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HIV/AIDS Prevention Committee Public Meeting November 21, 2013 Welcome and Purpose of Meeting James W. Gross, MPH Health Commissioner Public Health – Dayton & Montgomery County 1 Introductions and Logistics LeBarron Springer Community Member Co-Chair of HIV/AIDS Prevention Committee HIV and AIDS Infection Surveillance, Ohio and Region 7 Sara Paton, Ph.D. Epidemiologist Public Health—Dayton & Montgomery County November 21, 2013 Outline New diagnoses of HIV/AIDS (incidence) Living with a diagnosis of HIV/AIDS (prevalence) Deaths among persons reported with a diagnosis of HIV/AIDS STD summary APC Public Meeting 4 New Diagnoses of HIV/AIDS APC Public Meeting 5 New Diagnoses of HIV/AIDS 2012 Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013 6 Reported diagnoses of HIV infection by year of diagnosis and cumulative diagnoses Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013. Asterisk (*) indicates rate not calculated for case count < 5 due to unstable rates. Dash (-) indicates no cases were reported for the given category. 7 Diagnoses of HIV infection, by race/ethnicity and transmission category, Ohio 2012 HIV/AIDS Diagnosis Transmission Category White, not Hispanic Black, African American Hispanic/ Latino Asian/Pacific Islander Unknown No. % No. % No. % No. % No. % Male-to-male sexual contact 276 67% 242 62% 35 69% 1 20% 28 65% Injection drug use (IDU) 8 2% 6 2% 3 3% - - 1 2% Male-to-male sexual contact and IDU 15 4% 7 2% 1 2% - - 2 5% Heterosexual contact 8 2% 18 5% 1 2% - - 1 2% Other/unknown 105 25% 117 30% 11 22% 4 80% 11 26% Injection drug use 5 8% 2 2% 1 20% - - - - Heterosexual contact 21 36% 26 22% 1 20% - - 2 29% Other/unknown 33 56% 91 76% 3 60% 2 100% 5 71% Perinatal - - 1 13% - - - - - - Other/unknown - - 7 88% - - - - - - Total 471 Male adult or adolescent Female adult or adolescent Child (<13 yrs at diagnosis) 517 56 7 Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013; Dash (-) indicates no cases 50 8 Time to an AIDS diagnosis after a diagnosis of HIV infection, 2012 Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013 9 % of Reported Diagnoses of HIV Infection by Selected Characteristics, Ohio Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013 10 Number of New HIV and AIDS Cases by Transmission Category, 2012 Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013 11 Summary of New HIV/AIDS Diagnoses The HIV rate for 2011 in Montgomery County increased 7.1% compared to 2010 (15 vs. 14 per 100,000). Butler County had a 16% increase, Warren had a 28% increase and Ohio had a 8.3% increase in HIV rate. Males have a much higher percentage of cumulative HIV/AIDS cases (80-85% for the state and Region 7). New cases of HIV in females have decreased 25% from 2006 to 2012 while males have increased 8%. APC Public Meeting 12 Summary of New HIV/AIDS Diagnoses Black, non-Hispanics accounted for 43% of new HIV/AIDS diagnoses in 2012, but only represent approximately 14% of the population in Ohio. In Montgomery County, 2012, 60% of HIV cases converted to AIDS in less than 1 year. APC Public Meeting 13 Summary of New HIV/AIDS Diagnoses Among males in Ohio, 67% of 2012 diagnoses of HIV infection were transmitted through male-to-male sexual contact. Among females in Ohio, 36% of 2012 diagnoses of HIV infection were transmitted through heterosexual contact and 56% were unknown. APC Public Meeting 14 Living with a Diagnosis of HIV/AIDS APC Public Meeting 15 Reported Persons Living with a Diagnosis of HIV/AIDS Infection 2011 Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013 16 Reported Persons Living with a Diagnosis of HIV Infection from 2006 - 2011 Ohio 2006 = 13,174 Ohio 2011 = 17,807 *35% increase Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013. 17 Reported Persons Living with a Diagnosis of HIV Infection by Selected Characteristics, Ohio Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013 18 Persons Living with a Diagnosis of HIV Infection as of June 30, 2013, by Transmission Category. HIV/AIDS Diagnosis Transmission Category Ohio Montgomery Butler No. % Darke No. % 20 77% Miami No. % No. % No. % Male-to-male sexual contact 9,114 65% 648 72% Injection drug use (IDU) 657 5% 24 3% 9 4% - - - - Male-to-male sexual contact and IDU 607 4% 32 4% 6 3% 1 4% 1 Heterosexual contact 1,057 8% 54 6% 14 6% 1 4% 3 Other/unknown 2,561 18% 142 16% 51 24% 4 Injection drug use 400 11% 29 12% Heterosexual contact 2,132 59% 149 Other/unknown 1,082 30% 69 Perinatal 161 82% 11 79% 2 100% - - - Other/unknown 36 18% 3 21% - - - - Total 17,807 Preble Warren No. % No. % 5 56% 49 69% - - 2 3% 2% - - 1 1% 6% 1 11% 3 4% 15% 5 11% 3 33% 16 23% 7% 1 33% 2 11% 1 33% 1 4% 60% 30 56% 2 67% 14 78% 2 67% 11 48% 28% 20 37% - 2 11% - - 11 48% - - - 3 100% - - - - - Male adult or adolescent 137 63% 38 81% Female adult or adolescent 4 - Child (<13 yrs at diagnosis) 1,164 273 - 29 65 12 Ohio Department of Health HIV/AIDS Surveillance Program, Public Health – Dayton & Montgomery County. Data reported through June 30, 2013; Dash (-) indicates no cases 97 19 Summary of Persons Living with an HIV/AIDS Diagnosis In 2011, 1,161 people in Montgomery County were living with HIV/AIDS. This is a 35% increase from 2006. All counties in Region 7 and the state showed an increase from 2006 to 2011. The proportion of persons living with AIDS (not HIV) in Montgomery County 2011 was 52%, up from 51% in 2010. This proportion varies among counties (Warren has 58% living with AIDS). APC Public Meeting 20 Summary of Persons Living with an HIV/AIDS Diagnosis In Ohio 2011, those 45-49 years of age have the largest number and proportion of persons living with an HIV infection (19%) compared to other age groups. This is followed by 40-44 year olds (16%) and then 50-54 and 55-59 year olds (15% each). APC Public Meeting 21 Summary of Persons Living with an HIV/AIDS Diagnosis For 2011, an estimated 48% of all reported persons living with HIV have male-to-male sexual contact as their mode of transmission, 18% have heterosexual contact and 3% have Intravenous Drug User as their mode of transmission. Over the past 6 years there has been little change in demographics for persons living with HIV. APC Public Meeting 22 Deaths Among Persons with a Diagnosis of HIV/AIDS APC Public Meeting 23 Reported Deaths Among Persons with a Diagnosis of HIV Infection Notes: Deaths among persons with a diagnosis of HIV infection represent deaths attributed to any cause among persons reported with a diagnosis of HIV/AIDS. County reflects county of residence at time of earliest diagnosis. Source: Ohio Department of Health HIV/AIDS Surveillance Program. Data reported through Dec 31, 2012. 24 Sexually Transmitted Diseases APC Public Meeting 25 Chlamydia rates*, 2007-2012 *Rates are shown per 100,000 persons and were calculated using census estimates for that year except for 2011 which utilize 2010. Ohio Department of Health, STD Surveillance. Data reported through 05/05/13. 26 Gonorrhea rates*, 2007-2012 *Rates are shown per 100,000 persons and were calculated using census estimates for that year except for 2011 which utilize 2010. Ohio Department of Health, STD Surveillance. Data reported through 05/05/13. 27 Syphilis rates*, 2007-2012 *Rates are shown per 100,000 persons and were calculated using census estimates for that year except for 2011 which utilize 2010. Ohio Department of Health, STD Surveillance. Data reported through 05/05/13. 28 Hepatitis C cases*, 2008-2012 *Rates are shown per 100,000 persons and were calculated using census estimates for that year except for 2011 which utilize 2010. Ohio Disease Reporting System, Ohio Department of Heatlth 29 Summary of STDS Overall Chlamydia rates over the past 6 years have decreased. However, 2012 data shows an increase of Chlamydia in all counties of our region. Gonorrhea rates have decreased 29% in Montgomery County since 2007. Ohio and Butler have also shown decreases. The other counties have remained relatively stable except for Miami, which has had a 159% increase in Gonorrhea rates from 2006-2011. Syphilis rates are increasing in the region and state. Montgomery has increased 200% since 2007. APC Public Meeting 30 Summary of STDS Syphilis rates are increasing in the region and state from 2007-2012. Montgomery – 200% Butler – 988% Darke – 0% Miami – -200% Preble – 240% Warren – 660% APC Public Meeting 31 Summary of STDS Individuals who are infected with STDs are at least two to five times more likely than uninfected individuals to acquire HIV infection if they are exposed to the virus through sexual contact. In addition, if an HIV-infected individual is also infected with another STD, that person is more likely to transmit HIV through sexual contact than other HIV-infected persons. STD treatment reduces an individual's ability to transmit HIV. APC Public Meeting 32 Questions? [email protected] APC Public Meeting 33 MSM Statewide Initiative Kristen Neumann-Martiensen HIV Prevention Specialist for MSM 34 Personal Experience Adrian Neil Jr. Outreach Specialist Greater Columbus Mpowerment Center 35 Evidenced Based Initiatives Mark Pawelczak ODH Human Services Program Consultant HIV/STD Prevention Program 36 Group Facilitation Joyce Close BSN, RN Bureau Supervisor Communicable Disease Public Health – Dayton & Montgomery County 37 Evaluations Andrea Young BS Supervisor HIV/AIDS Programs Public Health – Dayton & Montgomery County 38