The most recent data on the target populations of the National HIV/AIDS Strategy in the greater Philadelphia area. Briana Morgan (OHP) first presented this information to a joint meeting of the Ryan White Planning Council and HIV Prevention Planning Council. In January, she gave a similar presentation to the Positive Committee.

1. THE PHILADELPHIA EMA
PERSPECTIVE
THE NATIONAL HIV/AIDS STRATEGY
NOVEMBER 12, 2015

2. We’ve come a long way in the fight against AIDS -
and we can’t let up now. For those whose lives are
still at risk, and for those who didn’t live to see
this moment, let’s keep working for an AIDS-free
generation.
President Barack Obama, July 30, 2015
THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE

3. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
THE FOUR NATIONAL HIV/AIDS STRATEGY GOALS
▸ Reducing new HIV infections
▸ Increasing access to care and improving health outcomes
for people living with HIV
▸ Reducing HIV-related disparities and health inequities
▸ Achieving a more coordinated national response to the
HIV epidemic

4. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
MAJOR CHANGES IN THE ENVIRONMENT BETWEEN 2010 AND 2015
▸ Introduction of Pre-Exposure Prophylaxis (PrEP)
▸ The implementation of the Affordable Care Act (including
Medicaid expansion throughout the EMA)
▸ Federal recommendations for routine HIV screening and
antiretroviral treatment for all people with HIV
▸ The creation of the HIV care continuum/treatment cascade
▸ New research, particularly in areas like PrEP and treatment
as prevention

5. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
MAJOR CHANGES IN THE NATIONAL HIV/AIDS STRATEGY BETWEEN 2010 AND 2015
▸ Adding PrEP as a major component
▸ Changes in language (i.e. “substance abusers” versus
“people who inject drugs”
▸ Ten new quantitative indicators
▸ Adding the HIV Care Continuum Initiative
▸ Updates to target populations

6. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2010 TARGET POPULATIONS
▸ Gay and bisexual men
▸ Black men and women
▸ Latinos and Latinas
▸ Substance abusers

7. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS
▸ Gay, bisexual, and other men who have sex with men of all races and
ethnicities
▸ Black women and men
▸ Latino men and women
▸ People who inject drugs
▸ Youth aged 13 to 24 years
▸ People in the Southern United States
▸ Transgender women

8. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
THE PHILADELPHIA EMA INTEGRATED EPIDEMIOLOGICAL PROFILE
▸ Updated on September 30, 2015
▸ Provides data on the nine-county Philadelphia Eligible Metropolitan Area,
including
▸ Sociodemographic characteristics (such as race, education, and poverty)
▸ HIV risk indicators (such as substance use and STDs)
▸ Local data on the scope of HIV/AIDS (such as new HIV/AIDS cases, and
the total number of people with HIV/AIDS)
▸ HIV/AIDS-related service use (such as HIV care services and HIV testing)

9. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS IN THE PHILADELPHIA EMA
▸ Gay, bisexual, and other men who have sex with men of all races
and ethnicities
▸ National estimates
▸ Census American Community Survey same-sex unmarried
partner household estimates
▸ National HIV Behavioral Surveillance
▸ Local HIV surveillance data
▸ Supplemental data

10. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Williams Institute Estimate
▸ National estimate
▸ An estimated 3.5% of adults identify as lesbian, gay, or
bisexual
▸ Crudely applied, this would be 188,425 people in the
EMA, and 90,793 men

11. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Census American Community Survey same-sex unmarried
partner household estimates (pp. 22-23 of epi profile)
▸ EMA-wide: 0.21% (4,180) of total households
▸ Philadelphia: 0.26% (1,519) of total households
▸ PA Counties: 0.19% (1,816) of total households
▸ NJ Counties: 0.17% (845) of total households

12. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ National HIV Behavioral Surveillance (p. 288 of epi profile)
▸ Philadelphia only
▸ 673 participants
▸ 49.5% Black, 25.3% White, 15.2% Hispanic, 5.9%
Multirace, 4.2% Other
▸ 27.5% HIV-positive; 6.4% new positives

13. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Local HIV Surveillance, 2013 (p. 174 of epi profile)
▸ EMA-wide: 36% (9,474) of people living with HIV/AIDS

14. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Local HIV Surveillance, 2013 (pp. 175 - 191 of epi profile)
▸ Philadelphia
▸ 33% (117) of new AIDS cases
▸ 33% (3,801) of people living with AIDS
▸ 51% (345) of new HIV (not AIDS) cases
▸ 37% (2,925) of people living with HIV (not AIDS)

15. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Local HIV Surveillance, 2013 (pp. 193 -212 of epi profile)
▸ PA Counties
▸ 35% (29) of new AIDS cases
▸ 35% (676) of people living with AIDS
▸ 34% (44) of new HIV (not AIDS) cases
▸ 39% (1,798) of people living with HIV (not AIDS)

16. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Local HIV Surveillance, 2013 (pp. 220 -212 of epi profile)
▸ NJ Counties
▸ 31% (14) of new AIDS cases (Burlington + Camden)
▸ 32% (20) of new HIV (not AIDS) cases (Camden)
▸ 35% (1,167) of people living with HIV/AIDS

17. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Local HIV Surveillance, 2013 (pp. 193 -212 of epi profile)
▸ PA Counties
▸ 35% (29) of new AIDS cases
▸ 35% (676) of people living with AIDS
▸ 34% (44) of new HIV (not AIDS) cases
▸ 39% (1,798) of people living with HIV (not AIDS)

18. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN OF ALL RACES AND ETHNICITIES
▸ Local HIV Surveillance, 2013 (pp. 220 -212 of epi profile)
▸ NJ Counties
▸ 31% (14) of new AIDS cases (Burlington + Camden)
▸ 32% (20) of new HIV (not AIDS) cases (Camden)
▸ 35% (1,167) of people living with HIV/AIDS

19. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS IN THE PHILADELPHIA EMA
▸ Black women and men
▸ Census American Community Survey estimates
▸ Local STD data
▸ Local HIV surveillance data

20. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
BLACK WOMEN AND MEN
▸ Census American Community Survey race/ethnicity
estimates (pp. 9 - 10 of epi profile)
▸ EMA-wide: 20.21% (1,087,776) of total population
▸ Philadelphia: 41.81% (649,339) of total population
▸ PA Counties: 9.42% (236,426) of total population
▸ NJ Counties: 15.31% (202,011) of total population

21. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
BLACK WOMEN AND MEN
▸ Local HIV Surveillance, 2013 (p. 174 of epi profile)
▸ EMA-wide: 58% (15,687) of people living with HIV/AIDS

22. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
BLACK WOMEN AND MEN
▸ Local HIV Surveillance, 2013 (pp. 175 - 191 of epi profile)
▸ Philadelphia
▸ 72% (253) of new AIDS cases
▸ 64% (7,420) of people living with AIDS
▸ 74% (500) of new HIV (not AIDS) cases
▸ 62% (4,982) of people living with HIV (not AIDS)

23. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
BLACK WOMEN AND MEN
▸ Local HIV Surveillance, 2013 (pp. 193 -212 of epi profile)
▸ PA Counties
▸ 46% (23) of new AIDS cases (Delaware and Montgomery)
▸ 36% (684) of people living with AIDS
▸ 52% (61) of new HIV (not AIDS) cases (Bucks, Delaware,
and Montgomery)
▸ 42% (749) of people living with HIV (not AIDS)

24. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
BLACK WOMEN AND MEN
▸ Local HIV Surveillance, 2013 (pp. 220 -212 of epi profile)
▸ NJ Counties
▸ 64% (36) of new AIDS cases (Burlington, Camden, and
Gloucester)
▸ 53% (43) of new HIV (not AIDS) cases (Burlington and
Camden)
▸ 47% (1,560) of people living with HIV/AIDS

25. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS IN THE PHILADELPHIA EMA
▸ Latino men and women
▸ Census American Community Survey estimates
▸ Local STD data
▸ Local HIV surveillance data

26. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
LATINO MEN AND WOMEN
▸ Census American Community Survey race/ethnicity
estimates (pp. 9 - 10 of epi profile)
▸ EMA-wide: 8.55% (460,534) of total population
▸ Philadelphia: 13.27% (206,033) of total population
▸ PA Counties: 4.85% (121,893) of total population
▸ NJ Counties: 10.05% (132,608) of total population

27. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
LATINO MEN AND WOMEN
▸ Local HIV Surveillance, 2013 (p. 174 of epi profile)
▸ EMA-wide: 14% (3,925) of people living with HIV/AIDS

28. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
LATINO MEN AND WOMEN
▸ Local HIV Surveillance, 2013 (pp. 175 - 191 of epi profile)
▸ Philadelphia
▸ 13% (46) of new AIDS cases
▸ 14% (1,619) of people living with AIDS
▸ 12% (81) of new HIV (not AIDS) cases
▸ 16% (1,242) of people living with HIV (not AIDS)

29. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
LATINO MEN AND WOMEN
▸ Local HIV Surveillance, 2013 (pp. 193 -212 of epi profile)
▸ PA Counties
▸ Fewer than 5 new AIDS cases in each county
▸ 10% (192) of people living with AIDS
▸ 13% (5) of new HIV (not AIDS) cases (Montgomery)
▸ 10% (172) of people living with HIV (not AIDS)

30. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
LATINO MEN AND WOMEN
▸ Local HIV Surveillance, 2013 (pp. 220 -212 of epi profile)
▸ NJ Counties
▸ 15% (5) of new AIDS cases (Camden)
▸ 33% (21) of new HIV (not AIDS) cases (Camden)
▸ 20% (666) of people living with HIV/AIDS

31. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS IN THE PHILADELPHIA EMA
▸ People who inject drugs
▸ Treatment Episode Data Set - Admissions (TEDS-A)
▸ National HIV Behavioral Surveillance
▸ Local HIV surveillance

32. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
PEOPLE WHO INJECT DRUGS
▸ Treatment Episode Data Set - Admissions (TEDS-A)
▸ 20.1% of males, 19.9% of females admitted to
substance use facilities identified injection as their
main method of drug consumption
▸ Largest age group was 25 - 34 year olds, followed by
18 - 24 year olds
▸ 93% of people who injected drugs were White, 6%
were Black, 8% were Hispanic

33. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
PEOPLE WHO INJECT DRUGS
▸ National HIV Behavioral Surveillance (p. 289 of epi profile)
▸ Philadelphia only
▸ 536 participants
▸ 34.5% Black, 48.7% White, 14.9% Hispanic, 1.6%
Multirace, <1% Other
▸ 6.3% HIV-positive; 3.9% new positives

34. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
PEOPLE WHO INJECT DRUGS
▸ Local HIV Surveillance, 2013 (p. 174 of epi profile)
▸ EMA-wide: 23% (6,082) of people living with HIV/AIDS

35. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
PEOPLE WHO INJECT DRUGS
▸ Local HIV Surveillance, 2013 (pp. 175 - 191 of epi profile)
▸ Philadelphia
▸ 13% (44) of new AIDS cases
▸ 27% (3,173) of people living with AIDS
▸ 5% (37) of new HIV (not AIDS) cases
▸ 18% (1,451) of people living with HIV (not AIDS)

36. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
PEOPLE WHO INJECT DRUGS
▸ Local HIV Surveillance, 2013 (pp. 193 -212 of epi profile)
▸ PA Counties
▸ Zero new AIDS cases in Chester County; fewer than 5 in all
others
▸ 22% (418) of people living with AIDS
▸ Fewer than 5 new HIV cases in 3 counties; 0 in
Montgomery
▸ 13% (235) of people living with HIV (not AIDS)

37. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
PEOPLE WHO INJECT DRUGS
▸ Local HIV Surveillance, 2013 (pp. 220 -212 of epi profile)
▸ NJ Counties
▸ Fewer than 5 new AIDS cases in Burlington and
Camden; zero in Gloucester and Salem
▸ Fewer than 5 new HIV cases in Burlington and
Camden; zero in Gloucester and Salem
▸ 16% (526) of people living with HIV/AIDS

38. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS IN THE PHILADELPHIA EMA
▸ Youth aged 13 to 24 years
▸ Census American Community Survey Estimates
▸ Youth Risk Behavior Survey
▸ Local teen pregnancy data
▸ Local STD surveillance
▸ Local HIV surveillance

39. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Census American Community Survey age estimates for 15
- 24 year olds (pp. 12 - 19 of epi profile/American
FactFinder)
▸ EMA-wide: 15.4% (747,876) of total population
▸ Philadelphia: 16.5% (253,556) of total population
▸ PA Counties: 16.1% (321,189) of total population
▸ NJ Counties: 13.1% (173,131) of total population

40. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Youth Risk Behavior Survey for high school students (pp. 90 - 97 of
epi profile)
▸ Philadelphia
▸ 21.8% of students reported 4+ sexual partners in life
▸ 37.7% sexually active (sex in past 3 months)
▸ 42.2% did not use a condom on last occasion
▸ 85.1% did not use birth control pills
▸ 20.8% did not use any method to prevent pregnancy

41. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Youth Risk Behavior Survey for high school students (pp. 90 - 97 of
epi profile)
▸ New Jersey (statewide)
▸ 12.2% of students reported 4+ sexual partners in life
▸ 29.1% sexually active (sex in past 3 months)
▸ 41.4% did not use a condom on last occasion
▸ 78.5% did not use birth control pills
▸ 13.8% did not use any method to prevent pregnancy

42. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Local HIV Surveillance, 2013 (p. 174 of epi profile)
▸ EMA-wide: 4% (1,074) of people living with HIV/AIDS

43. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Local HIV Surveillance, 2013 (pp. 175 - 191 of epi profile)
▸ Philadelphia
▸ 12% (41) of new AIDS cases (15 to 24)
▸ 2% (249) of people living with AIDS
▸ 27% (181) of new HIV (not AIDS) cases
▸ 7% (564) of people living with HIV (not AIDS)

44. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Local HIV Surveillance, 2013 (pp. 193 -212 of epi profile)
▸ PA Counties
▸ Zero in most counties; fewer than 5 in Montgomery
▸ 2% (27) of people living with AIDS (Delaware and
Montgomery)
▸ 22% (21) of new HIV (not AIDS) cases (Delaware and
Montgomery)
▸ 7% (119) of people living with HIV (not AIDS)

45. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Local HIV Surveillance, 2013 (pp. 220 -212 of epi profile)
▸ NJ Counties
▸ Fewer than 5 new AIDS cases in Burlington and
Camden; zero in Gloucester and Salem
▸ 11% (7) of new HIV (not AIDS) cases (Camden)
▸ 3% (85) of people living with HIV/AIDS (Burlington
and Camden)

46. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
YOUTH AGED 13 TO 24 YEARS
▸ Teen pregnancy data (pp. 56 - 57 of epi profile)
▸ Declining overall within the EMA
▸ Both reported pregnancies (in southeastern PA - data
not available in New Jersey) and live births

47. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
2015 TARGET POPULATIONS IN THE PHILADELPHIA EMA
▸ Transgender women
▸ Very little data available
▸ Williams Institute Estimate
▸ National estimate
▸ An estimated 0.3% of adults identify as transgender
▸ Crudely applied, this would be 16,141 people in the
EMA

48. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
NOT A TARGET POPULATION
▸ Aging people with HIV/AIDS
▸ Not identified in the National HIV/AIDS Strategy
▸ 44% of people with HIV/AIDS in the EMA were 50+ in
2013
▸ 61% of people with HIV/AIDS in the EMA were 45+ in
2013

49. THE NATIONAL HIV/AIDS STRATEGY: THE PHILADELPHIA EMA PERSPECTIVE
FOR MORE INFORMATION
▸ Download the Epi Profile at www.hivphilly.org
▸ Read the National HIV/AIDS Strategy at aids.gov
▸ Email Briana at briana@hivphilly.org