Houston/Harris County HIV Epidemiology Bureau of HIV/STD and Viral Hepatitis Prevention June 2013.

Slides:



Advertisements
Similar presentations
Impact of Age and Race on New HIV Infections among Men who have Sex with Men in Los Angeles County Shoshanna Nakelsky, MPH Division of HIV and.
Advertisements

1 Unmet Need Estimate Needs Assessment Committee December 2010 JoAnn Hilger, MPH Ryan White Grant Administrator.
HIV and STD in Maine Data from the Bureau of Health HIV/STD Program Contact: Mark Griswold (207)
Illustrating HIV/AIDS in the United States 2014 Update Denver, CO.
Illustrating HIV/AIDS in the United States 2014 Update New Haven-Milford, CT.
Wisconsin HIV/AIDS Surveillance Annual Review: Slide Set New diagnoses, prevalent cases, and deaths through December 2014 April 2015 P Wisconsin.
SOUTH CAROLINA EPIDEMIOLOGIC PROFILE Data available in an Integrated Epidemiologic Profile Core Epi Section Socio-demographic characteristics of.
STDs and HIV Among Youth in Nevada
Illustrating HIV/AIDS in the United States 2014 Update Houston/Harris County, TX.
2013 Update Illustrating HIV/AIDS in the United States Nevada.
Illustrating HIV/AIDS in the United States 2014 Update Baton Rouge, LA.
Illustrating HIV/AIDS in the United States 2014 Update Memphis, TN.
2013 Update Illustrating HIV/AIDS in the United States New York, NY.
Illustrating HIV/AIDS in the United States 2014 Update New York City, NY.
Illustrating HIV/AIDS in the United States 2014 Update Jackson, MS.
HIV/AIDS Prevention Committee Public Meeting November 21, 2013.
2013 Update Illustrating HIV/AIDS in the United States Philadelphia, PA.
Illustrating HIV/AIDS in the United States 2014 Update Philadelphia, PA.
Illustrating HIV/AIDS in the United States 2014 Update Milwaukee County, WI.
Illustrating HIV/AIDS in the United States 2014 Update Orlando MSA, FL.
1 HIV/STD Trends in Texas Sharon K. Melville, M.D., M.P.H. Texas Department of State Health Services Texas Public Health Association April 22, 2010.
2013 Update Illustrating HIV/AIDS in the United States New Orleans, LA.
HIV Infection Among Those with an Injection Drug Use*- Associated Risk, Florida, 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division.
Illustrating HIV/AIDS in the United States 2014 Update West Palm Beach (Palm Beach County, a division in the Miami MSA), FL.
2013 Update Illustrating HIV/AIDS in the United States Indiana.
Illustrating HIV/AIDS in the United States 2014 Update Bridgeport-Stamford-Norwalk, CT.
Illustrating HIV/AIDS in the United States 2014 Update Jacksonville MSA, FL.
HIV/STD Epidemiology in Oklahoma HIV/STD Service Division of Prevention and Preparedness Oklahoma State Department of Health.
Illustrating HIV/AIDS in the United States 2014 Update Atlanta, GA.
Continuing Education Meeting: Update on Syphilis, Gonorrhea, and Chlamydia Jan-Jun 2002 Liz Lee Senior Epidemiologist Bureau of Epidemiology Houston Department.
Epidemiology of HIV Among Hispanics Reported in Florida, Through 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division of Disease Control.
Racial Disparities in Antiretroviral Therapy Use and Viral Suppression among Sexually Active HIV-infected Men who have Sex with Men— United States, Medical.
Wisconsin Department of Health Services HIV/AIDS Surveillance Annual Review New diagnoses, prevalent cases, and deaths through December 31, 2013 April.
2013 Update Illustrating HIV/AIDS in the United States Virginia.
Illustrating HIV/AIDS in the United States 2014 Update Dallas, TX.
Illustrating HIV/AIDS in the United States 2014 Update Charlotte, NC.
Sexually Transmitted Disease (STD) Surveillance Report, 2009 Minnesota Department of Health STD Surveillance System Minnesota Department of Health STD.
Sexually Transmitted Infections Mysheika Williams Roberts, MD, MPH Medical Director Assistant Health Commissioner Columbus.
Illustrating HIV/AIDS in the United States 2014 Update Ft. Lauderdale (Broward County, a division in the Miami MSA), FL.
1 State of the State: HIV/STD in Texas Ann Robbins Texas Department of State Health Services June 2009.
Illustrating HIV/AIDS in the United States 2014 Update Columbia MSA, SC.
Illustrating HIV/AIDS in the United States 2014 Update Washington, DC.
Illustrating HIV/AIDS in the United States 2014 Update Detroit, MI.
Illustrating HIV/AIDS in the United States 2014 Update Chicago, IL.
Sexually Transmitted Disease (STD) Surveillance Report, 2013 Minnesota Department of Health STD Surveillance System Minnesota Department of Health STD.
SOUTH CAROLINA EPIDEMIOLOGIC PROFILE What is the Epi Profile? The HIV/AIDS Epidemiologic Profile is a document that: Describes the HIV/AIDS epidemic.
Illustrating HIV/AIDS in the United States 2014 Update San Francisco, CA.
Sexually Transmitted Disease (STD) Surveillance Report, 2008 Minnesota Department of Health STD Surveillance System Minnesota Department of Health STD.
1 HIV/STD in Texas Ann Robbins Texas Department of State Health Services June 2009.
Illustrating HIV/AIDS in the United States 2014 Update Boston, MA.
2013 Update Illustrating HIV/AIDS in the United States San Diego, CA.
Florida Department of Health HIV/AIDS & Hepatitis Program Annual data trends as of 12/31/2011 Living (Prevalence) data as of 05/16/2012 Epidemiology of.
2013 Update Illustrating HIV/AIDS in the United States San Francisco, CA.
2013 Update Illustrating HIV/AIDS in the United States Dallas, TX.
Illustrating HIV/AIDS in the United States 2014 Update Hampton Roads, VA.
2013 Update Illustrating HIV/AIDS in the United States Los Angeles, CA.
Illustrating HIV/AIDS in the United States 2014 Update Los Angeles County, CA.
2013 Update Illustrating HIV/AIDS in the United States Memphis, TN.
Illustrating HIV/AIDS in the United States 2014 Update Miami (Miami-Dade County, a division in the Miami MSA), FL.
Katarina Grande, HIV Surveillance Coordinator Casey Schumann, HIV Epidemiologist Wisconsin Department of Health Services Statewide Action Planning Group.
Illustrating HIV/AIDS in the United States
Illustrating HIV/AIDS in the United States
Illustrating HIV/AIDS in the United States
Illustrating HIV/AIDS in the United States
Illustrating HIV/AIDS in the United States
Needs Assessment Slides for Module 4
Illustrating HIV/AIDS in the United States
Presentation transcript:

Houston/Harris County HIV Epidemiology Bureau of HIV/STD and Viral Hepatitis Prevention June 2013

Epidemiology- the study of the distribution (who, what, where, when) and determinants (why, how) of health- related states in specified populations  Use epidemiology to control health problems  Epidemiology is the basic science of public health. It is a quantitative discipline based on principles of statistics and research methodologies.  Epidemiology deals with groups of people rather than individuals. Health-related states are NOT randomly distributed in human populations Definition of epidemiology

Uses of Epidemiology Identify the cause of disease and the factors that increase a person’s risk for disease To control health problems and the spread of disease Planning and targeting prevention efforts Monitoring and evaluating interventions  Establish baseline data  Was the intervention effective? Research  Aim: describe, explain, predict, and control Understanding and formulating new policy  National HIV/AIDS Strategy and focus on reducing HIV-related health disparities Funding decisions  What is the burden of disease in a community?

Nationwide HIV Overview More than 1.1 million people are living with HIV in the US. 18% of HIV positive persons are unaware of their status. Over 18,000 people diagnosed with AIDS die each year.  At the end of 2009, over 641,000 people with AIDS have died since the epidemic began. Source: CDC

New Diagnoses by Sub-Population From : Decrease in new infections among black women Continuing increase in new infections among young MSM

HIV Incidence Surveillance Incidence has remained stable since mid-1990s. In 2010, estimated 47,500 new infections nationwide  Impact most severe among young, black and Hispanic MSM, white MSM in 30s and 40s, and black women. HIV incidence surveillance began in 2005 to provide population- based estimates of the number of new HIV infections per year. Uses new methodology to determine recent from long- standing infections. Source: CDC

Houston/Harris County Overview Houston/Harris County  City of Houston most populous city in Texas and fourth most populous in US Least densely populated major metro area Most racially and ethnically diverse major metro area  Combined Population= 4,111,503  Harris Co.= 1,703 sq. miles Est Population= 4,343,023  HDHHS Jurisdiction for surveillance and partner services is Houston/Harris County The Houston-Sugar Land-Baytown MSA is a Census-defined area consisting of 10 counties  Population= 5,946,800 Sources: Census 2010, Kinder Institute 2012, Texas DSHS Population Projections 2012

Jurisdictional Areas 2013 Epi Profile: page 9

2013 Houston Area Integrated Epidemiological Profile for HIV/AIDS Prevention and Care Services Planning Houston Area Characteristics  Employment  Household Income  Poverty  Educational Attainment  Health Insurance  Foreign-Born and Linguistic Isolation  Fertility and Mortality Rates  Selected Causes of Death  Disability

Nationwide County Comparison  Chlamydia: Harris Co. ranked 3 rd in cases  Gonorrhea: Harris Co. ranked 5 th in cases  P&S Syphilis: Harris Co. ranked 8 th in cases  HIV: Houston Metropolitan ranked 12 th in rate of new HIV diagnoses  AIDS: Houston ranks 12 th in rate of AIDS diagnoses Source: CDC Surveillance Reports (HIV: 2010, STD: 2011)

Almost 70,000 people are living with HIV in Texas. Over 20,000 people are living with HIV in Houston/Harris County.

Houston/Harris Co. HIV Diagnoses, Source: eHARS- HDHHS Jan ’99: HIV reportable by name in TX

Growing Gap between Deaths and Number of PLWH

2013 Houston Area Integrated Epidemiological Profile for HIV/AIDS Prevention and Care Services Planning HIV/AIDS in the Houston Area  HIV Incidence  New Diagnoses of HIV  Persons Living with HIV (PLWH)  Mapping of New Diagnoses and PLWH  Deaths of PLWH  New Diagnoses, Prevalence, and Mortality: Five-Year Trends

Houston/Harris Co. HIV Diagnoses, 2011 HIV by Risk Source: eHARS- HDHHS, unknown risk re-distributed using the CDC’s multiple imputation technique When examining risk by sex, MSM accounted for 79.5% of transmission risk in males

Houston/Harris Co. HIV Diagnoses, 2011 HIV Rates by Age Source: eHARS- HDHHS

Chlamydia and Gonorrhea — Age- and sex-specific rates Houston/Harris County, 2011 Chlamydia rates do not include the following: n=2 missing sex, n=24 missing age Gonorrhea rates do not include the following: n=3 missing sex, n=6 missing age Source: HDHHS Chlamydia Gonorrhea

Source: eHARS- HDHHS, unknown risk re-distributed using the CDC’s multiple imputation technique What is the population of MSM in Houston/Harris County?

Source: eHARS- HDHHS, unknown risk re-distributed using the CDC’s multiple imputation technique

HIV Diagnoses — Rates by race/ethnicity Houston/Harris County, 1999–2011 Source: eHARS- HDHHS Nationally: 1 in 16 black men will be diagnosed with HIV at some point in his lifetime

Total Population vs. HIV-Infected

STD Rates by race/ethnicity, Houston/Harris Co. Syphilis (P&S) Chlamydia Gonorrhea Source: STD*MIS- HDHHS

Contributing Factors to HIV/STD Disparities Higher prevalence in community  Houston: highest rate of PLWHA in TX Stigma and/or discrimination  Houston: larger % of foreign-born and language other than English at home vs. TX overall Access to quality medical care and testing→ Delayed diagnosis and treatment  Houston: higher % of uninsured than TX overall Social determinants of health  Houston: median household income ~$7000 lower than TX median  Houston: lower % of high school graduates than TX overall HIV Prevalence Rate, by Income “STD disparities reflect socioeconomic disparities, which in turn reflect deep- rooted racial inequalities” (CDC, 2007) Individual sexual risk behavior does not account for the observed racial disparities in STDs (CDC, 2007) Source: Houston Area Comprehensive Plan, Graph: CDC, NHBS-HET −2007

HIV Co-Morbidity Why focus on STDs?  STDs can cause infertility, chronic pelvic pain, damage of internal organs, cancer, paralysis, sores and lesions, blindness, dementia, and/or death.  Those infected with STDs are 2-5 times more likely to acquire HIV if exposed.  If a person living with HIV/AIDS is infected with another STD, transmission of HIV to another person via sexual contact is more likely. HIV Co-Morbidity in Houston/Harris Co.  From January- December 2012, 39.0% of all interviewed primary and secondary syphilis cases were also HIV positive. This is an increase in co-morbidity as 31.2% of cases were HIV positive in  From January- December 2012, 58.1% of all interviewed primary and secondary syphilis cases among MSM were also HIV positive. This is an increase in co-morbidity as 52.1% of cases were HIV positive. Source: STD*MIS- HDHHS

2013 Houston Area Integrated Epidemiological Profile for HIV/AIDS Prevention and Care Services Planning Risk for HIV/AIDS in the Houston Area  HIV Testing and Awareness of Status  Chlamydia Trends  Gonorrhea Trends  Infectious Syphilis Trends HIV Service Utilization  Linkage to Care  Met Need  Treatment Cascade Profile of Out-of-Care Special Topics  Priority Populations  Co-Infection

Acknowledgements HIV/STD Surveillance Team and Bureau of Epidemiology, HDHHS Monica Slentz, Community Health Planning, Evaluation & Research, HDHHS Bureau of HIV/STD and Viral Hepatitis Prevention, HDHHS Ryan White Grants Administration and Ryan White Planning Council’s Office of Support for Houston EMA Houston HIV Community Planning Group (CPG) and Ryan White Planning Council (RWPC) TB/HIV/STD Epidemiology and Surveillance, Texas Dept. of State Health Services