1. HIV, Race and Risk in Atlanta, GA: Data from Emory University Studies Patrick Sullivan, DVM, PhD Emory University Center for AIDS Research

2. About AIDSVu AIDSVu is a compilation of interactive, online maps that allows users to visually explore the HIV epidemic in the U.S. alongside critical resources such as HIV testing and treatment center locations. AIDSVu’s mission is to make HIV prevalence data widely accessible and locally relevant. AIDSVu provides users with an intuitive, visual way to connect with complex information about persons living with an HIV diagnosis at national, state and local levels.

3. Rates of Persons Living with an HIV or AIDS Diagnosis, by ZIP Code, Atlanta, 2011 Notes: Rates include persons living with an HIV or AIDS diagnosis in Clayton, Cobb, Douglas, DeKalb, Fulton, and Gwinnett Counties at the end of 2011 and who were reported as of 12/31/2013. Data have not been adjusted for reporting delays. Data Source: Georgia Department of Public Health, Division of Health Protection, Epidemiology Program, HIV/AIDS Epidemiology Section. * Data are not shown to protect privacy because of a small number of cases and/or a small population size.

4. Black RatesWhite Rates Rates of Black & White Persons Living with an HIV or AIDS Diagnosis, by ZIP Code, Atlanta, 2011 Notes: Rates include persons living with an HIV or AIDS diagnosis in Clayton, Cobb, Douglas, DeKalb, Fulton, and Gwinnett Counties at the end of 2011 and who were reported as of 12/31/2013. Data have not been adjusted for reporting delays. Data Source: Georgia Department of Public Health, Division of Health Protection, Epidemiology Program, HIV/AIDS Epidemiology Section. * Data are not shown to protect privacy because of a small number of cases and/or a small population size.

5. Persons Living with an HIV DiagnosisPoverty Rates Rates of Persons Living with an HIV Diagnosis & Poverty Rates, by ZIP Code, Atlanta, 2011 Notes: Rates include persons living with an HIV or AIDS diagnosis in Clayton, Cobb, Douglas, DeKalb, Fulton, and Gwinnett Counties at the end of 2011 and who were reported as of 12/31/2013. Data have not been adjusted for reporting delays. Data Sources: Georgia Department of Public Health, Division of Health Protection, Epidemiology Program, HIV/AIDS Epidemiology Section. U.S. Census Bureau, Small Area Income and Poverty Estimates. * Data are not shown to protect privacy. † Data not available because the data source does not publish these data for this jurisdiction.

6. When did the study occur? Analysis and dissemination phase Preparing data Statistical analyses Publishing papers in scientific literature Dissemination to community and stakeholders Analysis and dissemination phase Preparing data Statistical analyses Publishing papers in scientific literature Dissemination to community and stakeholders 2010 2011 2012 2013 2014 2009 7/2010 – 12/2012: Recruitment 5/2009 - 7/2010 Planning, focus groups 7/2010 – 3/31/2014: Participant follow-up 1/2013 – 12/2014: Prevalence findings 1/2014 – 12/2014: Incidence findings “Active” study phase

7. HIV Prevalence, by Race and Age Sullivan et al – PLoS One 2014 Black MSM: 44%White MSM: 13%

8. Comparisons of Factors by Race Sullivan et al – PLoS One 2014 Compared to white MSM, black MSM reported: ▫ Fewer sexual partners and sex risks ▫ Less drug use ▫ A higher degree of same-race partnering ▫ Similar ages of partners ▫ Less pre-sexual discussion of HIV status ▫ Lower socioeconomic status (poverty, employment, insurance) ▫ Living in more disadvantaged census tracts Social determinants Partner pool / network

9. Driven largely by differences in HIV prevalence. However, differences in HIV care continuum will also contribute. Population Transmission Risk Kelley et al – PLoS One 2012

10. STI Incidence Rosenberg et al – CROI 2014 BMSMWMSM Rate Ratio Infections Rate (% / year) Infections Rate (% / year) Urethral Chlamydia174.9143.11.6 Urethral Gonorrhea82.310.210.3 Rectal Chlamydia3110.2215.41.9 Rectal Gonorrhea289.0153.82.4 Syphilis226.200.0

11. HIV Incidence Rosenberg et al – CROI 2014 Black MSMWhite MSM Overall Incidence rate6.6% / year1.7% / year New HIV infections248 % HIV-positive at end of study11.3%3.6% Age 18 – 24 Incidence rate12.1% / year1.0 % / year New HIV infections161 % HIV-positive at end of study16.6%1.6% Age 25+ Incidence rate3.5% / year1.9% / year New HIV infections87 % HIV-positive at end of study6.0%4.5%

12. 1.7 / 100 PY 8 infections Cum. Inc. (2-yr): 3.6% 1.7 / 100 PY 8 infections Cum. Inc. (2-yr): 3.6% 6.6 / 100 PY 24 infections Cum. Inc. (2-yr): 11.3% 6.6 / 100 PY 24 infections Cum. Inc. (2-yr): 11.3% Log-Rank P = 0.0005 Proportion HIV Infected

13. THANK YOU! Patrick Sullivanpsulli@emory.edu Eli Rosenbergesrose2@emory.edu Patrick Sullivanpsulli@emory.edu Eli Rosenbergesrose2@emory.edu