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

2 Outline  HIV Epidemiology –National data –Texas trends –HIV testing/treatment  STD Epidemiology –Syphilis –Chlamydia –Gonorrhea

3 USA: Reported AIDS and HIV Cases  As of the end of 2007, 1,051,875 AIDS cases have been reported in the United States Of these cases 7% were reported in Texas  As of the end of 2007, 328,103 HIV cases have been reported in the United States* Of these cases 8% were reported in Texas *Includes 47 states, District of Columbia and 5 U.S..territories with name-based reporting as of December 2007 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, Vol. 18

4 Cumulative Reported AIDS Cases: Top 5 States, 2007 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, Vol. 18

5 Texas: The Big Picture  Since 1980, >107,000 Texans have been diagnosed with HIV/AIDS  >41,000 Texans with HIV/AIDS have died  As of year end 2008, 62,772 Texans were living with HIV/AIDS

6 New AIDS Cases, Deaths, and Persons Living with AIDS: Texas, New AIDS Cases Deaths among AIDS Cases Living with AIDS

7 Persons Living with HIV/AIDS: Texas, 1987 N=1,204

8 Persons Living with HIV/AIDS: Texas, 1997 N=16,184

9 Persons Living with HIV/AIDS: Texas, 2007 N=62,805

HIV/AIDS In 2008… 4,293 Texans were newly-diagnosed with HIV ­33% of Texans who first learned they had HIV in 2008 were diagnosed with AIDS within 1 year 2,758 Texans living with HIV progressed to AIDS 1,280 Texans with HIV/AIDS died

11 Newly-diagnosed HIV Cases: Texas,

12 Newly-diagnosed HIV Case Rates by Race: Texas,

13 48% 11% 36% 5% Race/Ethnicity of New HIV/AIDS Case: Texas, % 29% 26% 2% White Hispanic Other/Unknown African American Texas Population n=24,383,647 HIV/AIDS Cases n=4,293

14 Newly-diagnosed HIV Case Rates by Sex: Texas,

15 Race/Ethnicity of New HIV/AIDS Cases: Texas, 2008 Females n=979 Males n=3,314

16 Newly-diagnosed HIV Case Rates by Age: Texas,

17 Age of New HIV/AIDS Cases: Texas, 2008

18 HIV/AIDS Cases by Transmission Category: Texas, 2008 Men who have sex with Men (MSM) Injection drug use (IDU) MSM & IDU Heterosexual contact* Males Females * Heterosexual contact with person known to have or to be at high risk for HIV infection ** Cases with an unknown or other mode of transmission are not included

19 Perinatally Exposed and Infected Children: Texas, n=7 n=13 n=12 n=9

20 HIV Testing and Care  An estimated 16,686 people are living with HIV in Texas and are unaware of their status (undiagnosed)  Approximately one-third of persons living with HIV in 2007 had unmet need for care  33% of Texans who first learned they had HIV in 2008 were diagnosed with AIDS within 1 year  Only 14% of Texans had an HIV test last year

21 Reportable STDs in Texas  Syphilis  Chlamydia  Gonorrhea

22 Primary and Secondary Syphilis Cases: Texas,

23 P&S Syphilis Case Rates by Race/Ethnicity: Texas,

24 P&S Syphilis Case Rates* by Year of Report and Sex: Texas, * Rate = Cases per 100,000 population. Female Male

25 P&S Syphilis Cases by Sex and MSM: Texas,

26 P&S Syphilis Case Rates by County: Texas, 2009

27 Congenital Syphilis Cases: Texas,

28 Chlamydia Cases: Texas,

29 Chlamydia Cases by Year of Report: Texas,

30 Chlamydia Case Rates Among Women by Race/Ethnicity: Texas, Hispanic Af. American White

31 Chlamydia Case Rates by County: Texas, 2009

32 Gonorrhea Cases: Texas,

33 Gonorrhea Case Rates by Race/Ethnicity: Texas,

34 Gonorrhea Cases by Age Group and Race/Ethnicity: Texas, 2009

35 Gonorrhea Case Rates by County: Texas, 2009

36 Acknowledgements  HIV/STD surveillance staff at local and regional health departments across the state and at the central DSHS HIV/STD program who collected the data used in this presentation  Ed Weckerly and Jennifer Chase of the DSHS TB/HIV/STD Epidemiology and Surveillance Branch who analyzed the data and prepared the slides

37 Questions?  Contact Information: Sharon K. Melville, M.D., M.P.H. Texas Department of State Health Services Manager, TB/HIV/STD Epidemiology and Surveillance Branch