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HIV Prevention By Theo Hodge, Jr. MD for

HIV Prevention By Theo Hodge, Jr. MD for. HIV Prevalence i n Certain Populations in the United States Is Higher Than in Some Nations With High Prevalence of HIV. 1,2. 3. 3. 3. 4. 4. 5. 5. 6. 6. 6. 6. 6. 6. 6.

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HIV Prevention By Theo Hodge, Jr. MD for

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  1. HIV PreventionBy Theo Hodge, Jr. MDfor

  2. HIV Prevalence in Certain Populations in the United States Is Higher Than in Some Nations With High Prevalence of HIV 1,2 3 3 3 4 4 5 5 6 6 6 6 6 6 6 1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2014; vol. 26. http://www.cdc.gov/hiv/library/reports/surveillance/. Published November 2015. Accessed April 2017; 2. U.S. Census Bureau. Population estimates. http://www.census.gov/programs-surveys/popest/data/data-sets.2013.html. Accessed April 2017; 3. Annual Epidemiology and Surveillance Reports for the District of Columbia. HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) Annual Report 2014; 4. AIDSVu. https://aidsvu.org/state/louisiana/new-orleans/. Accessed April 2017; 5. AIDSVu. https://aidsvu.org/state/new-york/new-york-city/. Accessed April 2017; 6. Prevalence of HIV, World Bank Group. http://data.worldbank.org/indicator/SH.DYN.AIDS.ZS. Accessed April 2017.

  3. Major Disparities Exist in the Estimated Lifetime Risk of HIV Diagnosis in the US One in n: 150 101 69 121 Lowest Risk Highest Risk 139 155 143 115 84 West Midwest 96 49 Northeast 13 115 98 93 103 102 86 159 South 51 97 85 56 138 81 54 Hess K, et al. CROI 2016. Boston, MA. #52. Adapted from CDC at https://www.cdc.gov/nchhstp/newsroom/2016/croi-2016.html#Graphics2. Accessed April 2017.

  4. Lifetime Risk of HIV Diagnosis Lifetime Risk of HIV Diagnosis by Race/Ethnicity Lifetime Risk of HIV Diagnosis Among MSM by Race/Ethnicity African-American Men 1 in 20 1 in 6 Total MSM African-American Women 1 in 48 African- American MSM 1 in 2 Hispanic Men 1 in 48 Hispanic Women 1 in 227 1 in 4 Hispanic MSM White Men 1 in 132 White MSM 1 in 11 White Women 1 in 880 • The overall lifetime risk of HIV in the United States is 1 in 99 • African-American men have highest lifetime risk of HIV of all races and ethnicities(1 in 20) • African-American MSM (1 in 2) and Hispanic MSM (1 in 4) have even higher lifetime risk of HIV Hess K, et al. CROI 2016. Boston, MA. #52. Adapted from CDC at https://www.cdc.gov/nchhstp/newsroom/2016/croi-2016.html#Graphics2. Accessed April 2017.

  5. Identification of Adult Candidates for TRUVADA for PrEP Individuals who engage in sexual activity in a high-prevalence area or social network AND have one or more of the following risk factors: Individuals with HIV-1-infected partner(s) OR + – Inconsistent or no condom use Sexual partners of unknown HIV-1 status with any of these risk factors Exchange of sex for commodities (money, food, shelter, drugs) ? Diagnosis of STIs Use of illicit drugs or alcohol dependence Incarceration • Uninfected individuals at high risk for sexually acquired HIV-1 may include: STI, sexually transmitted infection. TRUVADA Prescribing Information. Gilead Sciences, Inc. 2016.

  6. PrEP Utilization by Gender and Race in the US(2013 to Q1 2016) Males (n=24,594) Females (n=3485) White Females 3.8 and 4.4 times more likely to be started than their Black or Hispanic counterparts White Males 8.3 and 6.7 times more likely to be started than their Black or Hispanic counterparts Black White Hispanic Asian In 2014, 44% and 23% of new HIV infections were black and Hispanic persons compared with 27% for whites. Bush S, et al. J Int AIDS Soc. 2016;19(suppl 7):14-15. Abstract O314.

  7. National Electronic Prescription Database:New PrEP Starts in the US (2012-2015) Starting PrEP (2012-2015) • Highest rates of FTC/TDF for PrEP • Men: 76% • >25 years of age: 85% • States with the highest rate of PrEP use • Massachusetts, New York, Illinois • Barriers to PrEP use should be addressed in those at high risk of HIV acquisition • Women • <25 years of age • States with historically high infection rates Mera R, et al. JAIDS. 2016;19(suppl 5):30. Abstract TUAX0105LB.

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