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Poster presentation at the 17th Texas HIV/STD Conference, May 24-27, 2010.

Poster presentation at the 17th Texas HIV/STD Conference, May 24-27, 2010.

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    Epidemiology of hiv and aids in houston Epidemiology of hiv and aids in houston Presentation Transcript

    • Epidemiology of HIV and AIDS in Houston/Harris Co. Jeffrey Meyer, MD, MPH; Yvonne Lu, MD, MPH; Karen Chronister, PhD, Aaron Sayegh, PhD, MPH Bureau of Epidemiology, HIV/STD Surveillance Houston Dept. of Health and Human Services Funded by CDC Cooperative Agreement 04017 Presented at 17th Texas HIV/STD Conference May 24-27, 2010, Austin, Texas
    • • Problem Being Addressed: This poster describes the epidemiology of HIV and AIDS in Houston/Harris County, Texas through 2008. • Program Description: The Houston Department of Health and Human Services has been reporting cases of AIDS since 1983 and HIV since 1999 when it became a reportable disease in Texas. • Analysis of new AIDS cases showed a rapid increase from 1981 through 1992. With the use of highly active antiretroviral therapy (HAART) in 1996, the number of new AIDS cases precipitously dropped through 1999. Deaths also dramatically decreased. • Early in the epidemic, only 2% of the AIDS cases were in females. By 2008, 28% of new cases were female. • Trends in AIDS diagnosis show that from 1999 through 2008, AIDS cases have been increasing in Hispanic males, steady in black males and decreasing in white males. • Over the same period there has been an increase in AIDS cases in black females. • The proportion of AIDS cases by race has changed from early in the epidemic. In 2008, blacks accounted for 48% of new male AIDS cases and 77% of new female AIDS cases.
    • AIDS Diagnoses 0 200 400 600 800 1000 1200 1400 1600 1800 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 AIDS Diagnosis Year 1997 1998 1999 2000 AIDS Diagnoses in Houston/Harris Co by Sex 2001 2002 2003 2004 2005 Male Total Female 2006 2007 2008
    • Deaths in AIDS Patients 0 200 400 600 800 1000 1200 1400 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 Death Year 1996 1997 1998 1999 2000 2001 2002 Deaths in AIDS Patients Diagnosed in Houston/Harris Co by Race 2003 2004 Total White .Black 2005 Hispanic 2006 2007
    • Male AIDS Diagnoses in Houston/Harris Co by Race 1000 900 W hite 800 Black Hispanic 700 Multi/Unk/Other 600 AIDS Diagnoses 500 400 300 200 100 0 1982 1983 1985 1986 1987 1988 1990 1992 1993 1995 1997 1999 2000 2002 2004 2005 2006 2007 1981 1984 1989 1991 1994 1996 1998 2001 2003 2008 AIDS Diagnois Year
    • AIDS Diagnoses 0 50 100 150 200 250 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 AIDS Diagnosis Year 1997 1998 1999 2000 2001 Female AIDS Diagnoses in Houston/Harris Co by Race 2002 2003 2004 Black White 2005 Hispanic 2006 Multi/Unk/Other 2007 2008
    • Male AIDS Diagnoses in Houston/Harris Co by Transmission Risk 1200 Male-to-Male Sex Intravenous Drug Use Male-to-Male/IDU 1000 Heterosexual Contact with High Risk Partner Other No Reported Risk 800 AIDS Diagnoses 600 400 200 0 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 AIDS Diagnosis Year
    • Female AIDS Diagnoses in Houston/Harris Co by Transmission Risk 250 Intravenous Drug Use Heterosexual C ontact with High Risk Partner Other No Reported Risk 200 150 AIDS Diagnoses 100 50 0 1981 1982 1984 1985 1986 1988 1989 1992 1993 1996 1997 1999 2000 2001 2003 2004 2006 2007 2008 1983 1987 1990 1991 1994 1995 1998 2002 2005 AIDS Diagnosis Year
    • Proportion of Newly Diagnosed AIDS Cases in 2008 in Houston/Harris Co. by Risk and Race Male AIDS Cases (72% of Total) Risk/Race Black Hispanic White Multi/Unk/Other T otal Male-to-Male Sex 41% 59% 64% 62% 51% Intravenous Drug Use 12% 3% 4% 8% 7% Male-to-Male/IDU 7% 3% 8% 8% 6% Heterosexual Contact with High Risk Partner 20% 13% 5% 0% 14% Other/No Reported Risk 20% 22% 19% 23% 21% Total 100% 100% 100% 100% 100% Row % 48% 29% 21% 2% 100% Female AIDS Cases (28% of Total) Risk/Race Black Hispanic White Multi/Unk/Other T otal Intravenous Drug Use 14% 11% 33% 0% 15% Heterosexual Contact with High Risk Partner 61% 63% 39% 100% 59% Other/No Reported Risk 25% 26% 28% 0% 25% Total 100% 100% 100% 100% 100% Row % 77% 15% 8% 0% 100%
    • • Analysis of new HIV cases regardless of AIDS status showed a decrease in females from 1999 through 2008. In males, cases decreased from 1999 through 2003 and then increased through 2008. • In 2008, the rate of new HIV diagnoses in males was 3.3 times the rate in females with females accounting for 23% of new cases. Among males, blacks had 5.1 times the rate in whites with blacks accounting for 50% of the new male cases. In young men (13-24 yrs old) who have sex with men, the number of new HIV cases more than doubled from 1999 to 2008. • Among females, blacks had 10.1 times the rate in whites with blacks accounting for 74% of the new female cases. • The map of new HIV cases shows that HIV cases are not evenly distributed in Harris County but concentrated in specific geographic areas. • This analysis of new HIV cases in Houston/Harris Co. suggests that groups most at risk for HIV are men who have sex with men and black men and women in general.
    • HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co by Sex 1600 Male Female 1400 Total 1200 1000 HIV Diagnoses 800 600 400 200 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 HIV Diagnosis Year
    • Male HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co by Race 1200 1000 800 W hite Black HIV Diagnoses Hispanic 600 Multi/Unk/Other Total 400 200 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 HIV Diagnosis Year
    • Young Men (13-24 yrs old) Who Have Sex with Men: New HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co by Race 180 White 160 Black Hispanic Total 140 120 HIV Diagnoses 100 80 60 40 20 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 HIV Diagnosis Year
    • Female HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co. by Race 500 White 450 Black Hispanic 400 Multi/Unk/Other Total 350 300 HIV Diagnoses 250 200 150 100 50 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 HIV Diagnosis Year
    • Proportion and Rate of Newly Diagnosed HIV Cases, Regardless of AIDS Status, in 2008 in Houston/Harris Co. by Race and Sex Race Males % of Cases Population Rate Rate Females % of CasesPopulation Rate Rate (Cases/100, Relative to (Cases/100, Relative to 000/yr) Whites 000/yr) Whites White 179 18% 636200 28.1 1.0 36 12% 648764 5.5 1.0 Black 499 50% 345080 144.6 5.1 217 74% 385809 56.2 10.1 Hispanic 289 29% 868367 33.3 1.2 39 13% 796036 4.9 0.9 Multi/Unk/Other 26 3% 143652 18.1 0.6 3 1% 141808 2.1 0.4 Total 993 100% 1993299 49.8 295 100% 1972417 15.0 Race Total % of Cases Population Rate Rate Male Rate Relative to Female = 3.3 (Cases/100, Relative to 000/yr) Whites White 215 17% 1284964 16.7 1.0 Black 716 56% 730889 98.0 5.9 Hispanic 328 25% 1664403 19.7 1.2 Multi/Unk/Other 29 2% 285460 10.2 0.6 Total 1288 100% 3965716 32.5
    • Proportion of Newly Diagnosed HIV Cases, Regardless of AIDS Status, in 2008 in Houston/Harris Co. by Race, Sex, and Risk Male HIV Cases, Regardless of AIDS Status (77% of T otal) Risk/Race Black Hispanic White Multi/Unk/Other Total Male-to-Male Sex 48% 60% 75% 69% 57% Intravenous Drug Use 6% 1% 4% 0% 4% Male-to-Male/IDU 1% 1% 2% 0% 1% Heterosexual Contact with High Risk Partner 13% 12% 4% 8% 11% Other/No Reported Risk 32% 26% 14% 23% 27% Total 100% 100% 100% 100% 100% Row % 50% 29% 18% 3% 100% Female HIV Cases, Regardless of AIDS Status (23% of Total) Risk/Race Black Hispanic White Multi/Unk/Other Total Intravenous Drug Use 3% 5% 22% 0% 6% Heterosexual Contact with High Risk Partner 49% 49% 33% 100% 47% Other/No Reported Risk 48% 46% 44% 0% 47% Total 100% 100% 100% 100% 100% Row % 74% 13% 12% 1% 100%
    • HIV Diagnoses, Regardless of AIDS Status, in Adults/Adolescents by Age in Houston/Harris Co. by Sex 35% Male 30% 29% Female 29% 25% 22% 21% % of HIV Diagnoses 20% 17% 16% 16% 15% 13% 11% 10% 9% 5% 5% 5% 3% 3% 0% 13 - 19 yrs 20 - 24 yrs 25 - 29 yrs 30 - 39 yrs 40 - 49 yrs 50 - 59 yrs 60 and over Age Group
    • • Implications for HIV Prevention, Treatment, and Care: Surveillance data highlights people at highest risk of HIV/AIDS by sex, race, age, transmission risk and geography so that prevention and treatment services can be appropriately directed. • Acknowledgments: We wish to thank the staff of HIV/STD Surveillance for collecting and entering the data in eHARS and the Bureau of Community Health Statistics for plotting the GIS map. • For more information contact Jeffrey Meyer at jeffrey.meyer@cityofhouston.net or 713-832-393-4567.