New Jersey HIV/AIDS Epidemiologic Overview, 2017 (Data based upon - PowerPoint PPT Presentation

New Jersey HIV/AIDS Epidemiologic Overview, 2017 (Data based upon the HIV/AIDS Reporting System ‘eHARS,’ unless otherwise noted.) New Jersey Department of Health Division of HIV, STD, TB Services

INTRODUCTION  We will discuss: Incidence – new cases in 2015   True incidence is estimated to be about 10% greater than cases reported to the NJ Department of Health; the 10% includes unreported as well as undiagnosed cases. Prevalence – persons living with HIV in 2017.   Diagnosis Trends (2011 to 2015) and comparison to National figures.  HIV data will be examined by demographic status: gender, age, race, and exposure category  Review geographic dispersion of HIV in NJ.  NJ Care Continuum.  All surveillance data is based upon cases entered in the registry by December 31, 2017.

HIV INFECTION IN NEW JERSEY  New Jersey ranked 6th among the 50 states in the rate of adults and adolescents living with HIV/AIDS in 2015 and 11th in the rate of adults and adolescents diagnosed with HIV/AIDS in 2015.  Cumulatively, 81,437 cases of HIV/AIDS have been reported in New Jersey. As of December 31, 2017; 37,411 individuals were known to be alive and residing in New Jersey. Prevalent cases include 17,973 (48%) persons living with HIV only and 19,438 (52%) persons living with AIDS.  In 2015, there were 1,170 new diagnoses with HIV/AIDS in New Jersey. # of HIV/AIDS diagnoses in NJ for three most-affected subpopulation: 1) Hispanic/Latino MSM (not including MSM/IDU): 203. 2) Black MSM (not including MSM/IDU): 190. 3) Black Heterosexual Women: 130.  Between 2011 and 2015, the number of new adult/adolescent HIV/AIDS diagnoses decreased by 2%.  The percentage of concurrent HIV and AIDS diagnoses (cases that have already progressed to AIDS at the time of first diagnosis) has remained consistent over the last decade. In 2015, a quarter (25%) of new cases were concurrent HIV and AIDS diagnoses.

Incidence Rates of HIV Infection Among Adults and Adolescents, 2016 - United Sates Rates per 100,000: 16.8 in the South, 11.2 in the Northeast, 10.2 in the West, and 7.5 in the Midwest. NJ = 15.2

Number HIV/AIDS Diagnoses by Stage of Disease New Jersey, 2011 - 2015

HIV/AIDS and Gender New Jersey has historically had one of the highest proportions of HIV infections occurring in females, although the proportion of female cases is declining. New Jersey ranked 5 th in the number of cumulative HIV diagnoses among females in the U.S. through 2015. NJ ranked 7 th nationally in the rate of new infections; 24.2% of diagnoses in 2015 were among females. New Jersey ranked 8th nationally in the rate of adult and adolescent females living with HIV infection through 2016. A third (32.4%) of 2017 prevalent cases are among females, compared with a quarter of prevalent cases nationally.

Number HIV/AIDS Diagnoses by Gender New Jersey, 2011 - 2015

Transgender Cases -- New Jersey, December 31, 2017 Cumulative Cases (N=113) Prevalent Cases (N=93) Gender N % Gender N % M to Female 90 97% M to Female 110 97% F to Male 1 1% F to Male 1 1% Other gender ID 2 2% Other gender ID 2 2% Race/Ethnicity N % Race/Ethnicity N % White 7 8% White 6 5% Black 52 56% Black 62 55% Hispanic 33 35% Hispanic 44 39% Other/Unknown 1 Other/Unknown 1 1% 1% Age at Diagnosis N % Age at Diagnosis N % 13-24 30 32% 13-24 36 32% 25-34 41 44% 25-34 51 45% 35-44 16 17% 35-44 18 16% 45+ 6 6% 45+ 8 7% Transmission N % Transmission N % Sex 80 86% Sex 98 87% IDU-Related 2 2% IDU-Related 3 3% Unknown 11 12% Unknown 12 11%

Number Adult/Adolescent HIV/AIDS Diagnoses by Age Group -- New Jersey, 2011 - 2015

HIV/AIDS and Age While over two-thirds of prevalent cases were 45 or older in 2016; there appears to an increase in the proportion of persons being diagnosed at an earlier age. Between 2008- 2014, the number of diagnoses increased among males aged 13 to 34 years, especially those aged 13 to 24. In this latter group, the number of diagnoses rose from 162 in 2008 to 178 in 2014, increasing from 10% of male diagnoses in 2008 to 20% in 2014. Among women, the absolute number of diagnoses decreased in all age groups. However, the proportion of cases among females ages 13 to 24, increased from 9% of diagnoses in 2008 to12% of diagnoses in 2014. .

Number HIV/AIDS Diagnoses by Race/Ethnicity -- New Jersey, 2011 - 2015

Number of persons Living with HIV/AIDS, 2017 by Gender and Race in New Jersey

NUMBER AND PERCENTAGE OF HIV/AIDS DIAGNOSED IN 2015 BY RACE/ETHNICITY AND SEX – NEW JERSEY NJ males diagnosed NJ Females diagnosed HIV/AIDS HIV/AIDS 2015, N=887 2015, N=283 NJ eHARS as of 12/31/ 2017.

POPULATION (2016) AND PLWHA (2017) BY RACE/ETHNICITY – NEW JERSEY New Jersey Population Persons Living with 2016, N=8,944,469 HIV/AIDS New Jersey, 2017, N=37,411 NJ eHARS as of 12/31/ 2017. July 2017 Bridged-Race estimates for 2016 population

PERCENT FOR ADULT/ADOLESCENT HIV/AIDS DIAGNOSES BY AGE GROUP AND SEX -- NJ, 2015 Women (aged13+,N=280) Men (aged 13+,N=885) 50%

Number Adult/Adolescent HIV/AIDS Diagnoses by Race/Ethnicity and Age Group -- New Jersey, 2015 Hispanic White Black

HIV/AIDS and Mode of Transmission The number and percentage of new HIV/AIDS diagnoses due to IDU transmission in NJ diminished in recent years. In 2015, only 3.4% of men diagnosed with HIV/AIDS were IDU, this figure was 5.0% for women. Currently, 17% of persons living with HIV/AIDS in is attributed to IDU exposure. MSM has become the highest HIV/AIDS risk in NJ population. 57.5% of NJ men diagnosed with HIV/AIDS in 2015 were MSM. 55% of Black men diagnosed HIV/AIDS in 2015 were MSM and 64% of Hispanics men were MSM. The disparity of new cases in minorities is particularly pronounced for young MSM.

Number of Women Diagnosed HIV/AIDS by Exposure Category -- New Jersey, 2011 - 2015

Number of Men Diagnosed HIV/AIDS by Exposure Category -- New Jersey, 2011 - 2015

NEW HIV/AIDS CASES DIAGNOSED BY EXPOSURE CATEGORY, 2015 – NEW JERSEY Males diagnosed with HIV/AIDS Females Diagnosed HIV/AIDS 2015, N=887 2015, N=283

PLWHA BY EXPOSURE CATEGORY – NEW JERSEY EHARS DATA AS OF 12/31/2017 Males Living with HIV/AIDS Females Living with HIV/AIDS 2017, N=25,308 2017, N=12,103

HIV/AIDS Cases Diagnosed in 2015 by Planning Area New HIV/AIDS Cases Diagnosed in CY2015 per 100,000 2015 population, by Planning Area 6 Statewide rate= 13.1 per 100,000 2 5.0 – 8.9 1 9.0 – 13.9 8 14.0 – 22.9 23.0 + 3 9 7 Planning Area: 2015 New Cases Rate 1 Jersey City TGA 23.5 2 Newark EMA 20.3 3 Mercer 14.5 4 Atlantic-Cape May TGA 13.6 5 5 Cumberland 10.3 6 Bergen-Passaic TGA 9.7 7 NJ Portion of Philadelphia EMA 9.3 8 Middlesex-Somerset-Hunterdon 7.6 9 Monmouth-Ocean 5 .2 eHARS Data as of 12/31/2017, 2015 population from 2017 estimated

Persons Living with HIV/AIDS in 2017 by County Prevalence Rate: Persons Living with Counties: N (Rates) HIV/AIDS as of 12/31/2017 per 100,000 1 Essex 9601 (1205) population (Bridged Race Estimates 21 2 Hudson 5098 (752) 5 for July 1, 2016) 3 Union 2883 (519) Statewide rate= 418 per 100,000 15 4 Atlantic 1371 (506) 17 16 0.0 - 199 1 5 Passaic 2460 (484) 2 6 Mercer 1539 (415) 200 - 420 3 7 Cumberland 620 (403) 14 20 421 - 599 8 Camden 1909 (374) 10 600 + 9 Monmouth 1902 (304) 6 9 10 Middlesex 2160 (258) 11 Salem 155 (244) 12 Cape May 219 (232) 13 Burlington 888 (198) 13 19 14 Somerset 638 (191) 8 18 15 Bergen 1793 (191) 16 Warren 198 (186) 11 17 Morris 872 (175) 4 18 Gloucester 470 (161) 7 19 Ocean 818 (138) 20 Hunterdon 161 (129) 12 21 Sussex 174 (122) Data as of 12/31/2017

Socio-economic Status in New Jersey The percentage of New Jersey’s population living in poverty is lower than the nation as a whole. More than ten percent (10.4%) of New Jersey’s residents had incomes below the poverty level in 2016 compared to 15.1% nationally (Source: 2012-2016 American Community Survey 5-Year estimates). Counties with the lowest percentage of residents living below the poverty level (richest counties) are Hunterdon, Morris and Somerset. The richer counties tend to have lower HIV prevalence. Conversely, counties with the highest percentage of residents living below the poverty level (poorest counties) tend to have higher HIV incidence and prevalence. Essex, Hudson, Atlantic, Passaic, Mercer, Cumberland and Camden counties had the highest HIV/AIDS prevalence rates in 2017 and the highest poverty rates in 2016.