HIV/AIDS Epidemiology Partnership 1

1
HIV/AIDS EpidemiologyPartnership 1

• Escambia, Okaloosa,
• Santa Rosa and Walton Counties

Excluding Dept. of Corrections
Data as of 12/31/2004
2
HIV Case Reporting

• Reflects good demographic information
• Tends to represent more recent infections
• Now includes all reported HIV cases regardless of
  AIDS status
• No retroactive reporting prior to July 1997
• Patients are tested on a self-selected basis
• Anonymous tests are not reported
• Data represents a minimum estimate of HIV
  prevalence

3
HIV Prevalence Estimates and Cumulative HIV
AIDS Cases, Partnership 1, through 2004
4
AIDS Cases, Deaths and Persons Living with AIDS
(PLWA), by YearPartnership 1, 1985-2004
AIDS cases by year of diagnosis. AIDS deaths by
year of death. The AIDS surveillance case
definition was expanded for adults/adolescents in
1993. Data as of 03/20/05.
5
Presumed Living MSM HIV/AIDS Cases by Zip Code,
Partnership 1 through 2004 (data as of 01/31/05)
Presumed Living MSM HIV/AIDS Cases
0
1 - 20
21 - 40
Over 40
N557
NIRs are not redistributed. Includes MSM/IDU
cases.
6
Presumed Living IDU HIV/AIDS Cases by Zip Code,
Partnership 1, through 2004 (data as of 01/31/05)
Presumed Living IDU HIV/AIDS Cases
0
1 - 5
5 - 10
Over 10
N154
NIRs are not redistributed. Includes MSM/IDU
cases.
7
Presumed Living Heterosexual HIV/AIDS Cases by
Zip Code, Partnership 1, through 2004 (data as of
01/31/05)
Presumed Living Heterosexual HIV/AIDS Cases
0
1 - 20
21 - 40
Over 40
N358
NIRs are not redistributed.
8
Presumed Living HIV/AIDS Cases by Zip Code and
Race/Ethnicity Partnership 1, through 2004 (data
as of 01/31/05)
N1,189
Total includes all races, some which are not on
map.
9
Presumed Living HIV/AIDS Cases by Zip Code and
Sex Partnership 1, through 2004 (data as of
01/31/05)
N1,189
10
AIDS Case Rate per 100,000 Population by Year
of Report Partnership 1, 1995-2004
Population rates calculated from annual
population estimates.
11
HIV Case Rate per 100,000 Population (HIV
regardless of AIDS status) By Year of Report,
Partnership 1, 1998-2004
Population rates calculated from annual
population estimates. Data does not reflect HIV
incidence. HIV data includes those cases that
have converted to AIDS. These HIV cases cannot
be added with AIDS cases to get combined totals
since the categories are not mutually exclusive.
12
AIDS Cases and HIV (regardless of AIDS status)
Cases By Year of Report, Partnership 1, 1985-2004
The AIDS surveillance case definition was
expanded for adults/adolescents in 1993. HIV
infection reporting was implemented July 1997.
Comment Active surveillance for AIDS cases
results in 90 of diagnosed cases being
reported. Reported HIV cases tend to reflect
more recent transmission than AIDS cases. HIV
(regardless of AIDS status) cases includes those
cases that have converted to AIDS. These HIV
cases cannot be added with AIDS cases to get
combined totals since the categories are not
mutually exclusive. This is a preferred way to
monitor temporal trends in HIV infection. HIV
case reporting has greatly augmented the ability
to characterize the epidemic.
13
Resident HIV/AIDS Deathsby Year, Partnership 1,
1995-2003
Source Office of Vital Statistics, Death
CertificatesA change in coding of HIV/AIDS
deaths from ICD-9 to ICD-10, effective in 1999,
has resulted in an estimated increase of
approximately 14 in the annual number of
HIV/AIDS deaths.
14
Resident HIV/AIDS Death Rates Per 100,000
Population, by Race/Ethnicity, Partnership 1, 2003
MALES Rate ratios BlacksWhites, 121
HispanicsWhites, 01
Comment In 2003, black males were 12 times as
likely as white males to die of HIV/AIDS. Source
Office of Vital Statistics (Death Data) DOH,
Office of Planning, Evaluation and Data Analysis
(2003 Population Estimates)
15
Adult AIDS Cases by Sex and Year of
Report Partnership 1, 1995-2004
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Adult HIV Cases (regardless of AIDS status) by
Sex and Year of Report Partnership 1, 1998-2004
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
17
Partnership 1
Adult HIV Cases (regardless of AIDS status)
by Sex, 2004 (N93)
Adult AIDS Cases by Sex, 2004 (N91)
2000 Adult Census Population 50 Females and
50 Males
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
18
Adult AIDS Cases by Race/Ethnicity and Year of
Report Partnership 1, 1995-2004

• Factors Affecting Disparities
• Late diagnosis of HIV.
• Access to/acceptance of care.
• Delayed prevention messages.
• Stigma.
• Non-HIV STDs in the community.
• Prevalence of injection drug use.
• Complex matrix of factors related to
  socioeconomic status

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Adult Male AIDS Cases by Race/Ethnicity and Year
of Report Partnership 1, 1995-2004
20
Adult Female AIDS Cases by Race/Ethnicity and
Year of Report Partnership 1, 1995-2004
21
Adult HIV Cases (regardless of AIDS status) by
Race/Ethnicity and Year of Report Partnership 1,
1998-2004
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
22
Percent of Adult Male HIV Cases (regardless of
AIDS status) by Race/Ethnicity and Year of
Report Partnership 1, 1998-2004
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
23
Percent of Adult Female HIV Cases (regardless of
AIDS status) by Race/Ethnicity and Year of
Report Partnership 1, 1998-2004
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
24
Reported Adult AIDS Case Rates Per 100,000
PopulationBy Sex and Race/Ethnicity, Partnership
1, 2004
2004 FL Population Estimates, DOH, Office of
Planning, Evaluation and Data Analysis
25
Reported Adult HIV Case RatesPer 100,000
Population(regardless of AIDS status)By Sex and
Race/Ethnicity, Partnership 1, 2004
2004 FL Population Estimates, DOH, Office of
Planning, Evaluation and Data Analysis HIV data
does not reflect HIV incidence. HIV data includes
those cases that have converted to AIDS. These
HIV cases cannot be added with AIDS cases to get
combined totals since the categories are not
mutually exclusive.
26
Adult HIV and AIDS Cases, by Race/Ethnicity
vs. Partnership 1 Population, 2004
HIV (regardless of AIDS)
2004 Partnership 1 Population
AIDS
N 93
N 91
N566,964
2004 Partnership 1 Population, DOH, Office of
Planning, Evaluation and Data Analysis. Other
includes Asian/Pacific Islander, or American
Indian/Alaska Native, Multiracial or Other
race. HIV data includes those cases that have
converted to AIDS. These HIV cases cannot be
added with AIDS cases to get combined totals
since the categories are not mutually exclusive.
27
Adult AIDS Casesby Sex and Race/EthnicityPartner
ship 1, 2004
Females (N30)
Males (N61)
28
Adult HIV Cases(regardless of AIDS status)by
Sex and Race/EthnicityPartnership 1, 2004
Males (N62)
Females (N31)
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
29
Living HIV and AIDS Casesby Sex and Race
Ethnicity Partnership 1, through 2004
Males (N849)
Females (N325)
Other includes Asian/Pacific Islander, American
Indian/Alaska Native and Unknown races.
30
Percent of Adult AIDS Cases By Selected Age
Groups Partnership 1, 1995-2004
31
Percent of Adult HIV Cases (regardless of AIDS
Status) By Selected Age Groups, Partnership 1,
1998-2004
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
32
Percent of Adult AIDS Cases by Sex and Age Group
at Diagnosis Partnership 1, 2004
Males (N61)
Females (N30)
Percent
Percent
33
Percent of Adult HIV Cases (regardless of AIDS
status) by Sex and Age Group at Diagnosis
Partnership 1, 2004
Males (N62)
Females (N31)
Percent
Percent
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
34
Acronyms

• MSM - Men who have sex with men (includes
  homosexual and bisexual).
• IDU - Injecting drug user. This category assumes
  that needle-sharing has taken place.
• Hetero - Persons infected by a partner of the
  opposite sex.
• Blood - Persons exposed through receipt of
  contaminated blood/blood products, transplanted
  tissue/organs or artificial insemination. This
  category includes both confirmed and suspect
  cases pending investigation.
• NIR - No identified risk. Information regarding
  risk for HIV was unknown, not determined or
  denied. This information is updated when
  determined.

35
Adult AIDS Cases by Exposure Category and Year of
Report Partnership 1, 1995-2004
Note NIRs redistributed.
36
Adult HIV Cases (regardless of AIDS status) by
Exposure Category and Year of Report
Partnership 1, 1998-2004
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
Note NIRs redistributed.
37
Cumulative Adult AIDS Cases by Mode of Exposure
and Sex Partnership 1, Data through 2004
Males (N1,243)
Females (N301)
Note NIRs redistributed.
38
Total Adult Male Cases by Mode of Exposure and
Sex Partnership 1, 2004
HIV (regardless of AIDS status) (N62)
AIDS (N61)
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
Note NIRs redistributed.
39
Total Adult Female Cases by Mode of Exposure and
SexPartnership 1, 2004
HIV (regardless of AIDS status) (N31)
AIDS (N30)
HIV data includes those cases that have converted
to AIDS. These HIV cases cannot be added with
AIDS cases to get combined totals since the
categories are not mutually exclusive.
Note NIRs redistributed.
40
Annual Prevalence Adult Male HIV/AIDS Cases By
Mode of Exposure (NIRs redistributed)
Partnership 1, Reported 1995-2004
Adjustments have been made to account for the
redistribution of cases with no identified risk
(NIR). HIV infection reporting was
implemented July 1997. Comment PLWHAs represent
those in need of care and secondary prevention
initiatives to prevent further transmission. The
increase in number of PLWHAs is due to a
combination of factors survival time is
increasing, those recently reported are more
likely to be alive, and the annual number of
persons reported with HIV or AIDS exceeds the
number of deaths. MSM is the predominant mode of
exposure. MSM cases are increasing the fastest.
(data as of 03/20/05).
41
Annual Prevalence Adult Female HIV/AIDS Cases By
Mode of Exposure (NIRs redistributed)
Partnership 1, Reported 1995-2004
Adjustments have been made to account for the
redistribution of cases with no identified risk
(NIR). HIV infection reporting was
implemented July 1997. Comment PLWHAs represent
those in need of care and secondary prevention
initiatives to prevent further transmission. The
increase in number of PLWHAs is due to a
combination of factors survival time is
increasing, those recently reported are more
likely to be alive, and the annual number of
persons reported with HIV or AIDS exceeds the
number of deaths. Heterosexual cases are
increasing the fastest. (data as of 03/20/05).
42
Percentage of Reported HIV/AIDS Cases By Age,
Partnership 1, 2000 Through 2004
By Age at Diagnosis HIV cases plus AIDS cases,
Diagnosed from 2000 2004, N946
Comment Age at diagnosis among recently
diagnosed HIV/AIDS cases (alive or dead) is most
useful for planning primary HIV prevention.
However, the distribution of living HIV/AIDS
cases by current age, which is shifted towards
the older age groups due to survival time, is
most useful to focus on prevention for
positives, i.e., secondary prevention. It is
also useful to target those in need of care and
treatment and support for medication adherence.
13-29 yr 22 by age at diagnosis 10 by
current age 50 yr 11 by age at diagnosis. 19
by current age.
By Current Age PLWHAs through 2004, N1,197.


43
Living HIV/AIDS CasesBy Sex and Race/Ethnicity
Partnership 1, Data through 2004
Males N838
Females N337
Data as of March 20, 2005
44
Living Adult Male HIV/AIDS Cases (PLWHAs) By
Race/Ethnicity and Mode of Exposure Partnership
1, Data through 2004
White, non-Hispanic N(519)
Black, non-Hispanic N(290)
Hispanic N(23)
Heterosexual
MSM
IDU
Comment Among male PLWHAs, the distribution of
risk among blacks differs from that among whites
and Hispanics.
Adjustments have been made to redistribute NIR
cases. Data as of March 20, 2005.
45
Living Adult Female HIV/AIDS Cases (PLWHAs) By
Race/Ethnicity and Mode of Exposure Partnership
1, Data through 2004
White, non-Hispanic N(124)
Black, non-Hispanic N(202)
Hispanic N(7)
IDU
Hetero.
Comment Among female PLWHAs, the distribution of
risk among whites differs from that among blacks
and Hispanics.
Adjustments have been made to redistribute NIR
cases. Data as of March 20, 2005.
46
Some Useful Links
CDC HIV/AIDS Surveillance Reports (State and
Metro Data) http//www.cdc.gov/hiv/stats/hasrlink
.htm
MMWR (Special Articles on Diseases,
Including HIV/AIDS) http//www.cdc.gov/mmwr/
U.S. Census Data (Available by State,
County) http//www.census.gov
Florida Dept. of Health, Bureau of HIV/AIDS
Website (Slide Sets, Fact Sheets, Monthly
Surveillance Report, Counseling Testing Data,
etc., etc.) http//www.doh.state.fl.us/disease_ct
rl/aids/index.html
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• The reason for collecting, analyzing and
  disseminating information on a disease is to
  control that disease. Collection and analysis
  should not be allowed to consume resources if
  action does not follow.

--Foege WH et al. Int. J of Epidemiology 1976
529-37
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For Florida HIV/AIDS Surveillance Data Contact
[phone] Lorene Maddox, MPH Ext.
2613 Tracina Bush Ext. 2612 Deslyn
Thornhill, MPH Ext. 2517 Internet
http//www.doh.state.fl.us/disease_ctrl/aids/index
.html Intranet http//dohiws.doh.state.fl.us