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HIV/AIDS in Special Population Groups in Texas


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HIV/AIDS in Special Population Groups in Texas

  1. 1. Miranda Fanning, MPH TB/HIV/STD Epidemiology and Surveillance Texas Department of State Health Services Women with HIV in Texas
  2. 2. Outline <ul><li>Overview </li></ul><ul><li>Demographic Makeup </li></ul><ul><li>Risk Distribution </li></ul><ul><li>Testing Behaviors </li></ul><ul><li>Perinatal Surveillance </li></ul><ul><li>Future Steps </li></ul>
  3. 3. Overview <ul><li>Women account for 26% of all adult and adolescent HIV cases in the US* </li></ul><ul><li>Nationally, HIV is: </li></ul><ul><ul><li>5 th leading cause of death in women, 35-44* </li></ul></ul><ul><ul><li>6 th leading cause of death in women, 25-34* </li></ul></ul><ul><li>Biologically, women are more likely to be infected with HIV during sex** </li></ul><ul><li>* “CDC HIV/AIDS Facts Sheet” </li></ul><ul><li>** “HIV/AIDS Policy Facts Sheet” </li></ul>
  4. 4. Overview <ul><li>As of the end of 2008, 13,751 women were living with HIV/AIDS in Texas </li></ul><ul><ul><li>11 women per 10,000 are living with HIV </li></ul></ul><ul><ul><li>22% of total living HIV cases </li></ul></ul><ul><li>980 new female HIV cases diagnosed in 2008 </li></ul>
  5. 5. Women with HIV, by year of diagnosis, Diagnosed 2000-2008
  6. 6. Demographic Makeup: Women with HIV, by Race/Ethnicity, Diagnosed 2000-2008
  7. 7. Demographic Makeup: HIV Cases by Race/Ethnicity and Sex, Diagnosed 2000-2008
  8. 8. Demographic Makeup: Women with HIV, by Age Group, Diagnosed 2000-2008
  9. 9. Demographic Makeup: Adult HIV Cases, by Age and Sex, Diagnosed 2000-2008
  10. 10. Demographic Makeup: Women with HIV, by Age and Race/Ethnicity, Diagnosed 2000-2008
  11. 11. <ul><li>Risk factor information is captured for reported cases </li></ul><ul><li>Hierarchical approach used to determine which risk factor was the primary mode of transmission </li></ul><ul><li>Only one risk category determined for each individual </li></ul><ul><li>Primary mode of transmission for females inlcudes: </li></ul><ul><ul><li>Intravenous Drug Use </li></ul></ul><ul><ul><li>Heterosexual sex with </li></ul></ul><ul><ul><ul><li>An intravenous drug user </li></ul></ul></ul><ul><ul><ul><li>A bisexual male </li></ul></ul></ul><ul><ul><ul><li>A male with other risk factors </li></ul></ul></ul><ul><ul><ul><li>A male with document HIV infection, risk unspecified </li></ul></ul></ul><ul><ul><li>Other Less Common Risk Factors </li></ul></ul>Collecting Risk Information
  12. 12. Risk Factor Data Limitations <ul><li>To be categorized in Heterosexual Risk category, women must have a partner with: </li></ul><ul><ul><li>A documented infection; or </li></ul></ul><ul><ul><li>Another known risk factor </li></ul></ul><ul><li>If a case does not have a risk factor or does not meet the qualifications for Heterosexual Risk category, risk must be imputed </li></ul><ul><li>In 2008, 39% of female cases required risk imputation </li></ul>
  13. 13. Risk Distribution of Women with HIV, Diagnosed 2000-2008
  14. 14. Risk Distribution: Women with HIV, by Race/Ethnicity, Diagnosed 2000-2008
  15. 15. Risk Distribution: Women with HIV, by Age, Diagnosed 2000-2008
  16. 16. Testing Behaviors: Women with HIV, Time between HIV and AIDS Diagnosis, Initial diagnosis 2000-2008
  17. 17. Testing Behaviors <ul><li>Incidence Estimates indicated 50% of women diagnosed in 2008 were long term late testers </li></ul>
  18. 18. Perinatal Surveillance <ul><li>13,751 HIV+ women living in Texas </li></ul><ul><ul><li>8,201 (60%) are women of childbearing age (15-44 years) </li></ul></ul><ul><ul><li>361 (3%) delivered an HIV exposed infant </li></ul></ul>
  19. 19. Perinatally Exposed and Infected Children, Texas, 1999-2008
  20. 20. Perinatal Surveillance: Timing of HIV Diagnosis among HIV+ Women Delivering an Exposed Child, 2008 *Note: Excluding 3 women with unknown timing of HIV diagnosis
  21. 21. Conclusions <ul><li>Sub-populations of women with HIV show unique characteristics that warrant targeted approaches </li></ul><ul><li>Primary mode of transmission varies depending on age and race in HIV positive women in Texas </li></ul><ul><li>Education on early and routine testing in women would be advantageous </li></ul><ul><li>Testing during pregnancy is vital to reducing perinatal HIV transmission </li></ul>
  22. 22. Future Steps- Evaluation and Analysis <ul><li>Addition of presumed heterosexual category </li></ul><ul><li>Evaluate socio-economic characteristics to identify the proportion of HIV positive individuals in low-income communities </li></ul><ul><li>Additional research on testing behavior and cues for testing in women </li></ul>
  23. 23. Questions
  24. 24. Acknowledgements <ul><li>Presentation contributors: </li></ul><ul><ul><ul><li>Elvia Ledezma, MPH </li></ul></ul></ul><ul><ul><ul><li>Margaret Hawthorne, MPH </li></ul></ul></ul>