The document summarizes HIV testing and treatment patterns among Hispanics in Texas based on an analysis of multiple data sources. It finds that compared to other groups, Hispanics in Texas have higher rates of being unaware of their HIV status, not getting tested regularly, delaying care after diagnosis, and progressing to AIDS within a year. Barriers identified among Hispanic males include stigma, limited testing locations/hours, and cultural factors like views on masculinity and sexuality. Effective interventions are needed to increase HIV testing and earlier treatment initiation among Hispanics in Texas.
Dr. Kathleen Brady of Philadelphia's AIDS Activities Coordinating Office (AACO) gave this presentation at the January 9, 2013 Comprehensive Planning Committee meeting.
Global Medical Cures™ | HIV Among Women
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
2013 Council of State and Territorial Epidemiologists Annual ConferenceKellieWatkins1
Abstract for A Spatial-Temporal Relationship between New Diagnoses of HIV and Social Determinants of Health by Census Tract in Houston/Harris County: 2000 and 2010
Kathleen Brady from the Philadelphia Department of Public Health presented her annual updated on the HIV Epidemic in Philadelphia at a February 2015 combined meeting of the Philadelphia Ryan White Part A Planning Council and the HIV Prevention Planning Group.
Kathleen Brady - HIV in Philadelphia (Annual Epidemiological Presentation)Office of HIV Planning
On April 27, 2016, Kathleen Brady of the Philadelphia AIDS Activities Coordinating Office (AACO) presented her annual review of the HIV Epidemic in Philadelphia and the surrounding areas.
Dr. Kathleen Brady of Philadelphia's AIDS Activities Coordinating Office (AACO) gave this presentation at the January 9, 2013 Comprehensive Planning Committee meeting.
Global Medical Cures™ | HIV Among Women
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
2013 Council of State and Territorial Epidemiologists Annual ConferenceKellieWatkins1
Abstract for A Spatial-Temporal Relationship between New Diagnoses of HIV and Social Determinants of Health by Census Tract in Houston/Harris County: 2000 and 2010
Kathleen Brady from the Philadelphia Department of Public Health presented her annual updated on the HIV Epidemic in Philadelphia at a February 2015 combined meeting of the Philadelphia Ryan White Part A Planning Council and the HIV Prevention Planning Group.
Kathleen Brady - HIV in Philadelphia (Annual Epidemiological Presentation)Office of HIV Planning
On April 27, 2016, Kathleen Brady of the Philadelphia AIDS Activities Coordinating Office (AACO) presented her annual review of the HIV Epidemic in Philadelphia and the surrounding areas.
Reaching the Millennial Generation about HIV/AIDSYTH
What do young people see as the barriers and motivators to HIV prevention and treatment today? The Kaiser Family Foundation's (KFF) 2017 National Survey of Young Adults on HIV/AIDS reveals that stigma persists, there are significant gaps in knowledge, and many are unaware of the latest tools available. However, social media campaigns can help inform, change attitudes, and engage youth advocates in the movement to end HIV. Greater Than AIDS (GTA), a public information resource from KFF, develops campaigns that educate, empower, and motivate youth into action. Frequently featuring community ambassadors, GTA's resources reach priority populations through tailored messaging that answers common questions about HIV basics, testing, PrEP, and treatment. Attendees in this session will gain nuanced insight into the HIV information needs of today's youth, and explore how to engage and empower them in HIV prevention strategies.
26th International Papillomavirus Conference: Satellite Symposium
Enhancing HPV Prevention among Indigenous Populations: International Perspectives on Health and Well-Being
Montreal, Quebec
July 5, 2010
Panel 1 , Researching the Burden of HPV Disease, Immunization, and Cervical Screening among Indigenous Populations.
A new CDC report finds that hepatitis A infections in the U.S. have risen by 294% since 2015. In nine states and Washington, D.C., the increase in rates was 500% compared to previous years. Hepatitis A, which is the most common cause of viral hepatitis worldwide, is spread fecal-orally after contact with an infected person but is preventable through a vaccine. In the new report, which looked at transmissions between 2016 and 2018, the CDC received 15,000 reports of infections in the U.S.: People who reported drug use or homelessness made up the majority of those who had infections, followed by cases among men who have sex with men and among people who ate contaminated food.
Leandro Mena, MD, MPH
Chair and Professor of Population Health Science
Department of Population Health Science
University of Mississippi Medical Center
Get smart - New ways of looking at HIV data.UNAIDS
Using data from the 2009 AIDS epidemic update and UNGASS 2010 country progress reports, Get smart provides the most recent estimates of the epidemic’s scope and human toll and explores new trends in the epidemic’s evolution using innovative graphical representations.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Jens Lundgren, CHIP
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Julia del Amo, Instituto de Salud Carlos III, Madrid
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Basil Donovan from NCHECR addresses the global context; Australian trends in infectious syphilis; enhanced surveillance for syphilis; and the effects of syphilis on HIV infection, at AFAO's syphilis forum in May 2009.
Reaching the Millennial Generation about HIV/AIDSYTH
What do young people see as the barriers and motivators to HIV prevention and treatment today? The Kaiser Family Foundation's (KFF) 2017 National Survey of Young Adults on HIV/AIDS reveals that stigma persists, there are significant gaps in knowledge, and many are unaware of the latest tools available. However, social media campaigns can help inform, change attitudes, and engage youth advocates in the movement to end HIV. Greater Than AIDS (GTA), a public information resource from KFF, develops campaigns that educate, empower, and motivate youth into action. Frequently featuring community ambassadors, GTA's resources reach priority populations through tailored messaging that answers common questions about HIV basics, testing, PrEP, and treatment. Attendees in this session will gain nuanced insight into the HIV information needs of today's youth, and explore how to engage and empower them in HIV prevention strategies.
26th International Papillomavirus Conference: Satellite Symposium
Enhancing HPV Prevention among Indigenous Populations: International Perspectives on Health and Well-Being
Montreal, Quebec
July 5, 2010
Panel 1 , Researching the Burden of HPV Disease, Immunization, and Cervical Screening among Indigenous Populations.
A new CDC report finds that hepatitis A infections in the U.S. have risen by 294% since 2015. In nine states and Washington, D.C., the increase in rates was 500% compared to previous years. Hepatitis A, which is the most common cause of viral hepatitis worldwide, is spread fecal-orally after contact with an infected person but is preventable through a vaccine. In the new report, which looked at transmissions between 2016 and 2018, the CDC received 15,000 reports of infections in the U.S.: People who reported drug use or homelessness made up the majority of those who had infections, followed by cases among men who have sex with men and among people who ate contaminated food.
Leandro Mena, MD, MPH
Chair and Professor of Population Health Science
Department of Population Health Science
University of Mississippi Medical Center
Get smart - New ways of looking at HIV data.UNAIDS
Using data from the 2009 AIDS epidemic update and UNGASS 2010 country progress reports, Get smart provides the most recent estimates of the epidemic’s scope and human toll and explores new trends in the epidemic’s evolution using innovative graphical representations.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Jens Lundgren, CHIP
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Julia del Amo, Instituto de Salud Carlos III, Madrid
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Basil Donovan from NCHECR addresses the global context; Australian trends in infectious syphilis; enhanced surveillance for syphilis; and the effects of syphilis on HIV infection, at AFAO's syphilis forum in May 2009.
HIV Nursing and Home & Community Care Conference griehl
This joint presentation by Susann Nasewich and Greg Riehl will describe HIV Nursing as it relates to pre and post test counseling, and what is important to know for home and community care nurses and aides.
Estimating HIV prevalence and risk behaviors of transgender persons in the Un...Santé des trans
Cet article, paru en 2008 dans la revue AIDS and Behavior, présente une synthèse des données disponibles dans la littérature scientifique concernant la prévalence du VIH parmi les trans aux Etats-Unis et leurs facteurs de risque comportementaux par rapport à la transmission du virus.
Dr. Kathleen Brady of Philadelphia's AIDS Activities Coordinating Office (AACO) gave this presentation at the January 9, 2013 Comprehensive Planning Committee meeting.
Running Head: COMMUNITY ANALYSIS 1
Community Analysis
The most prevalent risk factors among racial and ethnic minorities are unprotected vaginal or anal sex, inadequate sex education, improving access to prevention and care services and drug use. Jackson, MS has a population of 173,212, with median household income of $32,250. Poverty is one of the major contributing factors to the risky behaviors and the rise of HIV infections within racial/ethnic minority youths. The residents with incomes below the poverty level in Jackson, MS by 2015 was 39.9%, and those with income below 50% of the poverty level was 19.2%, the breakdown is between ages 13 to 19 years of poor residents in Jackson, MS and the percentage is below half of poverty level of 20%. The most common race or ethnicity living below the poverty line in Jackson, MS is Black or African American, followed by White and Hispanic or Latino. The state of homelessness is on the rise and many of these shelters in Jackson, MS now have waiting lists with majority of its occupants are racial/ethnic minority. Even with the waiting lists, those that need to be sheltered will have to call ahead to confirm (City Data, 2015).
Mississippi is one of the most rustic states in the United States and its population is perhaps the poorest. According to the 2010 Census, Mississippi has a population of 2,967,297 people, with a racial distribution of 59% white, 37% black, 3% Hispanic, and 2% other. Mississippi ranks second in the nation (after the District of Columbia) for the highest proportion of African Americans. Through U.S. Census Bureau 2011 American Community Surveys, Mississippi levels the first in the country for the number of people living in poverty (22.6% of the total population) and the lowest middle household revenue ($36,919) (United State Census Bureau, 2011). According to the 2011 National HIV Surveillance Report, Mississippi had the 4th highest rate of HIV infection in the United States. The state’s capital city, Jackson, had the third highest rate of HIV diagnoses within aged 13 to 19 years and the eighth highest AIDS diagnosis by metropolitan statistical area (MSA) in 2011. For the past twenty years, numbers of peoples living with HIV in Mississippi has risen yearly. By the end of December 31, 2013, there was approximately 10,473 Mississippians living with HIV (National HIV Surveillance Report, 2013).
Secondary data
Jackson, MS the state’s capital city and with the most new HIV disease cases are identified in the West Central Public Health District V, which includes the metropolitan Jackson Hinds area, where 47% of all persons with HIV disease in Mississippi reside presently (Mississippi State Department of Health, 2015). According to data for states and metropolitan areas, it’s shown that racial and ethnic minority youths aged between 13 to 19 years rank 4th in the diagnose of HIV at 44.7%. The education b ...
Dr. Kathleen Brady (AACO)'s annual epidemiological update. This presentation was given to the Philadelphia EMA Ryan White Planning Council on Thursday, February 20, 2014.
Il s'agit d'une présentation powerpoint de la Directrice du Center Of Excellence For Transgender HIV Prevention,UCSF (2009)
Il y est question d'épidémiologie, bien évidemment, dans un contexte où n'existe aux Etats-Unis (comme en France) aucune donnée nationale sur le nombre de personnes trans, et donc encore moins sur le nombre de trans vivant avec le VIH. La présentation donne des pistes de recommandation concernant la production de données épidémiologiques spécifiques.
La présentation est également l'occasion de passer en revue les enjeux et déterminants de santé liés à l'épidémie de VIH chez les trans, et plus largement à leur état de santé.
Objectifs de l'épidémiologie du VIH chez les personnes trans :
- comprendre les tendances épidémiologiques en cours dans les populations transgenres ;
- comprendre les facteurs favorisant le risque de dissémination du VIH parmi les femmes transgenres
(déterminants négatifs) ;
- comprend les facteurs protecteurs contre les "facteurs négatifs du point de vue de la santé" (negative health outcomes) parmi les transgenres (déterminants positifs).
HIV/AIDS: Hispanic/Latino Disparities and Policy Recommendations
Daniel Santibanez, MPH, Department of Public Health, University of North Florida
Donna T. Jones, MS, RD, LD/N, Medical Nutrition Therapy of Florida, Inc.
July 22, 2005 - UNF Hispanic Health Issues Seminar
This is part 6 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.
The Effect Race and Income on HIV AIDS infection in African-Americans - Sunil...Sunil Nair
Race and Income has a significant influence on susceptibility to HIV/AIDS infections; Afro-Americans (Blacks) are 1.33 times more likely to be infected than whites. A significant finding is that the income level didn't change race's effect on HIV infections. Race has a significant effect on HIV infections or is an important predictor of incidence of HIV infections independent of the income. In other words, irrespective of the income level being black and poor increases the changes of being infected with HIV/AIDS.
Hepatitis C Risk Assessment, Testing and Referral for Treatment in primary Ca...Real Wellness, LLC
Dr. Robert Winn worked with a team to determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity.
Similar to HIV/AIDS in Special Population Groups in Texas (20)
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
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After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
HIV/AIDS in Special Population Groups in Texas
1. Douglas A. Shehan University of Texas Southwestern Medical Center -In collaboration with Texas Department of State Health Services- 17 th Texas HIV/STD Conference, May 2010 Our Emerging Challenge: HIV Testing and Treatment Among Hispanics in Texas
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4. Growing Hispanic Population in Texas Projected Texas Population by Specified Race/Ethnicity 1980 to 2040 Source: The Texas Data Center and the Office of the State Demographer Race/Ethnicity Population by Year 1980 Population millions (% of the population) 2040 Projected Population millions (% of the population) Hispanic 3.0 (21%) 18.8 (53%) Black 1.7 (12%) 3.4 (10%) White 9.4 (66%) 11.5 (32%)
12. BRFSS: HIV Testing Behavior Ever Tested for HIV among persons aged 18-64 years, Texas, 2007 Race/Ethnicity HIV Testing History Ever Tested Tested in Past Year Hispanic 41% 15% Black 64% 28% White 41% 10%
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15. Surveillance: Progression to AIDS w/in 1 Year of Dx, 2007 Progression to AIDS within 1 Year of HIV Diagnosis, Texas 2007
16. Surveillance: Progression to AIDS w/in 1 Year of Dx, 2007 Progression to AIDS within 1 Year of HIV Diagnosis Among Hispanic Persons, by Country of Origin, Texas 2007 Country of Origin * Persons with unknown country of birth were excluded from analysis
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22. Incidence Surveillance: 2008 Incidence Estimate Race/Ethnicity Estimated Percentages Newly infected in 2008 and not diagnosed in 2008 Hispanic 58% Black 52% White/Other 47% Overall 52%
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24. MMP: Delay in Starting Care, 2005 & 2007 Percentage of persons starting care more than 3 months after diagnosis
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Editor's Notes
The MPOWER Package
Read slide
Hispanics are the largest and fastest growing minority in Texas, increasing by 12% from 2000 to 2007 According to the US Census Bureau , Hispanics constituted 15% of the US population as of July 2007. The Texas Data Center and the Office of the State Demographer project that by 2020, the Texas Hispanic population will outnumber the White population A large majority of Texas Hispanics are Mexican/Mexican American, according to the Pew Hispanic Center-85% of the Hispanic population in Texas are of Mexican origin. (http://pewhispanic.org/)
The Hispanic population in Texas is growing at increasing rates. In 1980, the Hispanic population of Texas was just under 3 million. By 2040 will become the majority in Texas… it is estimated that there will be 18.8 million Hispanics in Texas. The percentage of Hispanics is projected to increase from 21 percent in 1980 to 53 percent of the population by 2040 . These changes are being driven both by high immigration rates and high birth rates.
Read Slide: In 2007: Over 1,200 newly diagnosed HIV cases were reported among Hispanics (accounting for 29% of all the new HIV/AIDS diagnoses) Approximately 15,000 Hispanic persons were living with HIV (accounting for 25% of all the persons living with HIV/AIDS in Texas) Over 800 Hispanics progressed to AIDS
This dot map is a visual display of the residence county of diagnosis for Hispanics living with HIV/AIDS in Texas in 2007. Additional information: Dots are placed randomly in the county of the individuals residence at diagnosis.
This slide represents the number of AIDS cases diagnosed among Hispanics and what proportion of the cases diagnosed Hispanics represented from 1990-2007. The bars indicate the number of cases by year (left axis) and the line represents the proportion of all diagnosed cases that Hispanics made up (right axis). Although the number of AIDS cases diagnosed has remained relatively stable over the last several years among Hispanics, the RED line indicates that Hispanics represent an increasingly large proportion of newly diagnosed AIDS cases over time.
Proportion of newly diagnosed AIDS cases that each racial/ethnic group represents over time Over time, the proportion of AIDS cases made up by whites has declined, whereas, Hispanics are representing an increasingly larger proportion of newly diagnosed cases. For the first time In Texas in 2007, the proportion of newly diagnosed AIDS cases among Hispanics surpassed the proportion of cases made up by Whites. This trend differs from what we’re observing nationally… where the proportion of AIDS cases represented by whites still exceeds that of Hispanics.
Because there are advances in HIV treatments it is alarming to see an increasing proportion of AIDS cases among Hispanics when we saw decreasing or stable proportions among the other race/ethic categories We know that two main underlying reasons individuals progress from HIV to AIDS are they are not testing or testing less frequently and unaware of their status and/or they are getting into care later The consequences of not knowing your status are that you may unknowingly infect others or unknowingly become co-infected with other STIs and/or drug-resistant strains of HIV Getting into care later can result in quicker progression to AIDS and poor outcomes including death This increasing proportion of AIDS cases among Hispanics led us to explore our available data to develop a picture of HIV Testing and Treatment Among Hispanics in Texas
In order to better understand testing and treatment practices among Hispanic persons in Texas, we began by examining all available data sources and comparing the results from these data sources. The data sources we reviewed were: Read slide
The first data source we examined was the 2007 BRFSS. BRFSS is a population based random digit dialed survey. BRFSS enables us to calculate general population-based estimates on HIV testing. In 2007, the BRFSS contained questions about HIV testing.
In 2007, we found that Hispanic persons were less likely to report ever having tested for HIV when compared to black persons. Hispanic persons were also less likely to report having tested for HIV in the past year when compared to black persons. POINT OUT NUMBERS IN TABLE The proportion of Hispanic persons having ever tested for HIV or having tested in the last year was nearly the same as the proportions for white persons. POINT OUT NUMBERS IN TABLE Additional Notes: no statistically significant difference between Hispanics and white for the “tested in past year” percentage The percentages are within each race group: i.e. of all black persons surveyed 64% said they had an HIV test ever, 36% said they had never had an HIV test
Hispanic persons were more likely to report that the last facility they received an HIV test was a clinic as compared to white and black persons who were more likely to report having been tested in private doctors office or at an HMO. REVIEW SLIDE
The second data source we examined was the Texas HIV/AIDS surveillance data Texas has been conducting AIDS surveillance since 1983 and in 1999, HIV became reportable by name. The key demographics collected are patient demographic characteristics, the mode of transmission, opportunistic infections, and virologic and immunologic status. In conjunction with core surveillance activities, Texas also implemented EPS to reduce perinatal HIV transmission and to evaluate perinatal prevention efforts For this presentation, we evaluated HIV/AIDS surveillance data for cases diagnosed through 2007
As can be seen in this graph a greater proportion of Hispanics, compared to Whites and Blacks, progressed to AIDS within one year of their HIV diagnosis. POINT OUT NUMBERS IN Graph *Percentages do not add up to 100% because cases with unknown progression time frame are excluded
We also noticed differences in progression from HIV to AIDS among Hispanics who were foreign born versus those who were born in the US. A greater proportion of Hispanics who were foreign born progressed to AIDS within 1 year of their HIV diagnosis. POINT OUT NUMBERS IN SLIDE Among Foreign Born Hispanic Persons who progressed to AIDS within 1 year of HIV diagnosis, >70% of the cases had a country of origin of Mexico. Additional Notes: We also looked at progression to AIDS among Hispanics in the border, metro, and non-metro areas and there were not major differences among the three groups. (Progression to AIDS within 1 year of diagnosis among Hispanic persons: Border-39%, Metro 41%, Non-Metro-40%)
Next we looked at our enhanced perinatal surveillance data which includes detailed information on HIV positive mothers and exposed babies This chart shows the proportion of HIV positive women who delivered an HIV-exposed infant by race. As you can see the patterns have stayed the same over the years with Black women representing over 60% of HIV positive women who deliver an HIV exposed infant Hispanic women represent on average 21% of all the HIV positive women delivering an HIV exposed infant, White women represent on average less than 14% of all HIV positive women who deliver an HIV exposed infant while women of other races (not Black, Hispanic or White) represent on average 5% of all HIV positive women delivering an HIV-exposed infant.
In 2007. Hispanics did not represent the highest proportion of HIV positive women delivering an exposed infant, as seen on the previous slide, however they did represent the largest proportion of HIV+ women delivering an infected infant, as seen in this graph. POINT OUT NUMBERS IN GRAPH
We also see slight differences among racial/ethnic groups when looking at factors that help prevent the transmission of HIV from the mother to the infant. This data is for HIV positive women delivering an infected infant from 2003-2007. As many of you know it is recommended that all women who are pregnant receive an HIV test during their pregnancy. For the period of 2003-2007, 38% (6 in 16) Hispanic women were diagnosed with HIV at or after delivery and 25% (6 in 25) Black women and 38% (3 in 8) White women were diagnosed at or after delivery. Hispanic and White women delivering an infected infant were more likely to be diagnosed at or after delivery when compared to black women. Receipt of antiretroviral therapy at the recommended intervals is also important in helping to prevent transmission of HIV from the mother to the child. ARV therapy is recommended at three intervals including pregnancy, labor and delivery and neonatally by the child. From 2003-2007, 29% (4 in 14) Hispanic women received antiretroviral (ARV) therapy at the 3 recommended intervals whereas 52% (13 in 25) Black women and 50% (4 in 8) White women received ARV therapy at the 3 recommended intervals. Hispanic women delivering an infected infant were more likely to not receive ARV therapy at the 3 recommended intervals when compared to Black and White women.
The third data source we examined and explored was the HIV Incidence Surveillance data HIV Incidence Surveillance is used to provide an estimates of the number of newly acquired HIV infections The HIV incidence estimate is generated using STARHS tests results and HIV testing history data for newly reported HIV cases The Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) test is a test that distinguishes between recent and long-standing HIV infection on a population level The STARHS test is performed on remnant serum specimens from confirmed HIV antibody positive tests Testing history data and ARV use data is gathered through patient interview and chart abstraction from patients that are newly diagnosed with HIV For this presentation we reviewed incidence data from cases diagnosed in 2007 and reported as of May 2009
Based on the HIV incidence surveillance data it was estimated that there were over 5,000 newly acquired HIV infections in Texas in 2008 which is greater than the number of cases diagnosed in 2008 In 2008. Hispanic persons accounted for 30% of these newly acquired HIV infections
In 2008 we found that Hispanic persons were more likely to be undiagnosed in their infection year. As you can see among the Hispanic population, 58% of the newly infected cases in 2008 were undiagnosed in 2008, compared to 52% of Blacks and 47% white/other Although the Hispanic population represents only 1/3 of the newly infected cases in 2007, they have the largest proportion of cases undiagnosed in their infection year.
The final data source we examined was the 2005 and 2007 Medical Monitoring Project data MMP collects information about people living with HIV who are receiving medical care in Texas The data is collected from patient interviews and medical record abstractions The 2005 and 2007 MMP data were used to evaluate delay in starting care among Hispanic persons
In 2005 and 2007, we saw that Hispanic persons were more likely to delay starting care for more than three months. Among those in care 21% of HIV-positive Hispanic persons delayed starting care for more than 3 months, compared to 13% of whites and 8% of African Americans. 2005 and 2007 total number of patients interviewed = 232. Hispanic = 70 (30.6%), White = 98 (n=42.8%), and Black = 52 (n=22.7%). (race and ethnicity info was available for 229 patients)
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As part of Texas’ response to this emerging challenge a qualitative study was conducted between June and September 2008 to identify barriers to testing and care among the Hispanic Male Community in Texas. READ Slide Extra information on methodology in case questions are asked: CPG requested the survey to be done. Members of groups and key informant interviews were recruited by CPG members and staff from community groups and CBOs.