1. Estimating the number of Kentuckians living with HIV disease with unmet needs for HIV-related primary care in calendar year 2010  Reducing new HIV infections is the first primary goal of the National HIV/AIDS Strategy (NHAS).  Increasing the number of persons diagnosed and linked into effective care and prevention services has the potential to significantly reduce morbidity and premature death, and decrease new HIV infections over time. ResultsBackground  Minority racial/ethnic groups have the highest percentages of unmet needs, therefore interventions should target these demographic groups. The percentages of Kentuckians with unmet needs are similar by sex and mode of transmission.  Local and state programs across the U.S. can use similar methodology as a model in the first step toward facilitating program planning to increase linkage to and retention in care.  The Kentucky Department for Public Health conducted a retrospective analysis of Kentucky residents diagnosed with HIV disease by December 31, 2010 and reported by December 31, 2011. HIV-related unmet needs definition:  Persons with unmet needs were those who were aware of their HIV status and not receiving HIV-related primary care through laboratory testing, or the Kentucky HIV/AIDS Care Coordinator Program (KHCCP), or Medicaid. Inclusion criteria:  Persons included were diagnosed with HIV disease by the end of 2010, while residing in Kentucky at time of diagnosis and living through December 31, 2010. Persons meeting these criteria and reported in the enhanced HIV/AIDS registry (eHARS) were analyzed for:  Laboratory reports of viral loads or CD4 assays collected in 2010; or  Evidence of care through the KHCCP database (CAREWare) during 2010; or  Evidence of care through Medicaid records for 2010.  Statistical analyses were completed using SAS ® software, version [9.2] and record linkages performed with Link Plus software.  All counts and percentages are estimates, due to limitations discussed.  The estimate does not account for migration in and out of the state. Kentucky is bordered by seven states. If treatment was sought out of state and testing done at a non-reference laboratory, then these persons may have been classified as out of care.  Although the definition calls for persons who are aware of their HIV status, Kentucky surveillance does not capture this information routinely. Therefore, the estimate includes persons reported in eHARS, regardless of HIV status awareness.  To estimate the number of Kentuckians living with HIV disease and aware of their status, who did not receive HIV-related primary care in calendar year 2010. Objective Methods Limitations Conclusions Peace Julie Nakayima, MPH 1, Kraig E Humbaugh, MD, MPH 1, Sara Robeson, MA, MSPH 1 1 Cabinet for Health and Family Services, Kentucky Department for Public Health, 275 E Main St, Frankfort KY Overall estimate: Of the 5,132 Kentuckians living with a diagnosis of HIV disease at the end of 2010, an estimated 38% had HIV-related unmet needs. Race/Ethnicity: Of the 246 Hispanics living with HIV disease at the end of 2010; Almost half had unmet needs (49%) Of the 1788 blacks living with HIV disease at the end of 2010; Almost half had unmet needs (45%) Of the 3027 whites living with HIV disease at the end of 2010; Over a third had unmet needs (34%) Key Point: HIV-related unmet needs were highest within minority groups in comparison to whites. Sex and Race/Ethnicity: Minority males living with HIV disease at the end of 2010 had the highest percentages of unmet needs: 52% of Hispanic males 48% of black males Minority females had comparable percentages of unmet needs: 39% of Hispanic females 37% of black females Key point: HIV-related unmet needs were highest among Hispanic males, black males, Hispanic females and black females in comparison to their white counterparts. Mode of Transmission: Of the 218 MSM and injection drug users (MSM/IDU) living with HIV disease 39% had unmet needs Of the 452 injection drug users (IDU) living with HIV disease 38% had unmet needs Of the 2719 men who have sex with men (MSM) living with HIV disease 35% had unmet needs Of the 820 high risk heterosexuals (HRH) living with HIV disease 30% had unmet needs Key Point: HIV-related unmet needs among Kentuckians were comparable by mode of transmission. Geographic Distribution The authors thank all programs within the Kentucky Cabinet for Health and Family Services for providing data for this analysis including: The Ryan White Part B Care Coordinator Program Department for Medicaid Services Acknowledgements