1. HIV/AIDS Prevalence & Mortality Report, 2006 Minnesota Department of Health HIV/AIDS Surveillance System Minnesota Department of Health HIV/AIDS Surveillance System

2. Introduction (I) These three introduction slides provide a general context for the data used to create this slide set. If you have questions about any of the slides please refer to the Companion Text to the Minnesota HIV/AIDS Prevalence & Mortality Report, 2006 or HIV/AIDS Prevalence & Mortality Technical Notes. This slide set displays estimates of the number of persons living with HIV/AIDS ( prevalence ) and mortality in Minnesota by person, place, and time. The slides rely on data from HIV/AIDS cases diagnosed through 2006 and reported to the Minnesota Department of Health (MDH) HIV/AIDS Surveillance System.

3. Introduction (II) Data analyses exclude persons diagnosed in federal or private correctional facilities, but include state prisoners (n=116) and persons arriving to Minnesota through the HIV+ Refugee Resettlement Program (n=156 prevalent cases) and other immigrants reporting a positive test prior to their arrival in Minnesota (n=35 prevalent cases). Some limitations of surveillance data: Data do not include HIV-infected persons who have not been tested for HIV Data do not include persons whose positive test results have not been reported to the MDH Data do not include HIV-infected persons who have only tested anonymously Case numbers for the most recent years may be undercounted due to delays in reporting

4. Introduction (III) Persons are assumed to be alive unless the MDH has knowledge of their death. Persons whose most recently reported state of residence was Minnesota are assumed to be currently residing in Minnesota unless the MDH has knowledge of their relocation. Our ability to track changes of residence, including within the state, is limited. Vital status and current residence are updated through one or more of the following methods: Standard case reporting Correspondence with other health departments Active surveillance (monthly) Death certificate reviews (annually) National Death Index match

5. National Context HIV/AIDS in Minnesota: Annual Review

6. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review

7. Overview of HIV/AIDS in Minnesota HIV/AIDS in Minnesota: Annual Review

8. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review HIV/AIDS in Minnesota: New HIV Infection, HIV (non-AIDS) and AIDS Cases by Year, 1993-2006 *Includes all new cases of HIV infection (both HIV (non-AIDS) and AIDS at first diagnosis) diagnosed within a given calendar year. ^Includes all new cases of AIDS diagnosed within a given calendar year, including AIDS at first diagnosis. This includes refugees in the HIV+ Resettlement Program, as well as, other refugee/immigrants diagnosed with AIDS subsequent to their arrival in the United States.

9. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review HIV/AIDS in Minnesota: Number of Prevalent Cases, and Deaths by Year, 1993-2006 *Deaths among MN AIDS cases, regardless of cause and location of death. ^Deaths in Minnesota among people with HIV or AIDS, regardless of cause and location of diagnosis.

10. Persons Living with HIV/AIDS in Minnesota Persons Living with HIV/AIDS in Minnesota HIV/AIDS in Minnesota: Annual Review

11. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Estimated Number of Persons Living with HIV/AIDS in Minnesota As of December 31, 2006, 5,566 * persons are assumed alive and living in Minnesota with HIV/AIDS 3,105 living with HIV infection (non-AIDS) 2,461 living with AIDS This number includes 920 persons who were first reported with HIV or AIDS elsewhere and subsequently moved to Minnesota This number excludes 860 persons who were first reported with HIV or AIDS in Minnesota and subsequently moved out of the state * This number includes persons who reported Minnesota as their current state of residence, regardless of residence at time of diagnosis. Includes state prisoners and refugees arriving through the HIV+ Refugee Resettlement Program, as well as, HIV+ refugee/immigrants arriving through other programs.

12. Place HIV/AIDS in Minnesota: Annual Review

13. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review None 1 - 10 11 - 30 31 - 90 91 - 150 151 – 1,000 1,001 – 3,175 Number Living with HIV/AIDS Living HIV/AIDS Cases by County of Residence, 2006 Total number = 5,566 (34 people missing residence information) * Counties in which a state correctional facility is located. City of Minneapolis – 2,309 City of St. Paul – 808 Suburban # – 1,674 Greater Minnesota - 741 # 7-county metro area, excluding the cities of Minneapolis and St. Paul St. Louis Itasca Cass Lake Polk Beltrami Aitkin Pine Cook Koochiching Otter Tail Clay Roseau Marshall Becker Todd Stearns Kittson Swift Lyon Pope Morrison Wilkin Renville Carlton Martin Hubbard Rice Wright Norman Fillmore Mower Crow Wing Nobles Murray Grant Sibley Brown Lake of the Woods Rock Redwood Douglas Kandiyohi Jackson Meeker Goodhue Winona Isanti Faribault Dakota Freeborn Olmsted Lincoln Blue Earth Scott Stevens Anoka Houston Steele Traverse Dodge Wadena Nicollet McLeod Hennepin Kanabec Lac Qui Parle Chippewa Wabasha Benton Carver Pennington Big Stone Cottonwood Waseca Chisago Le Sueur Mahnomen Yellow Medicine Pipestone Red Lake Sherburne Watonwan Clearwater Mille Lacs Washington Ramsey * * * * * * * * *

14. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Anoka Hennepin Dakota Ramsey Washington Carver Scott Map of Metro Area: Living HIV/AIDS Cases by County of Residence, 2006 * * * None 1 - 10 11 - 30 31 - 90 91 - 150 151 – 1,000 1,001 – 3,175 Number Living with HIV/AIDS City of Minneapolis – 2,309 City of St. Paul – 808 Suburban # – 1,674 Total number (Metro only) = 4,791 # 7-county metro area, excluding the cities of Minneapolis and St. Paul * Counties in which a state correctional facility is located

15. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Persons Living with HIV/AIDS in Minnesota by Current Residence, 2006 Total Number = 5,566 (34 persons missing residence information) Suburban = Seven-county metro area including Anoka, Carver, Dakota, Hennepin (except Minneapolis), Ramsey (except St. Paul), Scott, and Washington counties. Greater MN = All other Minnesota counties, outside the seven-county metro area.

16. Gender and Race/Ethnicity HIV/AIDS in Minnesota: Annual Review

17. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Persons Living with HIV/AIDS in Minnesota by Gender, 2006 4,300 (77%) 1,266 (23%)

18. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Persons Living with HIV/AIDS in Minnesota by Gender and Race/Ethnicity*, 2006 * African-born refers to Blacks who reported an African country of birth; African American refers to all other Blacks. ^ Other includes persons with unknown or multiple races (n=35).

19. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Persons Living with HIV/AIDS in Minnesota by Gender and Race/Ethnicity, 2006 Males (n = 4,300)Females (n = 1,266) n = Number of persons Afr Amer = African American (Black, not African-born persons) Afr born = African-born (Black, African-born persons) Amer Ind = American Indian Other = Multi-racial persons or persons with unknown race

20. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Number of Cases and Rates (per 100,000 persons) of Persons Living with HIV/AIDS by Race/Ethnicity – Minnesota, 2006 Race/EthnicityCases%Rate White, non-Hispanic 3,03555%70.2 Black, African-American 1,21422%723.5 Black, African-born 67512%1350-1918 Hispanic 4278%297.8 American Indian 972%119.6 Asian/Pacific Islander 831%49.3 Other^ 351%X Total 5,566100%113.1 Accurate population estimates for African-born persons and MSM (any race) living in Minnesota are unavailable – anecdotal (50,000) and 2000 US Census data (35,188) ) were used to create the range of rates reported for African-born. ^ Other = Multi-racial persons or persons with unknown race Census Data used for rate calculations. African-born refers to Blacks who reported an African country of birth; African American refers to all other Blacks. Cases with unknown race are excluded.

21. Age HIV/AIDS in Minnesota: Annual Review

22. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Persons Living with HIV/AIDS in Minnesota by Age Group, 2006

23. Mode of Exposure HIV/AIDS in Minnesota: Annual Review

24. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Males Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 White Males (n = 2,674) n = Number of persons MSM = Men who have sex with men Other = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes.

25. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review African American Males (n = 821) n = Number of persons MSM = Men who have sex with men Other = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes. Refers to Black, African American (not African-born) males. Males Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006

26. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Hispanic Males (n = 352) n = Number of persons MSM = Men who have sex with men Other = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes. Males Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006

27. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review African-born Males (n = 317) n = Number of persons MSM = Men who have sex with men Other = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk Heterosex = Heterosexual contact Mode of Exposure has been estimated using the following breakdown: 5% - MSM, 90% - Heterosex, and 5% - Other. For additional detail see the HIV Prevalence & Mortality Technical Notes. Refers to Black, African-born males. Males Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006

28. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review American Indian Males (n = 58) Males Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of persons MSM = Men who have sex with men Other = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes.

29. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Asian Males (n = 53) Males Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of persons MSM = Men who have sex with men Other = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes.

30. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Females Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 African American Females (n = 393) n = Number of personsOther = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes. Refers to Black, African American (not African-born) females.

31. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review White Females (n = 361) Females Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of personsOther = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes.

32. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review African-born Females (n = 358) Females Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of personsOther = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using the following proportions: 95% - Heterosexual, 5% - Other. For additional detail see the HIV Prevalence & Mortality Technical Notes. Refers to Black, African-born females.

33. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Hispanic Females (n = 75) Females Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of personsOther = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes.

34. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review American Indian Females (n = 39) Females Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of personsOther = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using prevalent cases with known risk. For additional detail see the HIV Prevalence & Mortality Technical Notes.

35. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Asian Females (n = 30) CAUTION: Small number of cases – interpret carefully. Females Living with HIV/AIDS in Minnesota by Estimated Mode of Exposure, 2006 n = Number of personsOther = Hemophilia, transplant, transfusion, mother w/ HIV or HIV risk IDU = Injecting drug use Heterosex = Heterosexual contact Mode of Exposure has been estimated using the following proportions: 95% - Heterosexual, 5% - Other. For additional detail see the HIV Prevalence & Mortality Technical Notes.

36. Special Populations HIV/AIDS in Minnesota: Annual Review

37. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Foreign-Born Persons Living with HIV/AIDS in Minnesota by Region of Birth, 1990-2006 Region of Birth Latin Amer/Car – Includes Mexico, Caribbean, and Central/South American countries

38. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review African-Born Persons Living with HIV/AIDS Compared to Other Minnesota Cases by Gender, 2006 African-born Persons Total Number = 678 Includes persons arriving to Minnesota through the HIV+ Refugee Resettlement Program and other refugee/immigrant programs and 3 White African- born persons U.S.-born Cases Total Number = 4,569

39. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Persons Living with HIV/AIDS born in Latin America/Caribbean Countries Compared to Other Minnesota Cases by Gender, 2006 Latin/Caribbean Persons Total Number = 229 U.S.-born Cases Total Number = 4,569 Includes Mexico and all Central/South American and Caribbean countries.

40. Mortality HIV/AIDS in Minnesota: Annual Review

41. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Reported Deaths* among Male MN AIDS Cases 1990-2006 * Deaths among MN AIDS cases, regardless of location and cause.

42. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Reported Deaths* among Female MN AIDS Cases 1990-2006 * Deaths among MN AIDS cases, regardless of location and cause.

43. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Reported Deaths* in Minnesota among Males with HIV Infection, 1990-2006 * Deaths in Minnesota among people with HIV infection regardless of location of diagnosis and cause of death. HIV (non-AIDS) or AIDS

44. Data Source: Minnesota HIV/AIDS Surveillance System HIV/AIDS in Minnesota: Annual Review Reported Deaths* in Minnesota among Females with HIV Infection, 1990-2006 * Deaths in Minnesota among people with HIV infection regardless of location of diagnosis and cause of death. HIV (non-AIDS) or AIDS