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The scientific study of disease distribution and

The scientific study of disease distribution and the factors that cause diseases to spread in communities. Analyze the facts Educate others Build partnership Lend their perspectives Raise critical questions Seek knowledge. The number of people living with HIV/AIDS during a given year.

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The scientific study of disease distribution and

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  1. The scientific study of disease distribution and the factors that cause diseases to spread in communities

  2. Analyze the facts • Educate others • Build partnership • Lend their perspectives • Raise critical questions • Seek knowledge

  3. The number of people living with HIV/AIDS during a given year In 2006, an estimated 1,106,400 individuals were living with HIV/AIDS in the United States

  4. In 2006, an estimated 56,300 individuals became HIV infected in the U.S. The annual number of people who become HIV infected in a given period of time, typically a year.

  5. A rate measures a certain quantity or amount of one thing considered in relation to a unit of another thing. In public health, rates help describe the number of events per population unit, typically expressed as health events or disease per 100,000 people.

  6. A rate consists of a numerator and a denominator. 525,600 / 56,300 = 9.33 Annual minutes (numerator) divided by annual infections (denominator)equals a rate of 9 ½ minutes per infection

  7. Rates allow us to compare communities of different sizes. The numerator is the number of health events or disease and the denominator is the defined population at risk (including those who experience the event/disease): numerator ____________ x 100,000 = population rate denominator

  8. Based on meta-analysis, CDC estimates that: • An estimated 4% of U.S. males had same-sex behavior in the past 5 yrs • 7% of U.S. males have ever had MSM behavior • MSM account for an estimated 2% of the total U.S. population

  9. CDC notes and disclaimers: • • These estimates are preliminary! • • More complete analysis • – Refine meta-analysis estimates • – Re-calculate rates; also do by race and age • – May conduct separate analysis for young MSM • Identify population estimates for IDU and HET

  10. Transmission Rate: Represents the amount of transmission that occurs annually in relation to the population infected with HIV. Technically, this is HIV incidence divided by prevalence in a given year.

  11. HIV Transmission Rate (TR) CDC published in 2008 back-calculation estimates for HIV incidence and prevalence between 1977 and 2006. The new estimates allow retrospective TR calculations. Hall et al. JAMA. 2008; 300: 520- 529.

  12. HIV Transmission Rate, United States, 1977-2006 Source: Holtgrave et al. JAIDS 2009

  13. HIV Transmission Rate, United States, 1977-2006 Source: Holtgrave et al. JAIDS 2009

  14. What are the characteristics of people who become infected with HIV? • How do we understand population trends in the epidemic?

  15. Research advocates askcritical questions: • Do the data give an accurate picture of the epidemic? • Where/when/how was data collected? • What methodologies were employed in data collection, analysis, and presentation? • Who was involved? • How might disease surveillance be improved?

  16. Change HIV/AIDS Surveillance System Categories to More Accurately Reflect How Women Acquire HIV, Advocates Say • End the “seriously flawed” CDC hierarchical classification system that classifies most cases of HIV among women as “no identified risk” • Allow health departments to classify cases as “presumed heterosexual” when the male partner’s HIV status and/or risk factors are unknown • Collect “acquisition category” information to reflect “sexual networks and/or social networks” of elevated HIV prevalence. New data might include: • Prevalence of HIV where the person lives • The area’s post-incarceration rates • Drug/alcohol and homelessness partners for the area ms.foundation.org/File%20Library/NWAC/NWACpolicypropchartformFINALforweb.pdf

  17. Advocates Say Outreach and Surveillance Programs Undercount: • Transgender populations • Asian/Pacific Islanders • Undocumented people • American Indians/Native Hawaiians • Rural populations Without accurate surveillance, undercounted populations may receive fewer dollars for HIV prevention, care, and research activities

  18. Person Living with AIDS in 2005 By Region http://www.southernaidscoalition.org/policy/southern_states_manifesto_2008.pdf

  19. San Francisco Project maps concentration of HIV viral load across the city to determine where expanded services are needed

  20. To alter the course of the epidemic, We need to model where it is currently headed • Advocates shared a model with the White House comparing stable growth in the epidemic against progress toward defined goals • They call on the federal government to include a scientifically rigorous model in the National HIV/AIDS Strategy • The paper includes other important recommendations nationalaidsstrategy.org/2010/advocates-recommend-key-components-of-an-effective-strategy/

  21. 2007-2016 Projected Epidemic Based on A Constant 5% Transmission Rate

  22. David Ernesto Munar Vice President AIDS Foundation of Chicago 312-334-0933 dmunar@aidschicago.org aidschicago.org aidsconnect.net/dose

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