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HIV Epidemiology Trends for Women, Adolescents, and Children

HIV Epidemiology Trends for Women, Adolescents, and Children. Kate Goodin, MPH Senior Epidemiologist Florida Department of Health Division of Disease Control and Health Protection Bureau of Communicable Diseases HIV/AIDS and Hepatitis Prevention Section.

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HIV Epidemiology Trends for Women, Adolescents, and Children

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  1. HIV Epidemiology Trends for Women, Adolescents, and Children Kate Goodin, MPH Senior Epidemiologist Florida Department of Health Division of Disease Control and Health Protection Bureau of Communicable Diseases HIV/AIDS and Hepatitis Prevention Section

  2. Disclosures of Financial Relationships This speaker has no significant financial relationships with commercial entities to disclose. This speaker will not discuss any off-label use or investigational product during the program. This slide set has been peer-reviewed to ensure that there are no conflicts of interest represented in the presentation.

  3. Objectives • Recognize the distribution and patterns of HIV infection in these populations • Discuss recent transmission trends

  4. Background • Information presented • Reported cases of HIV infection, 2008-2011 • Measured data, not estimates • Does not account for: • Unreported • Undiagnosed

  5. OVERALL TRENDS

  6. The Epidemic in Florida, 2011 Population: 18.8 million(4th in nation)Cumulative AIDS cases: 124,069(3rd in nation)Cumulative pediatric AIDS cases: 1,543(2nd in nation)Cumulative HIV (not AIDS) cases: 47,695 (2nd in nation of 46 states with HIV name reporting)Persons living with HIV/AIDS: 97,436  (3rd in nation)HIV prevalence estimate: at least 130,000 HIV Incidence Estimates are approximately 5,000 per year, 2006-2009 Deaths due to HIV/AIDS: 1,005 (2011) 60% White 16% Black 22% Hispanic 2% Other* 29% White 49% Black 20% Hispanic 2% Other* *Other = Asian/Pacific Islanders; American Indians/Alaskan Natives; multi-racial. Trend data as of 12/31/2011, Living data as of 05/16/2012

  7. HIV Infection Cases and Rates*, by Year of Report, Florida, 2002-2011 *Source: Population estimates are provided by FloridaCHARTS

  8. Statewide Data: N=5,904 State Rate = 36.7 Rate per 100,000 population 0 0.1 to 15.0 15.1 to 30.0 > 30.0 HIV Infection Case Rates* by County of Residence,** Reported in 2011, Florida *Population data are from FloridaCHARTS **County totals exclude Department of Corrections cases (N=169).

  9. WOMEN

  10. Adult HIV Infection Cases, by Sex, Reported in the United States* and Florida U.S., 2010 N=47,129 Florida, 2011 N=6,027 *Source: US data, CDC HIV surveillance report, Vol. 22, Table 1a, 2011 data not available, HIV cases are Estimated reports for 46 states with confidential HIV reporting.

  11. Adult AIDS Cases by Sex, Reported in the United States* and Florida U.S., 2010 N=33,015 Florida, 2011 N=3,441 *Source: US data, CDC HIV surveillance report, Vol. 22, Table 2a, 2011 data not available.

  12. Adult HIV Infection Cases, by Sex and Race/Ethnicity, Reported in 2011, Florida Males N=4,608 Females N=1,419 *Other includes Asian/Pacific Islanders, Native Alaskans/American Indians and mixed races

  13. Adult Female HIV Infection Cases, by Mode of Exposure and Year of Report, 2002–2011, Florida Note: NIRs redistributed.

  14. Summary • Overall HIV infections in Florida have been decreasing • About a quarter of new HIV infections in Florida are in women • However, about a third of new AIDS diagnosis are in women • New HIV infections in women are more likely to be among black women

  15. Blacks make up a majority of HIV infection cases in both men and women • True • False

  16. PEDIATRIC AND PERINATAL CASES

  17. Perinatally Acquired HIV Infected Cases, Born in Florida, by Year of Birth, 1979-2011 Note: Includes all perinatally acquired HIV Infection cases born in Florida.

  18. Perinatally Acquired HIV Infection Cases Born in Florida, by Mother’s Mode of Exposure and Year of Birth, 1979-2011 Born 1979-1993 N =626 Born 1994-2011 N =567

  19. Time of Maternal HIV Testing Among Perinatally Acquired HIV Infection Cases Born in Florida, 2005-2011 (N=79)

  20. Yes No Perinatally Acquired HIV Infection Cases in Children Whose Mom’s HIV status was Known Prior to Delivery Born in Florida 2005-2010 Adequate Prenatal Care Began by 4th month with 5+ visits Any Prenatal ART AZT and/or antiretrovirals

  21. Yes No Perinatally Acquired HIV Infection Cases in Children Whose Mom’s HIV status was Known Prior to Delivery Born in Florida 2005-2010 ART During Labor AZT and/or antiretrovirals Elective Caesarean Delivery

  22. Perinatally Acquired HIV Infection Cases in Children Born in Florida 2005-2010 Received any Neonatal ART Breastfed

  23. Cumulative Pediatric HIV/AIDS Cases, by “Expanded” Modes of Exposure, Reported through 2011, Florida *Note: 5% (exploded pieces) are NOT perinatal transmission cases

  24. Summary • Perinatal HIV infections have decreased dramatically in Florida • Over 50% of perinatal HIV infections were born to mothers who did not know their HIV status prior to conception • Only about a third of mothers of perinatally HIV infected babies received adequate prenatal care

  25. Perinatally acquired HIV infections are most commonly associated with which maternal risk factor? • Injection drug use • Heterosexual contact • Transfusions • Other

  26. What proportion of perinatally acquired HIV infections were born through elective caesarian? • 12% • 76% • 39% • 54%

  27. ADOLESCENTS AND YOUNG ADULTS

  28. ADOLESCENT AND YOUNG ADULT FEMALES

  29. Reported HIV Cases in Females 13-24 Years of Age by Age Group and Transmission Category, Florida 2008-2011

  30. ADOLESCENT AND YOUNG ADULT MALES

  31. Reported HIV Cases in Males 13-24 Years of Age by Age Group and Transmission Category, Florida 2008-2011

  32. Reported HIV Cases in Males 13-19 Years of Age by Transmission Category and Year of Diagnosis, Florida 2008-2011

  33. Reported HIV Cases in Males 20-24 Years of Age by Transmission Category and Year of Diagnosis, Florida 2008-2011

  34. Reported HIV Cases in Males 13-24 Years of Age by Age Group and Year of Diagnosis, Florida 2008-2011

  35. Reported HIV Cases in Males 13-19 Years of Age by Race/Ethnicity and Year of Diagnosis, Florida 2008-2011

  36. Reported HIV Cases in Males 20-24 Years of Age by Race/Ethnicity and Year of Diagnosis, Florida 2008-2011

  37. Summary • The number of new HIV infections in males 20-24 has been increasing over the past four years • This increase is seen in all racial/ethnic groups • The number of new HIV infections among males 13-19 has been decreasing over the past four years • This decrease is among black and Hispanics, but there has been an increase among whites

  38. The largest risk for transmission among adolescent and young adult males is • Heterosexual contact • Injection drug use • MSM • Perinatal infection

  39. Among adolescents 13-19 years of age, all racial/ethnic groups experienced a decrease in HIV infections reported in 2011 • True • False

  40. Resources Much of the information provided here was produced by the Surveillance group within the HIV/AIDS and Hepatitis Prevention Section. Additional information from them can be accessed at the links below. Florida Department of Health http://www.doh.state.fl.us/Disease_ctrl/aids/index.html Trends and Statistics http://www.doh.state.fl.us/disease_ctrl/aids/trends/trends.html

  41. Questions? Contact Information: Kate Goodin 850-245-4448 Kate_Goodin@doh.state.fl.us

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