females. Black females comprise nearly 47% of all new HIV diagnoses, while 44% were reported among white females. On the contrary, white males reportedly had the highest diagnosis rate with 64%, whereas new diagnosis rates among black males were 30% in 2018. Around 56% of HIV cases in Kentucky were diagnosed in MSM (men who have sex with men), 14% got infected via heterosexual intercourse, 10% contracted the virus via IDU (intravenous drug use), and 5% contracted it through both means between 2007 and 2017.

In 2018, around 7,337 people were living with HIV in the state, and the number of newly diagnosed cases was 372, AIDSVu reports. As per the statistics shared by the DPH for Public Health's HIV/AIDS Surveillance Program, by 2018, around 10,567 total HIV infections were detected among Kentuckians since 1982. This shows, there has been a considerable rise in the infection rate over the past five years.

The department also noted that out of these reported infections, 63% progressed to AIDS. Reportedly, among the 3,924 cases diagnosed since 007, nearly 1,530 or 39% progressed to AIDS by June 2018. The department published its HIV Surveillance Report, 2018, where it was reported that the annual HIV diagnosis rates remained steady between 2007 and 2016, with 7.1 to 9.0 cases per 100,000 people.

However, in Kentucky, injection drug use is a leading risk factor for HIV transmission. As per a cluster investigation carried out in January 2018 in Northern Kentucky, injection drug use was higher in those newly diagnosed with HIV, reported the Kentucky Department for Public Health. Moreover, as noted above, the rate of new HIV diagnoses in white, non-Hispanic Kentuckians is much higher than anywhere in the USA (52% and 26%, respectively). This could be partially attributed to the greater percentage of the White population across the state.

The transmission of HIV disease via injection drug use is a cause of concern for the state's department of health and public health officials. The number of cases reported in Northern Kentucky only increased from 2 in 2014 to 29 in 2018, whereas statewide, HIV cases via injection drug usage rose from 22 in 2014 to 67 in 2018.

Government Initiatives

In Kentucky, STDs are regarded as a public health crisis, and the rates are inclining when the state is dealing with the opioid epidemic. In the past five years, the rate of STDs has included by 30%, while funding has declined significantly as the state’s attention is diverted towards the opioid issue.

“We are seeing an increasing number of syphilis and other STD outbreaks associated with the opioid crisis. As rates go up, funding has gone down. So while STDs have increased by 30 percent in the last five years to reach an all-time high, the amount of federal money for prevention and education has consistently gone down since 2003, [which is] critical for states like Kentucky, West Virginia and Ohio,” said the spokesperson for the National Coalition of STD Directors, Matt Prior.

Despite the decrease in funding, Kentucky state has launched several initiatives to deal with the STD crisis. the Kentucky Sexually Transmitted Disease Prevention and Control Program’s primary goal is to prevent the spread and complexities associated with STDs. This initiative is designed to extend care provision and testing/treatment facilities across the state for common STDs, including chlamydia, gonorrhea, syphilis, HIV, genital herpes, trichomoniasis, and bacterial vaginosis (BV).

In Kentucky, local health departments are required to offer the testing facility for chlamydia, gonorrhea, and syphilis and provide treatment to people diagnosed with, exposed to, or at risk of getting an STD. Patients with other STDs/STIs will receive counseling about their condition and be referred to a healthcare provider to treat the disease. A service fee is charged, but the diagnosis is kept confidential.

However, if patients cannot pay, they won’t be denied testing or treatment opportunities, as per the state law. Moreover, according to state law, those who tested positive for an STD will mandatorily receive help from local health departments, and the care providers will follow up with them. The only condition patients need to abide by is getting tested regularly.

In Jefferson County, the state’s most badly affected area in STD rates, health officials are mandated to offer testing at local STD clinics. They may also visit local correctional facilities to serve those at-risk people who cannot access health care. Unlike other states where expedited partner therapy is allowed (according to which doctors can offer prescriptions to both partners even if one of them visits them), Kentucky prohibits this practice.

Initiatives to Prevent HIV

The Kentucky Department for Public Health HIV/AIDS Section is responsible for assessing the current and future rates/impact of HIV in the state. The Kentucky Cabinet for Health and Family Services Department for Public Health (DPH) has implemented a new program in collaboration with the University of Kentucky called the Kentucky Income Reinvestment Program (KIRP).

This initiative aims to improve health care delivery across the state via disease prevention, education, treatment, and professional services for people living with HIV. This program is launched alongside the existing Ryan White HIV/AIDS funded programs already implemented in Kentucky and harm reduction programs at the statewide operating local health departments.

According to DPH commissioner Jeff Howard, "this collaborative partnership will strengthen our capabilities to combat the spread of HIV in the region. This program is a first step in creating a more innovative approach to reaching at-risk populations, strengthening our public health approaches to disease prevention and providing improved care."

This initiative will entail pilot programs to fund innovative HIV prevention projects across the state and address barriers in access to care and supportive services for high-risk populations and those living with HIV.

Apart from preventing new HIV cases, this program will also attempt to educate existing health care providers/under-training health professions' students to address mental health issues and substance use disorders hindering effective HIV and medical care.

To deal with HIV outbreaks, the state's law allows all county health departments to offer a syringe exchange program to reduce the spread of infection and reduce drug usage.

Another important initiative is Data to Care public health strategy, in which HIV surveillance data is used to identify people living with HIV who aren't in care and link them to health care services. This program is supported by the Centers for Disease Control and Prevention. It also supports them along the HIV care continuum.

Age, Gender, Social, and Ethnic Disparities

According to the 2013 Kentucky Minority Health Status Report, the rates of STDs vary by disease, ethnicity, and race in the state. National statistics reflect that racial/ethnic minorities make up the largest share of STDs. In contrast, in Kentucky, the rates of chlamydia and syphilis are higher among whites, whereas gonorrhea cases are highest among the black population. On the other hand, Hispanics reported the lowest rates of all three common STDs between 2009 and 2013.

Similarly, teen pregnancy rates are constantly declining in whites, blacks, and Hispanics in Kentucky. Overall, teen pregnancy rates are higher among blacks and Hispanics compared to whites.

Interestingly, in this state, Hispanic and black populations are younger than whites and are more likely not to own homes, earn less, and lack health insurance. But, in terms of high school graduation, Asians, blacks, whites all have similar standing.

Kentucky health officials claim that opioid and meth abuse has contributed significantly to rising STD rates statewide, but it broke all previous records in 2017. Opioid users are at a higher risk of contracting infectious diseases because they are more prone to engaging in unsafe sexual behavior, such as having unprotected sex.

HIV-Specific Data

According to the HIV Surveillance Report 2018, since the earliest reported cases of HIV back in 1982, most of the diagnoses of HIV among Kentucky residents have been reported in males with 83% (8,739 cases overall). In terms of age at the time of diagnosis, males aged 30-39 comprised 34% of all HIV cases, which is higher than any other age group among males. The same age group accounted for the highest number of cases among White males.

On the other hand, among Black males, 35% of all reported cases in 2018 were diagnosed in people aged 20-29 years, whereas 29% of cases were diagnosed in the 30-39 age group. Around 40% of HIV diagnoses among Hispanic males were identified in the 20-29 age group, and the 40-49 age group reported the lowest number of cases in this ethnicity.

White males between the 40-49 age group accounted for 23% of all reported HIV cases in 2018, while 20% of black males were diagnosed with the virus. Only 6% of blacks diagnosed with HIV were in their teens at the time of diagnosis, and 2% of white and Hispanic males were in their teens, comparatively.

A similar pattern is noted among HIV-infected females. The highest number of HIV cases (32%) were diagnosed in females aged 30-39. The rate was almost similar for Black and White females, whereas Hispanic females aged between 20 and 29 reported the highest number of cases (46%).

The highest number of cumulative HIV cases in 2018 determined the men having sex with men (MSM) as the primary exposure route as 67% of all cases among males had this cause of infection. Around 49% of adult females were exposed to the virus via heterosexual contact with an HIV-infected or high-risk individual, such as those who injected drugs.