San Mateo County Jurisdictional HIV Prevention Plan 2012 - 2016 Darryl Lampkin, HIV Prevention Supervisor Eduardo Moreira-Orantes, HIV Prevention Team Lead STD/HIV Program January 10, 2013

Overview of San Mateo County San Mateo County Profile Covers most of the San Francisco Peninsula just south of San Francisco and north of Santa Clara County Mostly suburban and rural areas with a few small urban centers 2010 Census documented population to be approximately 718,451 people Racial composition: 53.4% white; 26.2% Asian/Pacific Islander; 25.4% Hispanic; and 2.6% African American

Overview of San Mateo County HIV Prevention Services: 2009 - 2012 AIDS Program was established in 1985 and integrated with STD Control Unit in 2008 to become STD/HIV Program In 2009, lost over two-thirds of funding through CA State Office of AIDS funding cuts; and, over half of HIV Prevention staff was laid off Eliminated contractors and almost all HE/RR interventions Continued to provide mobile HIV testing, outreach, individual level risk reduction, and community mobilization through OA funds Group-level education and HIV testing provided through SAMHSA ADP set-aside funds Syringe exchange services provided through County general funds

Overview of San Mateo County HIV Prevention Services: 2012 – 2016 In 2011, applied for funding through CDC PS 12-1201 as part of San Francisco Metropolitan Statistical Area (MSA) with San Francisco and Marin County Expanded HIV Prevention unit to include two (2) disease investigators Appointed non-voting seat on San Francisco HPPC Developed Jurisdictional and Comprehensive HIV Prevention Plan 2012-16 as part of CDC PS 12-1201 scope of work

Overview of San Mateo HIV/AIDS Epidemic HIV/AIDS Prevalence Highlights: As of December 2011: 1,467 people living with HIV/AIDS; almost 63% living with AIDS Gender/age: Males make up 83% of all cases; and, over half of cases are over age 50 years Race/ethnicity: Whites account for half of cases; African Americans account for (14%) of cases and make up less than 3% of population; Hispanics are emerging as disproportionately impacted by HIV Transmission: MSM account for 58% of cases; heterosexual contact (12%); and IDU (11%) Note: San Mateo continues to have a notable share of cases identified as no risk reported/no identifed risk (11%)

Overview of San Mateo HIV/AIDS Epidemic HIV Incidence Highlights: As of December 2011: 83 people were newly diagnosed with HIV Gender/age: Males make up 90% of all cases; and, almost half of cases between ages 20 – 39 years Race/ethnicity: Hispanics (31%); Asian/Pacific Islanders (28%); white (29%); African American (11%) Transmission: MSM account for 57% of cases; no risk reported/no identified risk (30%); and MSM/IDU and heterosexual contact (6%) Emerging: Hispanics in zip codes 94063/94080; API with MSM risks; heterosexual sex while high on non-IDU substances

San Mateo County Newly Diagnosed HIV Infections1 2007 2008 2009 2010 2011 Total Number 61 74 56 73 83 Gender Male Female Transgender 89% 11% 0% 84% 15% 1% 14% 2% 76% 19% 4% 90% 10% Race/Ethnicity White Black Latino/Hispanic Asian/Pacific/Islander Multi-Race/Other/Unknown 41% 7% 38% 8% 36% 34% 9% 48% 37% 29% 31% 28% Risk MSM IDU Heterosexual Contact MSM + IDU No reported risk/Other/Unk 59% 13% 3% 18% 50% 12% 5% 51% 61% 25% 57% 6% 30% 1 San Mateo County data are reported through December 31, 2011 from the electronic HIV/AIDS Reporting System (eHARS).

San Mateo County Overview of HIV/AIDS Epidemic Risk Factors of Living HIV/AIDS Cases by Race/Ethnicity 2011

San Mateo County Overview of HIV/AIDS Epidemic

Geographical Distribution of HIV/AIDS

San Mateo HIV Prevention Plan Priority Risk Populations Targeted Behavioral/Risk Populations Men Who Have Sex with Men (MSM) Heterosexual sex while high on non-IDU substances African Americans countywide Hispanics in zip codes 94063/94080

San Mateo County HIV Prevention Plan Goals Reduce new HIV infections in San Mateo County Increase the percentage of HIV-diagnosed people who are linked to and retained in care Decrease racial/ethnic health disparities in gay/bisexual men, African Americans, and Hispanics

Resources for HIV Prevention and Care Funding Source Activities Funded San Mateo County General Funds Syringe Exchange STD Testing and treatment CDC HIV Prevention Funds (San Francisco DPH) HIV testing and outreach Risk Reduction Counseling Drop-in Support Group Partner Services Linkage to Care Prevention with Positives Condom Distribution Community mobilization SAMHSA (Interagency Memorandum with Behavioral Health Agency) HIV testing and education in alcohol and drug recovery programs Ryan White Part A/B   Comprehensive HIV primary care Pharmacy assistance Ancillary support services Housing Opportunities for People with AIDS (HOPWA) Rent/Mortgage Assistance Utility Assistance Case Management Ryan White – Minority AIDS Initiative Linkage to/retention in care for minority HIV-positive clients

San Mateo County HIV Prevention Strategies Required Activities: Targeted HIV Testing and Outreach Prevention with Positives Condom Distribution Recommended Activities: Syringe exchange and disposal Mobilization efforts in racial/ethnic communities Policy initiatives (service integration and infrastructure development)

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