HIV IN THE MARYLAND PORTION OF THE WASHINGTON METROPOLITAN AREA - - PowerPoint PPT Presentation

HIV IN THE MARYLAND PORTION OF THE WASHINGTON METROPOLITAN AREA

WASHINGTON PLANNING COUNCIL APRIL 19, 2017 Colin Flynn, Chief HIV Surveillance, Epidemiology and Evaluation Maryland Department of Health and Mental Hygiene Prevention and Health Promotion Administration

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MISSION AND VISION

MISSION



The mission of the Prevention and Health Promotion Administration is to protect, promote and improve the health and well-being of all Marylanders and their families through provision of public health leadership and through community-based public health efforts in partnership with local health departments, providers, community based organizations, and public and private sector agencies, giving special attention to at-risk and vulnerable populations. VISION



The Prevention and Health Promotion Administration envisions a future in which all Marylanders and their families enjoy optimal health and well-being.

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U.S. Prevalence

 CDC estimated 1,107,700 adults/adolescents

were living with HIV at the end of 2014

– 37,200 in Maryland

 15.0% were undiagnosed

– 15.3% in Maryland

 Satcher Johnson, CROI 2017

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Living Adult/Adolescent HIV Diagnoses, Year-end 2014 Ranked by Rates

• CDC. HIV Surveillance Report, 2015. Vol. 27. Table 24.

Rank State/Territory Reported Cases Rate per 100,000 1 District of Columbia 15,200 2,665.0 2 New York 130,753 781.6 3 U.S. Virgin Islands 565 642.1 4 Maryland 32,002 638.9 5 Florida 103,696 609.0 6 Puerto Rico 17,072 567.3 7 Georgia 46,870 564.0 8 Louisiana 18,950 493.0 9 New Jersey 35,682 474.8 10 Delaware 3,213 406.9 United States 970,319 360.0

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Washington

Montgomery Prince George’s

Maryland Ryan White Eligible Metropolitan Areas Baltimore-Columbia-Towson

Frederick Calvert Charles

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Living HIV Diagnoses, Year-end 2014 Ranked by Estimated Rates

• CDC. HIV Surveillance Report, 2015. Vol. 27. Table 26.

Rank Metropolitan Area Reported Cases Rate per 100,000 1 Miami-Fort Lauderdale-West Palm Beach, FL 51,494 867.3 2 New York-Newark-Jersey City, NY-NJ-PA 139,679 695.1 3 Baton Rouge, LA 4,957 600.5 4 Baltimore-Columbia-Towson, MD 16,325 585.8 5 New Orleans-Metairie, LA 7,263 580.1 6 Jackson, MS 3,181 550.0 7 Atlanta-Sandy Springs-Roswell, GA 28,568 508.7 8 San Francisco-Oakland-Hayward, CA 23,217 505.2 9 Orlando-Kissimmee-Sanford, FL 10,603 455.7 10 Jacksonville, FL 6,455 454.3 13 Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 24,823 410.0 26 Washington-Arlington-Alexandria, DC-VA-MD-WV 19,610 325.0 United States (50 states, DC, PR only) 972,166 301.5

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Adult/Adolescent HIV Trends Washington MSA (MD Portion)

Data as reported through 6/30/16

100 200 300 400 500 600 700 800 900 1,000 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015

Number of Events Year of Diagnosis or Death

Reported HIV Diagnoses Reported AIDS Diagnoses Reported AIDS Deaths

HIV reporting transition 2007-2008

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Adult/Adolescent HIV/AIDS Prevalence Washington MSA (MD Portion)

Data as reported through 6/30/16

2,000 4,000 6,000 8,000 10,000 12,000 14,000 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015

Number of Cases Year

Living HIV Cases without AIDS Living HIV Cases with AIDS

+ 15.3% undiagnosed

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Adult/Adolescent Cases Washington MSA (MD)

Reported HIV Diagnoses during 2015 Living HIV Cases on 12/31/2015 Washington MSA (MD) 640 11,631 Calvert 3 103 Charles 26 412 Frederick 13 320 Montgomery 176 3,736 Prince George’s 422 7,060

Using data as reported through 6/30/2016

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Washington MSA (MD), Living Adult/Adolescent HIV Cases by County, 12/31/15

Calvert 1% Charles 3% Frederick 3% Montgomery 32% Prince George's 61%

N = 11,631

Using data as reported through 6/30/2016

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Living Adult/Adolescent HIV Case Rates per 100,000 Population by County, Washington MSA (MD), 12/31/15

Maryland Washington MSA Calvert Charles Frederick Montgomery Prince George's Rate 633 572 135 318 156 432 930

100 200 300 400 500 600 700 800 900 1,000 Population on 7/1/15. Cases on 12/31/15 as reported through 6/30/16

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Sex at Birth Trends Washington MSA (MD)

100 200 300 400 500 600 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number of Diagnoses Year of Diagnosis Male Female Data as reported through 6/30/16

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Age Trends Washington MSA (MD)

50 100 150 200 250 300 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number of Diagnoses Year of Diagnosis 13-19 20-29 30-39 40-49 50-59 60+ Data as reported through 6/30/16

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Race/Ethnicity Trends Washington MSA (MD)

100 200 300 400 500 600 700 800 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number of Diagnoses Year of Diagnosis Hispanic NH Black NH White NH Other Data as reported through 6/30/16

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Washington MSA (MD) Living Adult/Adolescent HIV Cases by Country of Birth, 12/31/15

N % Total 11,631 100.0 United States 9,244 79.5 Africa 1,348 11.6 Asia 69 0.6 Caribbean 137 1.2 Central America 317 2.7 Europe/Canada/Australia 41 0.4 South America 116 1.0 Other 17 0.1 Unknown 342 2.9

Using data as reported through 6/30/2016

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Exposure Categories MSM: Men who have Sex with Men IDU: Injection Drug Use MSM/IDU: Men who have Sex with Men AND Inject Drugs HetSex: Heterosexual Contact with a Person that has or is at Risk for HIV Infection

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Washington MSA (MD) Living Adult/Adolescent HIV Cases by Exposure Category, 12/31/15

MSM 43% MSM/IDU 2% IDU 7% HetSex 48% Other <1%

N (with Risk) = 8,307 (71% of Total)

Using data as reported through 6/30/2016

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Washington MSA (MD) Living Adult/Adolescent HIV Cases by Exposure Category and Sex at Birth, 12/31/15

1,000 2,000 3,000 4,000 5,000 6,000 Male Female Cases MSM MSM/IDU IDU HetSex Other

Using data as reported through 6/30/2016

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Risk Trends Washington MSA (MD)

50 100 150 200 250 300 350 400 450 500 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number of Diagnoses Year of Diagnosis MSM IDU MSM/IDU HET Data as reported through 6/30/16

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Continuum of Care Washington MSA (MD) Current Residence

Data as reported through 6/30/16

100.0% 83.7% 69.1% 58.4% 45.7% 13,423 11,235 9,269 7,836 6,136 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% HIV Infected HIV Diagnosed Linked to HIV Care Retained in HIV Care Suppressed VL Percent Engagement in HIV Care

Prevalence-Based Estimated Number and Percentage of HIV Infected Adults Engaged in Selected Stages of the Continuum of Care

Prevention and Health Promotion Administration

http://phpa.dhmh.maryland.gov/oideor/chse