Transcript Slide 1

HIV/STD Trends in Texas
Sharon K. Melville, M.D., M.P.H.
Texas Department of State Health Services
Texas Public Health Association
April 22, 2010
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Outline
 HIV Epidemiology
– National data
– Texas trends
– HIV testing/treatment
 STD Epidemiology
– Syphilis
– Chlamydia
– Gonorrhea
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USA: Reported AIDS and HIV Cases
 As of the end of 2007, 1,051,875 AIDS cases
have been reported in the United States
• Of these cases 7% were reported in Texas
 As of the end of 2007, 328,103 HIV cases have
been reported in the United States*
• Of these cases 8% were reported in Texas
*Includes 47 states, District of Columbia and 5 U.S. .territories with name-based
reporting as of December 2007
Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2006. Vol. 18
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Cumulative Reported AIDS Cases:
Top 5 States, 2007
181,461
New York
148,949
California
109,524
Florida
Texas
New Jersey
72,828
50,694
Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2006. Vol. 18
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Texas: The Big Picture
 Since 1980, >107,000 Texans have been
diagnosed with HIV/AIDS
 >41,000 Texans with HIV/AIDS have died
 As of year end 2008, 62,772 Texans were
living with HIV/AIDS
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New AIDS Cases, Deaths, and Persons Living
with AIDS: Texas, 1980-2008
6000
40000
Living with AIDS
New AIDS Cases / Deaths
New AIDS Cases
30000
4000
25000
3000
20000
15000
2000
10000
1000
5000
Deaths among AIDS Cases
0
0
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08
Year
6
Persons Living with AIDS
35000
5000
Persons Living with
HIV/AIDS: Texas, 1987
N=1,204
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Persons Living with
HIV/AIDS: Texas, 1997
N=16,184
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Persons Living with
HIV/AIDS: Texas, 2007
N=62,805
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2008 HIV/AIDS
In 2008…
• 4,293 Texans were newly-diagnosed with HIV
- 33% of Texans who first learned they had HIV in 2008
were diagnosed with AIDS within 1 year
• 2,758 Texans living with HIV progressed to AIDS
• 1,280 Texans with HIV/AIDS died
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Newly-diagnosed HIV Cases:
Texas, 1999-2008
7000
HIV
AIDS
6000
Cases
5000
4000
3000
2000
1000
0
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Year
11
Newly-diagnosed HIV Case Rates by Race:
Texas, 1999-2008
100
Hispanic
Cases per 100,000
90
Af. American
White
Other
80
70
60
50
40
30
20
10
0
99
00
01
02
03
04
05
06
07
08
Year of Diagnosis
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Race/Ethnicity of New HIV/AIDS Case:
Texas, 2008
Texas Population
n=24,383,647
HIV/AIDS Cases
n=4,293
White
29%
48%
African American
43%
11%
36%
Hispanic
26%
5%
Other/Unknown
2%
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Newly-diagnosed HIV Case Rates by Sex:
Texas, 1999-2008
45
Females
Cases per 100,000
40
Males
35
30
25
20
15
10
5
0
99
00
01
02
03
04
05
06
07
08
Year of Diagnosis
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Race/Ethnicity of New HIV/AIDS Cases:
Texas, 2008
Males
n=3,314
Hispanic
32%
Females
n=979
Hispanic
20%
AfricanAmerican
Other
38%
2%
Other
2%
AfricanAmerican
59%
White
19%
White
28%
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Newly-diagnosed HIV Case Rates by Age:
Texas, 1999-2008
0-14
15-24
25-34
35-44
45+
70
Cases per 100,000
60
50
40
30
20
10
0
99
00
01
02
03
04
05
06
07
08
Year of Diagnosis
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Age of New HIV/AIDS Cases:
Texas, 2008
25-34
30%
15-24
20%
0-14
<1%
45+
23%
35-44
27%
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HIV/AIDS Cases by Transmission Category:
Texas, 2008
Females
Males
3%
18%
12%
7%
82%
78%
Men who have sex with Men (MSM)
Injection drug use (IDU)
Heterosexual contact*
MSM & IDU
* Heterosexual contact with person known to have or to be at high risk for HIV infection
** Cases with an unknown or other mode of transmission are not included
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Perinatally Exposed and Infected Children:
Texas, 1999-2008
Infected
450
8
400
7
350
6
300
5
250
n=13
200
4
n=12
3
150
n=9
100
n=7
50
2
Percent Infected
No. of Perinatal
Exposures
Exposures
1
0
0
99
00
01
02
03
04
05
06
07
08
Year of Birth
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HIV Testing and Care
 An estimated 16,686 people are living with HIV in
Texas and are unaware of their status (undiagnosed)
 Approximately one-third of persons living with HIV
in 2007 had unmet need for care
 33% of Texans who first learned they had HIV in
2008 were diagnosed with AIDS within 1 year
 Only 14% of Texans had an HIV test last year
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Reportable STDs in Texas
 Syphilis
Chlamydia
Gonorrhea
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Primary and Secondary Syphilis Cases:
Texas, 1971-2009
7,000
6,000
Cases
5,000
4,000
3,000
2,000
1,000
0
71
73
75
77
79
81
83
85
87
89
91
93
95
97
99
01
03
05
07
09
Year
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P&S Syphilis Case Rates by Race/Ethnicity:
Texas, 1995-2009
40
Cases per 100,000
35
Af. American
Hispanic
White
30
25
20
15
10
5
0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
23
Cases per 100,000
P&S Syphilis Case Rates* by Year of Report
and Sex: Texas, 1998-2009
10
9
8
7
6
5
4
3
2
1
0
Male
Female
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
24
* Rate = Cases per 100,000 population.
P&S Syphilis Cases by Sex and MSM:
Texas, 2003-2009
1,800
1,600
MSM P&S
Male P&S
Female P&S
1,400
492
Cases
1,200
451
1,000
265
800
600
400
200
0
196
162
180
245
181
175
472
2004
309
537
451
317
384
459
484
479
503
615
2005
2006
2007
2008
2009
231
269
126
2002
257
2003
Year
25
P&S Syphilis Case Rates by County:
Texas, 2009
Rates
0.0 Cases/100,000
0.1 to 3.9 Cases/100,000
4.0 to 9.9 Cases/100,000
10 or More Cases/100,000
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Congenital Syphilis Cases:
Texas, 1991-2009
400
350
Cases
300
250
200
150
100
50
0
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Year
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Chlamydia Cases:
Texas, 1988-2009
120,000
100,000
Cases
80,000
60,000
40,000
20,000
0
88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Year
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Cases
Chlamydia Cases by Year of Report:
Texas, 2000-2009
110,000
100,000
90,000
80,000
70,000
60,000
50,000
40,000
30,000
20,000
10,000
0
Males/Unk All Ages
Females Other Ages
Females Age 15-24
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Year
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Chlamydia Case Rates Among Women by
Race/Ethnicity: Texas, 1991-2009
1,800
Cases per 100,000
1,600
Af. American
1,400
1,200
1,000
Hispanic
800
600
400
White
200
0
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Year
30
Chlamydia Case Rates by County:
Texas, 2009
Rates
0 Cases/100,000
1 to 299 Cases/100,000
300 to 499 Cases/100,000
500 or more Cases/100,000
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Cases
Gonorrhea Cases:
Texas, 1971-2009
100,000
90,000
80,000
70,000
60,000
50,000
40,000
30,000
20,000
10,000
0
71 73 75 77 79 81 83 85 87 89 91 93 95 97 99 01 03 05 07 09
Year
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Gonorrhea Case Rates by Race/Ethnicity:
Texas, 1991-2009
1,800
Cases per 100,000
1,600
White
Af. American
Hispanic
1,400
1,200
1,000
800
600
400
200
0
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Year
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Gonorrhea Cases by Age Group and
Race/Ethnicity: Texas, 2009
All Other
Ages, AA
17%
All Other
Ages, H
9%
All Other
Ages, W
6%
All Ages,
Oth/Unk
6% 15-24, W
10%
15-24, AA
36%
15-24, H
16%
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Gonorrhea Case Rates by County:
Texas, 2009
Rates
0 Cases/100,000
1 to 49 Cases/100,000
50 to 149 Cases/100,000
150 or more Cases/100,000
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Acknowledgements
 HIV/STD surveillance staff at local and
regional health departments across the state
and at the central DSHS HIV/STD program
who collected the data used in this presentation
 Ed Weckerly and Jennifer Chase of the DSHS
TB/HIV/STD Epidemiology and Surveillance
Branch who analyzed the data and prepared
the slides
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Questions?
 Contact Information:
Sharon K. Melville, M.D., M.P.H.
Texas Department of State Health Services
Manager, TB/HIV/STD Epidemiology and
Surveillance Branch
[email protected]
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