HIV
This presentation is the property of its rightful owner.
Sponsored Links
1 / 31

HIV Care Continuum New Diagnoses, 2011, Georgia PowerPoint PPT Presentation


  • 107 Views
  • Uploaded on
  • Presentation posted in: General

HIV Care Continuum New Diagnoses, 2011, Georgia. Persons with HIV Engaged in S elected S tages of the Continuum of Care, United States. 82. 66. Percent. 37. 33. 25. Hall et al . XIX International AIDS Conference, 2012 ART, antiretroviral therapy.

Download Presentation

HIV Care Continuum New Diagnoses, 2011, Georgia

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Hiv care continuum new diagnoses 2011 georgia

HIV Care Continuum New Diagnoses, 2011, Georgia


Persons with hiv engaged in s elected s tages of the continuum of care united states

Persons with HIV Engaged in Selected Stages of the Continuum of Care, United States

82

66

Percent

37

33

25

Hall et al. XIX International AIDS Conference, 2012

ART, antiretroviral therapy


Care continuum methodology new hiv diagnoses 2011 georgia

Care Continuum Methodology, New HIV Diagnoses 2011, Georgia

  • Adults and adolescents are those aged >= 13 years

  • Diagnosed between 01/01/11 -12/31/11

  • Alive at least 15 months after diagnosis

  • Residence at diagnosis and current address within Georgia

  • Excludes 52 persons deceased within 15 months of diagnosis

  • Linked to care = CD4 or VL within 3 months of diagnosis , excluding day of diagnosis

  • Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

  • Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

  • Estimated percentage prescribed ART derived from the Medical Monitoring Project (MMP) Georgia sample

  • Viral suppression (VS) = VL<200 copies/ml in most recent viral load

  • All percentages are percent of total number of persons diagnosed with HIV


Hiv care continuum methodology

HIV Care Continuum Methodology

Months 4-15 after diagnosis

Months 0-3 after diagnosis

Confirmatory Diagnosis Date

CD4 or Viral Load

CD4 or Viral Load

CD4 or Viral Load

Last viral load <200 copies/ml

  • This person is:

  • Linked YES

  • Engaged YES

  • Retained YES

  • Virally suppressed YES


Hiv care continuum methodology1

HIV Care Continuum Methodology

Months 4-15 after diagnosis

Months 0-3 after diagnosis

HIV Confirmatory Diagnosis Date

CD4 or Viral Load

CD4 or Viral Load

Last viral load undetectable

  • This person is

  • Linked YES

  • Engaged YES

  • Retained NO

  • Virally suppressed YES

  • “Engaged in care” is minimal engagement that indicates the person “touched” the medical system at least once during that 12 month period


Hiv care continuum methodology2

HIV Care Continuum Methodology

Months 4-15 after diagnosis

Months 0-3 after diagnosis

HIV Confirmatory Diagnosis Date

CD4 or Viral Load

CD4 done but no viral load done

  • This person is

  • Linked NO

  • Engaged YES

  • Retained YES

  • Virally suppressed NO

  • If no viral load done, it is assumed to be not suppressed


Adults and adolescents diagnosed with hiv infection georgia 2011

Adults and adolescents diagnosed with HIV infection, Georgia, 2011

Adults and adolescents >= age 13, diagnosed 01/01/11 -12/31/11, Georgia = 2885

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Prescribed ART derived from MMP sample

Viral suppression (VS) = VL<200 copies/ml in most recent viral load = 1307

Note: all percentages are proportion of total number of persons diagnosed with HIV in category


Adults and adolescents diagnosed with hiv infection by race ethnicity georgia 2011

Adults and adolescents diagnosed with HIV infection, by race/ethnicity, Georgia, 2011

Adults and adolescents >= age 13, diagnosed 01/01/11 - 12/31/11, Georgia = 2885

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml in most recent viral load

American Indian/Alaska Native, Asian, and Native Hawaiian/Other Pacific Islanders combined equal <2% of new diagnoses and are included in Other/Unknown


Adult and adolescent males diagnosed with hiv infection by race ethnicity georgia 2011

Adult and adolescent males diagnosed with HIV infection, by race/ethnicity, Georgia, 2011

Adult and adolescent males >= age 13, diagnosed 01/01/11 - 12/31/11, Georgia = 2214

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml in most recent viral load

American Indian/Alaska Native, Asian, and Native Hawaiian/Other Pacific Islanders combined equal <2% of new diagnoses and are included in Other/Unknown


Adult and adolescent females diagnosed with hiv infection by race ethnicity georgia 2011

Adult and adolescent females diagnosed with HIV infection, by race/ethnicity, Georgia, 2011

Adult and adolescent females >= age 13, diagnosed 01/01/11 - 12/31/11, Georgia = 655

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml in most recent viral load

American Indian/Alaska Native, Asian, and Native Hawaiian/Other Pacific Islanders combined equal <2% of new diagnoses and are included in Other/Unknown


A dults and adolescents diagnosed with hiv infection by age georgia 2011

Adults and adolescents diagnosed with HIV infection, by age, Georgia, 2011

N=258

N=655

N=537

N=649

N=786

Adults and adolescents >= age 13, diagnosed 01/01/11 - 12/31011, Atlanta = 2885

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml most recent viral load

Note: all percentages are percent of total number of persons diagnosed with HIV in category


Transmission category definitions

Transmission category definitions

  • Multiple imputation was used to re-distribute transmission category where missing

  • MSM = Male to male sexual contact

  • IDU = Injection drug use

  • MSM/IDU = Male to male sexual contact and injection drug use

  • HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

  • Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified


Adult and adolescent males diagnosed with hiv infection by transmission category georgia 2011

Adult and adolescent males diagnosed with HIV infection, by transmission category*, Georgia, 2011

Adult and adolescent males >= age 13, diagnosed 01/01/11 - 12/31/11, Georgia = 2214

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml in most recent viral load

Multiple imputation was used to re-distribute transmission category where missing

*MSM = Male to male sexual contact IDU = Injection drug use

MSM/IDU = Male to male sexual contact and injection drug use

HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified


A dults and adolescent females diagnosed with hiv infection by transmission category georgia 2011

Adults and adolescent females diagnosed with HIV infection, by transmission category*, Georgia, 2011

N=411

N=163

N=81

Adults and adolescent females >= age 13, diagnosed 01/01/11 - 12/31/11, Georgia = 655

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml in most recent viral load

Multiple imputation was used to re-distribute transmission category where missing

*IDU = Injection drug use

HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified


Adult and adolescent black msm diagnosed with hiv infection by age georgia 2011

Adult and adolescent Black MSM diagnosed with HIV infection, by age, Georgia, 2011

Adult and adolescent males >= age 13, diagnosed 01/01/11 - 12/31011, Georgia = 1050

Linked to care = CD4 or VL within 3 months of diagnosis

Engaged in care >= 1 CD4 or VL 4-15 months after diagnosis

Retained in care >= 2 CD4 or VL at least 3 months apart 4-15 months after diagnosis

Viral suppression (VS) = VL<200 copies/ml in most recent viral load

Note: all percentages are percent of total number of persons diagnosed with HIV in category


The hiv care continuum can help us

The HIV Care Continuum can help us…

  • Focus our efforts for linkage, retention and viral suppression.

  • Identify groups at increased risk for dropping out of each step in the continuum.

  • Monitor our progress in improvement of linkage, retention, and viral suppression.

  • Identify disparities not only in prevalence but in care

  • Evaluate efforts addressing specific populations with low viral suppression.

  • Monitor efforts in improving viral suppression in specific counties, census tracts, zip codes and some specific facilities

  • Encourage improvement in surveillance data completeness (race, sex, transmission category)


Stage of hiv disease at diagnosis

Stage of HIV disease at diagnosis

  • Stage at diagnosis is defined by the first CD4 done within 3 months of diagnosis

    Stage 1 = CD4 >=500

    Stage 2 = CD4 200-499

    Stage 3 = CD4 <200 or OI

  • Stage at diagnosis is unknown if no CD4 done within 3 months of diagnosis


Hiv care continuum new diagnoses 2011 georgia

Stage of disease by earliest CD4 count within 3 months of HIV diagnosis, adults and adolescents, Georgia, 2011

N=418

N=649

N=561

N=1257

Adults and adolescents >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2885

CD4<200 = Stage 3 disease (AIDS)

Stage unknown = no CD4 within 3 months of diagnosis


Hiv care continuum new diagnoses 2011 georgia

Stage of disease by earliest CD4 count within 12 months of HIV diagnosis, adults and adolescents, Georgia, 2011

N=484

N=766

N=632

N=1003

Adults and adolescents >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2885

CD4<200 = Stage 3 disease (AIDS)

Stage unknown = no CD4 within 12 months of diagnosis


Hiv care continuum new diagnoses 2011 georgia

Number and proportion of adults and adolescents by stage at diagnosis by earliest CD4 count within 3 and 12 months after diagnosis, by race/ethnicity, Georgia, 2011

Adults and adolescents >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2885

CD4<200 = Stage 3 disease (AIDS)

Stage Unknown = no CD4 within 3 or 12 months of diagnosis

*American Indian/Alaska Native, Asian and Native Hawaiian/Pacific Islander groups together constitute <2% of adults diagnosed with HIV in Georgia, 2011 and are grouped with other/unknown race/ethnicity

** N = total number in this category


Hiv care continuum new diagnoses 2011 georgia

Stage of disease by CD4 count within 12 months of HIV diagnosis, adults and adolescents, by race/ethnicity, Georgia 2011

N=1616

N=271

N=144

N=854

Adults >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2885

CD4<200 = Stage 3 disease (AIDS)

Stage Unknown = no CD4 within 12 months of diagnosis

*American Indian/Alaska Native, Asian and Native Hawaiian/Pacific Islander groups together constitute <2% of adults diagnosed with HIV in Georgia, 2010 and are grouped with Unknown race/ethnicity


Hiv care continuum new diagnoses 2011 georgia

Number and proportion of adults and adolescents by stage at diagnosis using earliest CD4 count within 3 and 12 months after diagnosis, by sex, Georgia, 2011

Adults and adolescents >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2869

CD4<200 = Stage 3 disease (AIDS)

Stage Unknown = no CD4 within 3 or 12 months of diagnosis

*N = total number in this category

Excludes 16 cases for which sex was not reported


Hiv care continuum new diagnoses 2011 georgia

Stage of disease by CD4 count within 12 months of HIV diagnosis, adults and adolescents, by sex, Georgia, 2011

N=655

N=2214

Adults and adolescents >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2869

Excludes 16 cases for which sex was not reported

CD4<200 = Stage 3 disease (AIDS)

Stage Unknown = no CD4 within 12 months of diagnosis


Hiv care continuum new diagnoses 2011 georgia

Number and proportion of adult and adolescent males by stage at diagnosis by earliest CD4 count within 3 and 12 months after diagnosis, by transmission category*, Georgia, 2011

Adult and adolescents males >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2214

CD4<200 = Stage 3 disease (AIDS) Stage Unknown = no CD4 within 3 or 12 months of diagnosis

Multiple imputation used to re-distribute transmission category where missing

*MSM = Male to male sexual contact IDU = Injection drug use

MSM/IDU = Male to male sexual contact and injection drug use

HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified

**N = total number in this category


Hiv care continuum new diagnoses 2011 georgia

Stage of disease by earliest CD4 count within 12 months of HIV diagnosis, adult and adolescent males, by transmission category*, Georgia, 2011

N=36

N=68

N=1386

Adults and adolescent males >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2214

CD4<200 = Stage 3 disease (AIDS) Stage Unknown = no CD4 within 12 months of diagnosis

Multiple imputation used to re-distribute transmission category where missing

*MSM = Male to male sexual contact IDU = Injection drug use

MSM/IDU = Male to male sexual contact and injection drug use

HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified


Hiv care continuum new diagnoses 2011 georgia

Number and proportion of adult and adolescent females by stage at diagnosis using earliest CD4 count within 3 and 12 months after diagnosis, by transmission category*, Georgia, 2011

Adult and adolescent females >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 655

CD4<200 = Stage 3 disease (AIDS)

Stage Unknown = no CD4 within 3 or 12 months of diagnosis

Multiple imputation used to re-distribute transmission category where missing

*IDU = Injection drug use

HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified

**N = total number in this category


Hiv care continuum new diagnoses 2011 georgia

Stage of disease by CD4 count within 12 months of HIV diagnosis, adult and adolescent females, by transmission category*, Georgia, 2011

N=81

N=411

N=163

Adult and adolescent females >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 655

CD4<200 = Stage 3 disease (AIDS)

Stage Unknown = no CD4 within 12 months of diagnosis

Multiple imputation used to re-distribute transmission category where missing

*IDU = Injection drug use

HET = Heterosexual contact with a person known to have, or to be at high risk for, HIV infection

Other = hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified


Limitations

Limitations

  • Incomplete reporting

  • Missing data for race/ethnicity, sex, and complete address at diagnosis

  • Lack of transmission category information

  • Estimation using multiple imputation to redistribute risk when missing

  • Definition of heterosexual transmission (sexual contact with a known HIV infected partner or person with increased risk, i.e., MSM or IDU)

  • Missing laboratory reports

  • CD4 within 3 and 12 months of diagnosis yields high unknown stage in Georgia


Uncertainties

Uncertainties

  • Populations for which data are missing may be fundamentally different

  • How to obtain data for transgender category

  • How to improve completeness of reporting

  • Data on ART use

  • Understanding barriers to ART adherence

  • Prioritizing further research


Hiv care continuum new diagnoses 2011 georgia

Viral suppression on most recent viral load, by stage of disease at or within 3 months of HIV diagnosis, adults and adolescents, Georgia, 2011

N=418

N=649

N=1257

N=561

Adults and adolescents >= age 13, diagnosed 1/1/2011 - 12/31/2011, Georgia = 2885

CD4<200 = Stage 3 disease (AIDS)

Stage unknown = no CD4 within 3 months of diagnosis


Hiv care continuum new diagnoses 2011 georgia

For information on HIV prevention visit

http://dph.georgia.gov/hiv-prevention-program

For more information on HIV surveillance in Georgia, visit

http://dph.georgia.gov/georgias-hivaids-epidemiology-surveillance-section


  • Login