Delaware HIV Planning Council July 22, 2015 12:00-3:00 IN COLLABORATION WITH:
Introductions � Name � Organization and/or Location � Question of the day: � How long have you been active in the field of HIV/AIDS?
Committee Report M E M B E R S H I P & C O M M U N I T Y E N G A G E M E N T ( M C E ) W O R K I N G G R O U P
Committee Report S P E C I A L C O M M I T T E E O N P A R T Y R O L E S A N D R E S P O N S I B I L I T I E S
Committee Tasks Develop a set of roles and responsibilities to guide HPC, 1. and HPC subcommittee work. Develop annual work plan and timeline to guide HPC. 2. Develop Memorandum of Understanding between HPC, 3. DPH, and DHC.
Committee Process � Meetings: � Meeting 1: June 23, 2015 � Meeting 2: July 7, 2015 � Deliverables: � Party Roles and Responsibilities � Work Plan � Memorandum of Understanding
Committee Findings: Delaware Division of Public Health � Uses HPC advice and recommendations, and Department expertise to act as final decision maker regarding HIV planning and fund usage: Creates HPC; reviews and approves HPC policies and procedures; and, 1. collaborates and provides guidance to HPC – where appropriate. Prepares and submits: 2. Statewide Coordinated Statement of Need (SCSN); and, • Integrated Comprehensive HIV Prevention and Care Plan. • Sets funding priorities; allocates HIV prevention and care resources. 3. Using HPC guidance, participate in community engagement process. 4. Collects, analyzes, and reports quality measurement data for HIV grantees. 5.
Committee Findings: Delaware HIV Consortium � Assists the HPC in carrying out its responsibilities: Logistical and staff support for all HPC-, and HPC committee-meetings 1. Provide research, analytical, and writing support in the completion of HPC 2. duties . Manage the HPCs budget and reporting requirements 3. Serve as intermediary between the DPH, and the HPC. 4.
Committee Findings: Delaware HIV Planning Council � Serve as an advisory body to the state’s Division of Public Health: Institute policies and procedures that reflect CDC and HRSA “best 1. practices” for HIV community planning. Actively participate in the development and implementation of the state’s 2. mandated deliverables. Advise DPH on needs assessment methodology – participate as needed. 3. Provide recommendations on service priorities to improve care continuum 4. Work with DPH to determine additional responsibilities to fall under HPC 5. purview.
Committee Findings : Work Plan � Needs Assessment � CDC/HRSA Integrated Statewide Coordinated Statement of Need/Prevention and Care Plan � Priority Setting and Resource Allocation � Community Engagement Process � Quality, Performance, and Evaluation Data
Committee Findings: HPC Working Groups
Committee Recommendations Motion to accept the findings from the Special Committee 1. on Roles and Responsibilities regarding the roles and responsibilities of the HPC, HPC working groups, the DPH, and the DHC. 2. Motion to use findings language in the development of the HPC Work Plan and timeline, and in the Memorandum of Understanding between HPC leadership, DPH leadership, and DHC leadership.
2015 HIV/AIDS Epidemiology Update 2014 Data James Dowling Health Program Coordinator Division of Public Health
EXECUTIVE SUMMARY As an addition to the biannual HIV/AIDS report last produced in 2014 by the Delaware HIV/AIDS Surveillance Office, this document is intended to provide nurses, doctors and various planning groups the information required to understand the current status of the HIV epidemic in Delaware. By the end of 2014, Delaware had 3,540 persons living in the state with HIV disease. Unfortunately, African Americans in Delaware continue to be disproportionately represented among newly infected persons. In 2014 alone, African Americans were a full 62% of all new infections in Delaware despite being only 22% of the total population. By gender, males made up 64% of the new infection in 2014 and females 36%. African American males were 64% of all new infections in 2014 among all males and a full 41% of the total new infections in 2014 regardless of gender. By age group the highest level of new infections occurred among the 20-29 year olds with 33% of all new infections in 2014 occurring among this group. While it is often difficult to pin down exact cause of death with relation to AIDS patients, one trend remains undeniable in Delaware. Less people with AIDS are dying when compared to the 1980’s and 1990’s, while the total number of persons living in the state is exponentially larger than in those earlier times. This provides clear indication that medical treatment in Delaware has been very successful at keeping people with HIV and AIDS alive. By exposure factor, we do recognize an increase in the number of new infections among males who have sex with males (MSM) over the last four years. This fact has caused this risk factor to be the top cause of new infections on average from 2010 through 2014. This report goes beyond these limited data points and the reader should take advantage of this information by giving the report a start to stop analysis.
Primary Sources � Evaluation HIV/AIDS Reporting System (EHARS) – Collects infection data from all legally bound reporting sources throughout the State. � 2014 U.S. Census Estimates � 2012 CDC HIV/AIDS Surveillance Report
Questions � Special data request must be made through HIV/AIDS Surveillance Coordinator James Dowling – Phone – (302)744-1143 – Email – james.dowling@state.de.us – (special data is that which is not specifically covered in the following slides)
HIV/AIDS Trends in Delaware 3,540 living cases of HIV/AIDS (December 2014) Delaware infected 1 out of every 264 (n = 3,540) --AA = 1/92 (n = 2,147) --White = 1/554 (n = 1,074) --Hispanic = 1/340 (n = 247) (ratios based on latest available U.S. Census Estimates and reported Living HIV/AIDS cases)
Gender Groups
TRENDS IN HIV/AIDS IN DE � Gender --Males - 48% of Delaware’s population, yet 71% of all HIV/AIDS cases through 2014 --Females - 52% of Delaware’s population, 29% of all reported Delaware cases through 2014
New Infections in Delaware by gender 1997 - 2014 Note: Data perspective change from number of HIV cases and number AIDS cases to the number of New Infections Male Female 200 HIV Reporting Began 07/01 150 100 50 0 Year 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Total # 207 220 146 223 279 215 232 216 182 151 173 160 153 131 109 136 115 116
Race Ethnicity Groups
TRENDS IN DE (Cont) � Ethnicity -- African Americans (disproportionately high HIV/AIDS rate) 44% cases attributed to African-Americans in the late 80s---Stands at 65% at the end of 2014 despite being 22% of Delaware’s population
New Infections Diagnosed in Delaware Race/Ethnic Groups, 1997-2014 Caucasian AA Hispanic Other NOTE: Other = Am Indian, Native Alaskan Asian, Native Hawaiian and Multi Race 250 HIV Reporting Began 07/01 200 150 100 50 0 Year 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Total # 207 220 146 223 279 215 232 216 182 151 173 160 153 131 109 136 115 116
New Infections Diagnosed in Delaware by Gender and Race/Ethnic Groups, 1997-2014 Caucasian Male Caucasian Female AA Male AA Female Hispanic Male Hispanic Female Other Male Other Female Unknown 140 HIV Reporting 120 Began 07/01 100 80 60 40 20 0 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Year Total # 207 220 146 223 279 215 232 216 182 151 173 160 153 131 109 136 115 116
Age Groups
TRENDS IN DE (Cont) � AGE HIV - 58% reported were between ages of 20 – 39 at diagnoses - Teen groups not infected at rates seen in many other states, DE = 6% Stage 3 HIV (AIDS) - 70% reported were between ages 30-49 at diagnoses
New Infections Diagnosed in Delaware by age Group, 1997-2014
Mortality
TRENDS IN DE (Cont) � Mortality Better Treatment = Longer lives
HIV/AIDS Deaths 3,540 Living with HIV/AIDS in Deaths December 2014 200 Combination therapy begins 150 100 50 0 9 9 9 9 9 0 0 0 0 0 1 1 1 3 5 7 9 1 3 5 7 9 1 3 523 Living with 2014 death HIV/AIDS in ascertainment December 1988 incomplete
HIV/AIDS Deaths by Race, 1991 to 2014 Black White Hispanic Other 120 100 Number of Deaths 80 60 40 20 0 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 -20 2014 death Year ascertainment incomplete Note: Deaths are proportionate to infections across groups
HIV/AIDS Deaths by Gender, 1991 to 2014 Male Female 160 140 Number of Deaths 120 100 80 60 40 20 0 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 2014 death Year ascertainment incomplete
Geography --49% of all HIV/AIDS cases reported in Delaware through 2014 originated from Wilmington Metropolitan area.
22% 64% 2014 Estimated 30% Delaware Pop.= 933,547 Source: US Census 48% 16% Delaware Land Area 1,954 square miles 20%
Delaware Land 22% Area 1,954 square miles 30% 74% 48% Cumulative HIV/AIDS Cases January 1981 – Dec 2014 n = 5,750 11% 64% 2014 Delaware Pop.= 933,547 16% 15% 20%
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