1 State of the State: HIV/STD in Texas Ann Robbins Texas Department of State Health Services June 2009

2 In 2007, there were 122,717 reported diagnoses of sexually transmitted diseases.

3 Chlamydia Cases,

4 Chlamydia Case Rates by County 2007

5 Gonorrhea Cases,

6 Gonorrhea Case Rates by County 2007

7 Primary and Secondary Syphilis Cases by Year of Report,

8 P&S Syphilis Case Rates by County - Texas, 2008

9 Persons Living with HIV/AIDS, New Diagnoses of HIV/AIDS, and Deaths among those with HIV/AIDS

10 Texas Persons Living with HIV/AIDS (PLWHA) by County 2006

11 Burden of STD in Texas disproportionately borne by racial/ethic minorities.

12 Chlamydia Case Rates by Year of Report and Race/Ethnicity - Texas,

13 Gonorrhea Case Rates by Race/Ethnicity

14 P&S Syphilis Case Rates by Year of Report and Race/Ethnicity - Texas,

15 The rate of living HIV cases among Blacks in Texas is 3 to 4 times higher than the rate in Whites or Latinos.

16 Number and Rate of PLWHA by Race/Ethnicity, The number of black persons living with HIV/AIDS surpassed that of whites in The rate in 2007 was 4-5 times higher for blacks than for others. NumberRate

17 Rate of new HIV/AIDS diagnoses in Black women is 8 times higher than rate in Latinas, 20 times higher than rate in White women.

18 New Diagnoses, Number and Rate, by Sex and Race/Ethnicity, 2006

19 Over 5,000 newly acquired HIV infections in Texas in 2007 –Blacks accounted for 39% –Latinos accounted for 30% –Whites/Others accounted for 31% 2007 Incidence Estimate

20 One in…are Living with HIV/AIDS One in 378 of all Texans One in 498 of White Texans One in 565 of Hispanic Texans One in 112 of Black Texans

21 In Texas, heterosexual transmissions account for a growing number of newly diagnosed HIV cases, but MSM still make up the majority of new HIV diagnoses and an increased number of syphilis diagnoses.

22 P&S Syphilis Cases by Year of Report by Sex and MSM Risk,

23 Mode of transmission in new and living cases of HIV in Texas, 2007

24 1 in 3 Texans with HIV was diagnosed with AIDS within 1 year of first HIV + test

25 % of Texans with HIV and AIDS Diagnoses within 1 Month and 1 Year

26 BRFSS: HIV Testing Behavior HIV Testing History EverIn Past Year Hispanic 41%15% Black 64%28% White 41%10% Ever Tested for HIV among persons aged years, Texas, 2007

27 Estimated Percentages Newly infected in 2007 and unaware of their status Hispanic64% 55% 58% 59% Black White/Other Overall Incidence Surveillance: 2007 Incidence Estimate

28 Complexity Intersecting and Accelerating Epidemics –Psychiatric involvement Major depression Substance use and abuse Need to address structural factors –Constrict or eliminate choices –Physically, socially, psychologically separate and isolate

29 Texas Hospital Discharge Data: Cost of HIV/AIDS and Hepatitis Admissions, 2005