Florida Department of Health HIVAIDS Section Data as of 6302018 To protect promote and improve the health of all people in Florida through integrated state county and community efforts Technical Notes ID: 744426
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Slide1
State of the HIV Epidemic in Florida, 2017
Florida Department of Health
HIV/AIDS Section
Data as of 6/30/2018
To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. Slide2
Technical Notes
HIV
d
iagnoses by year of diagnosis represent
persons whose HIV was diagnosed in that year, regardless of AIDS status at time of diagnosis.
AIDS and HIV
diagnoses by year of diagnosis are not mutually exclusive and cannot be added together.HIV prevalence data represent persons who were living with an HIV diagnosis in the reporting area through the end of the calendar year (regardless of where they were diagnosed).Resident deaths due to HIV represent persons who resided in Florida and whose underlying cause of death was HIV, regardless if their HIV status was reported in Florida or not. Slide3
Technical Notes, Continued
Adult
d
iagnoses represent ages 13 and older; pediatric diagnoses are those under the age of 13.
For data by year of diagnosis, the age is by age
at
diagnosis. For living data, the age is by current age at the end of the most recent calendar year, regardless of age at diagnosis.Unless otherwise noted, Whites are non-Hispanic, Blacks are non-Hispanic and Other (which may be omitted in some graphs due to small numbers) represents Asian/Pacific Islander, American Indian/Alaskan Native, or mixed races.For data by year, area and county data will exclude diagnoses where the residence at diagnosis was listed as Florida Department of Corrections or Federal Correctional Institution (FDC/FCI). For living data, FDC/FCI diagnoses will not be excluded from area and county data.Slide4
Implement routine HIV and Sexually Transmitted Infections (STIs) screening in health care settings and priority testing in non-health care settings
Provide rapid access to treatment and ensure retention in care (Test and Treat)
Improve and promote access to antiretroviral pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (
nPEP
)Increase HIV awareness and community response through outreach, engagement, and messaging
Florida’s Plan to Eliminate HIV Transmissionand Reduce HIV-related DeathsSlide5
MSM:
Men who have sex with men
or male-to-male sexual contact. The term MSM indicates a behavior that allows for HIV transmission, it does not indicate how individuals self-identify in terms of sexuality or gender.
IDU:
Injection drug useMSM/IDU: Men who have sex with men or male-to-male sexual contact & injection drug useHeterosexual:
Heterosexual contact with person who received an HIV diagnosis or known HIV riskOther Risk: Includes hemophilia, transfusion, perinatal and other pediatric risks and other confirmed risks
Definitions of Mode of Exposure CategoriesSlide6
HIV Diagnosis Rates by Area of Residence, 2016,
United States (U.S.)
1 U.S. Rate=12.3 N=39,782
1 Source: US data: HIV Surveillance Report, 2016 (most recent available) Vol. 28, Table 24 (HIV data for all 50 states) http://www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htmSlide7
Rankings of HIV Case Rates (all ages) by State1
Diagnosed in 2016, United States
Rate per 100,000 population
1 Source: US data: HIV Surveillance Report, 2016 (most recent available) Vol. 28, Table 24 (HIV data for all 50 states) http://www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htmSlide8
Rankings of HIV Case Rates (all ages) by
MSA
1Diagnosed in 2016, United StatesRate per 100,000 population
1 Source: US data: HIV Surveillance Report, 2016 (most recent available) Vol. 28, Table 24 (HIV data for all 50 states) http://www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htmSlide9
2016
2017Trend
Total Population and PLWH Cases
Population20,231,09220,555,7281.6% increase
Persons Living with an HIV diagnosis (PLWH)115,266
116,9441.5% increaseStrategic Long Term GoalsReduce the annualnumber of HIV diagnoses4,8054,949
3.0% increaseIncrease the percent of PLWH Retained in Care68.0%68.3%0.3% increase
Increase the percent of PLWH with a Suppressed Viral Load60.5%
61.5%1.1% increaseReduce the annual number of babies born in Florida with perinatally acquired HIV to less than 588N/AAdditional IndicatorsReduce annual numberof AIDS diagnoses2,1162,044
3.4% decreaseReduced the annual number of HIV-related deaths86474913.3% decreaseSlide10
HIV Diagnoses by Year of Diagnosis, 1978–2017, FloridaSlide11
1981 – First AIDS case report1985
– First HIV antibody test in Florida
1989 – “Crack” cocaine epidemic increases syphilis and AIDS diagnoses1991 – First Ryan White Planning Group established1992 – The beginning of highly active antiretroviral therapy (HAART)1993 – The Centers for Disease Control and Prevention (CDC) expands the case definition of AIDS1994 – Food and Drug Administration approved OraSure saliva HIV test1997 – Florida implemented physician and laboratory reporting of HIV by name on July 12006
– HIV reporting laws expanded in Florida2007 – Expansion of electronic laboratory reporting (ELR)Key events to note in the HIV/AIDS epidemicSlide12
HIV Trends in FloridaSlide13
HIV Diagnoses by Year of Diagnosis, 2008–2017, Florida
10 year % change (2008–2017) = 18% decreaseSlide14
AIDS Diagnoses by Year of Diagnosis, 2008–2017, Florida
10 year % change (2008–2017) = 51% decreaseSlide15
HIV Tests Conducted in Florida and Seropositivity
1
, 1986–2017
1
Seropositivity is defined as the percent of positive over the number of tests conducted each year. HIV Counseling and Testing data as of 6/30/2018.Slide16
Seropositivity
1
among Males by Age Group and Race/Ethnicity from HIV Tests Conducted in Florida 2017
1
Seropositivity is defined as the percent of positive over the number of tests conducted each year. HIV Counseling and Testing data as of 6/30/2018.Slide17
Seropositivity
1
among Females by Age Group and Race/Ethnicity from HIV Tests Conducted in Florida 2017
1
Seropositivity is defined as the percent of positive over the number of tests conducted each year. HIV Counseling and Testing data as of 6/30/2018.Slide18
Perinatally Acquired HIV Diagnoses, Born in Florida,
by Year of Birth, 1979–2017
Year of Birth
Number of Diagnoses% Change from previous year
201310
20146
-40%2015950%20168
-11%201780%1992–1994 introduction of HAART
1
1Hightly active antiretroviral therapy (HAART) is an HIV treatment that suppresses viral load and reduces HIV transmissionSlide19
Perinatal HIV Exposures, 2017, Florida, N=460
Perinatal HIV Exposures
State Total N=460
Numbers on map are number of
perinatally acquired HIV diagnosesState Total N=8 Slide20
Adult (Age 13+) HIV Diagnoses
by Sex and
Year of Diagnosis, 2008–2017, Florida
Male to Female
Ratio
2008 = 2.6 to 12017 = 3.7 to 1Slide21
Adult (Age 13+) HIV Diagnoses, by Race/Ethnicity
and Year of Diagnosis, 2008–2017, Florida
Other includes American Indian/Alaska Native, Asian/Pacific Islander, and multi-racial.Slide22
HIV Cases Rates
1
per 100,000 Population by
Race/Ethnicity and Year of Diagnosis, 2008–2017, Florida
1
Source: Population data were provided by Florida CHARTS as of 6/30/2018.
Other includes American Indian/Alaska Native, Asian/Pacific Islander, and multi-racial.Slide23
HIV Diagnoses Among Asians and American Indians,
by Race/Ethnicity, Diagnosed 1982–2017, FloridaSlide24
Adult (Age 13+) HIV Diagnoses Among Asians and American Indians,
By Year of Diagnosis, 1982–2017, FloridaSlide25
Adult (Age 13+) HIV Diagnoses, by Age Group at Diagnosis and
Year of Diagnosis, 2008–2017, FloridaSlide26
Adult (Age 13+) HIV Diagnoses by Mode of Exposure and
Year of Diagnosis,
2008–2017,
FloridaSlide27
Adult (Age 13+) Male HIV Diagnoses, by Mode of Exposure and
Year of Diagnosis, 2008–2017, FloridaSlide28
Adult (Age 13+) Female HIV Diagnoses by Mode of Exposure and
Year of Diagnosis, 2008–2017, FloridaSlide29
Demographics of HIV Diagnoses
in FloridaSlide30
HIV Diagnosis Rate
per 100,000 population
State Rate=24.1
HIV Diagnosis Rates
1
by County of Residence
2 Diagnosed in 2017, Florida
Numbers on map are number ofHIV diagnosesState Total N=4,949
1
Source: Population data were provided by Florida CHARTS as of 6/30/2018. 2County totals exclude diagnoses from Department of Corrections and Federal Correctional Institutions (N=68).Slide31
HIV Diagnoses by County of Residence
1
,
Diagnosed in 2017, and Registered Testing Sites2, Florida
HIV Diagnoses
State Total N=4,949
Numbers on map are number of registered testing sites
State Total N=1,439
1
County totals exclude diagnoses from Department of Corrections and Federal Correctional Institutions (N=68).2Source: HIV Counseling and Testing data as of 9/4/2018.Slide32
Percentage of Adult (Age 13+) HIV and AIDS Diagnoses
and Population
1
, by Race/Ethnicity, 2017, Florida
Florida Adult
Population Estimates
N=17,600,236HIV N=4,933AIDS N=2,039
Other includes American Indian/Alaska Native, Asian/Pacific Islander, and multi-racial.1Source: Population data are provided by Florida CHARTSSlide33
Adult (Age 13+) HIV Case Rates
1
by Sex and Race/Ethnicity,
Diagnosed in 2017, Florida
Ratios:
Males
Black to White, 5.2 to 1 Hispanic to White, 3.0 to 1Females Black to White, 11.9 to 1 Hispanic to White, 2.2 to 11Source: Population data are provided by Florida CHARTSSlide34
Adult (Age 13+) AIDS Case Rates
1
by Sex and Race/Ethnicity, Diagnosed in 2017, Florida
Ratios:
Males
Black to White, 6.2 to 1
Hispanic to White, 2.4 to 1Females Black to White, 16.7 to 1 Hispanic to White, 2.1 to11Source: Population data are provided by Florida CHARTSSlide35
Adult (Age 13+) HIV Diagnoses, by Sex and
Age Group at Diagnosis, Diagnosed in 2017, FloridaSlide36
Adult (Age 13+) Male HIV Diagnoses, by Race/Ethnicity and Age Group at Diagnosis, Diagnosed in 2017, Florida
Other includes American Indian/Alaska Native, Asian/Pacific Islander, and multi-racial.Slide37
Adult (Age 13+) Female HIV Diagnoses, by Race/Ethnicity and Age Group at Diagnosis, Diagnosed in 2017, Florida
Other includes American Indian/Alaska Native, Asian/Pacific Islander, and multi-racial.Slide38
Adult (Age 13+) HIV Diagnoses, by Sex and
Mode of Exposure, Diagnosed in 2017, Florida
Other Risk includes hemophilia, transfusion, perinatal and other pediatric risks as well as other confirmed risks. Slide39
Adult (Age 13+) Male HIV Diagnoses by Race/Ethnicity and
Mode of Exposure, Diagnosed in 2017, Florida
Other includes Asian/Pacific Islander, Native Alaskan/American Indian and Multi-racial individuals.
Other Risk includes hemophilia, transfusion, perinatal and other pediatric risks as well as other confirmed risks. Slide40
Adult (Age 13+) Female HIV Diagnoses by Race/Ethnicity and
Mode of Exposure, Diagnosed in 2017, Florida
Other includes Asian/Pacific Islander, Native Alaskan/American Indian and Multi-racial individuals.
Other Risk includes hemophilia, transfusion, perinatal and other pediatric risks as well as other confirmed risks. Slide41
HIV Diagnoses by Select Country of Birth,
1
Diagnosed in 2017, Florida
1
Select countries of birth include countries with 45 or more diagnoses. Excludes “Other” and “Unknown” country of birth.Slide42
HIV Diagnoses by Select Country of Birth
1
Outside the US, Diagnosed 2013–2017, Florida
1
Select countries of birth include countries with 65 or more diagnoses. Excludes “Other” and “Unknown” country of birth.Slide43
HIV Co-morbidity DataSlide44
Adult (Age 13+) Early Syphilis Case Rates
1
by Sex and Year of Diagnosis, 2013–2017, Florida
Male to Female Ratio
2013 = 8.0 to 1
2017 = 7.0 to 1
1Source: Early Syphilis data provided by the STD & Viral Hepatitis Section. Source: Population data are provided by Florida CHARTS as of 6/30/2018.Slide45
Adult (Age 13+) Chlamydia and Gonorrhea
1
Diagnoses,
by Year of Diagnosis, 2013–2017, Florida
1
Source: STD data provided by the Sexually Transmitted Disease & Viral Hepatitis Section. Slide46
Adult (Age 13+) Early Syphilis
1
and HIV Diagnoses,
Diagnosed 2013–2017, Florida
1
Source: Early Syphilis data provided by the STD & Viral Hepatitis Section.
2Co-infected persons are infected with both HIV and early syphilis at the same time. Early SyphilisHIVCo-infectedSlide47
Adult (Age 13+) HIV Diagnoses with STD1 by Type and Year of STD Report,
2 2013–2017, Florida
Year of STD ReportHIV/Early Syphilis
HIV/ChlamydiaHIV/Gonorrhea
20131,4991,225
1,1942014
1,8301,4011,32520152,1981,554
1,73420162,4021,8282,013
20172,425
2,2012,3871Sexually transmitted disease (STD) 2Source: PRISM, STD Section as of 6/30/2018Slide48
Adult (Age 13+) AIDS Diagnoses with TB by Year of TB Report1, Florida, 2013–2017
Year of TB Report
HIV/TB 2013
842014
632015
612016
66201758
1Source: TB Section. Data as of 7/24/2018Slide49
HIV Prevalence in Florida Slide50
PLWH Rate
per 100,000 population
State Rate=569
Persons Living with HIV (PLWH) Rates
1
by County of Residence
2 Diagnosed in 2017, Florida
Numbers on map are number ofPLWHState Total N=116,944 Slide51
One-In-Statements for Adults (Age 13+)
Living with HIV in Florida, Year-end 2017
One in 151 adults in Florida were known to be living with HIV
One in 295 Whites were living with HIVOne in 49 Blacks were living with HIVOne in 155 Hispanics were living with HIVSlide52
Adults (Age 13+) Living with HIV Year-end 2017, Florida, N=116,782Slide53
Transgender
1
Adults (Age 13+) Living with HIV, Year-end 2017, Florida
1
Limitations: Transgender data were not aggressively collected or recorded until 2013 therefore numbers may be underrepresented.Slide54
HIV Care in FloridaSlide55
HIV Care Continuum Definitions
Persons Living with HIV
: The number of persons known to be living with an HIV diagnosis (PLWH) at the end of 2017, from data as of 6/30/2018
Ever in Care: PLWH with at least one documented Viral Load (VL) or CD4 lab, medical visit, or prescription from HIV diagnosis through 3/31/2018In Care: PLWH with at least one documented VL or CD4 lab, medical visit, or prescription from 1/1/2017 through 3/31/2018
Retained in Care: PLWH with two or more documented VL or CD4 labs, medical visits, or prescriptions at least three months apart from 1/1/2017 through 6/30/2018Suppressed Viral Load: PLWH with a suppressed VL (<200 copies/mL) on the last VL from 1/1/2017 through 3/31/2018Slide56
116,944
108,461
87,18471,955
Persons Living with HIV (PLWH) in Floridaalong the HIV Care Continuum in 2017Slide57
4,949
3,336
Persons who Received an HIV Diagnosis in 2017 in Florida along the HIV Care Continuum4,370Slide58
58,756
55,010
44,81038,581
Persons Living with HIV (PLWH) with an MSM Mode of Exposure in Florida, along the HIV Care Continuum in 201740,907Slide59
11,639
10,745
8,5705,950
Women of Childbearing Age (WCBA) Living with HIV in Florida, along the HIV Care Continuum in 2017
7,677Slide60
300
290
238174
Adult (Age 13+) Transgender Women1 Living with HIV in Florida,
along the HIV Care Continuum in 2017208
1
Transgender women are defined as those whose sex assigned at birth is male but who identify and live as female.Slide61
Persons Living with HIV (PLWH) in Florida by Race
along the HIV Care Continuum in 2017Slide62
Percentage of Persons Living with HIV (PLWH)
in Florida, who were Retained in Care
1 in 2017
Statewide Data:
N=116,94468% Retained in Care
1Retained in Care: PLWH with two or more documented viral load (VL) or CD4 labs, medical visits or prescriptions at least three months apart, 1/1/2017 through 6/30/2018.Slide63
Percentage of Persons Living with HIV (PLWH) in Florida who had a Suppressed Viral Load (VL)
1 in 2017
Statewide Data:
N=116,944
62% Suppressed VL(<200 copies/mL)
1PLWH with a suppressed VL (<200 copies/mL) on the last VL from 1/1/2017 through 3/31/2018.Slide64
Percentage of Persons Living with HIV (PLWH)
in Florida who were Not In Care1
in 2017
Statewide Data:
N=116,94425% Not In Care
1PLWH who did not
receive at least one documented VL or CD4 lab, medical visit, or prescription from 1/1/2017 through 3/31/2018.Slide65
Percent of Unmet Need of Care Services of Persons Living with HIV (PLWH) in Florida, Medical Monitoring Project (MMP)
1, Florida, 2016
1
Source: MMP 2016 health survey participants 2 Percent of persons surveyed who claimed they received the specific service.3
Percent of persons who did NOT receive the specific service who had a need for that service.Slide66
HIV-1 Antiretroviral Drug Resistance
1 in HIV Diagnoses with a
Genotype Sequence, Florida, 2017
1 Source: eHARS
and Stanford HIV Drug Resistance Database 2 PI=protease inhibitors 3NRTI=nucleoside reverse transcriptase inhibitors4NNRTI=non-nucleoside reverse transcriptase inhibitors 5IN=integrase inhibitorsSlide67
HIV-related Deaths in Florida Slide68
Resident Deaths
1
Due to HIV by Year of Death,2008–2017, Florida10 year % change (2008–2017) = 47%1Source: Florida Department of Health, Division of Public Health Statistics and Performance Management, Bureau of Vital Statistics, Death Certificates (as of 6/30/2018). Slide69
Rate
1
of Resident Deaths2 due to HIV, by Race/Ethnicity and Year of Death, 2008–2017, Florida
1Source: Population data were provided by Florida CHARTS. 2Source: Florida Department of Health, Bureau of Vital Statistics, Death Certificates. Slide70
Ratios:
Males
Blacks to White, 5.6 to 1 Hispanic to White, 1.2 to 1 Females Blacks to White, 16.3 to 1
Hispanic to White, 1.1 to 1
Rate1 of Resident Deaths2 due to HIV,by Sex and Race/Ethnicity, 2017, Florida
1Source: Population data were provided by Florida CHARTS. 2Source: Florida Department of Health, Bureau of Vital Statistics, Death Certificates. Slide71
Deaths Due to HIV Among Persons Age 25 to 44, 2017, Florida
HIV is the 8
th
leading cause of death overallHIV is the 8th leading cause among males HIV is the 7
th leading cause among females HIV is the 13th leading cause among WhitesHIV is the 5th leading cause among Blacks
HIV is the 9th leading cause of death among Hispanics
1Source: Florida Department of Health, Division of Public Health Statistics and Performance Management, Bureau of Vital Statistics, Death Certificates (as of 6/30/2018). Slide72
Death Rates
1 for the Top Seven Leading Causes of Death
2 Among Persons 25–44 Years of Age, by Year of Death, 1988–2016, Florida1Source: Population data were provided by Florida CHARTS as of 6/30/2018. 2Source: Florida Department of Health, Division of Public Health Statistics and Performance Management, Bureau of Vital Statistics, Death Certificates (as of 6/30/2018).
Slide73
HIV PreventionSlide74
Florida’s Top-Nine Priority Populations
1
for Primary HIV Prevention in 2017
1
MSM=(MSM and MSM/IDU Diagnoses) and IDU=(IDU and MSM/IDU Diagnoses), therefore the data are not mutually exclusive. Slide75
Florida’s Top-Nine Priority Populations
1
Prevention for PLWH in 2017
1
MSM=(MSM and MSM/IDU Diagnoses) and IDU=(IDU and MSM/IDU Diagnoses), therefore the data are not mutually exclusive. Slide76
HIV Testing
Pre-Exposure Prophylaxis (
PrEP)Antiretroviral Therapy (ART)
Florida HIV/AIDS HotlineAll adolescents and adults (ages 13–64) should be tested for HIV at least once during their lifetime. Persons at increased risk for HIV should be tested annually. Per Florida law, all pregnant women are to be tested for HIV and other sexually transmitted infections (STI) at their initial prenatal care visit, again at 28–32 weeks and at labor and delivery if HIV status is unknown.www.knowyourhivstatus.comFor persons at increased risk for HIV, a pill (
Truvada) once daily, can reduce the risk of acquiring HIV by over 90%. Condoms are still recommended during sex to prevent other STDs, which are increasing in Florida, and which can increase HIV risk.www.preplocator.orgFor persons newly diagnosed with HIV, starting ART with a provider immediately after diagnosis improves health outcomes by preventing disease progression and reducing viral load, making transmission highly unlikely.To find a care provider or to learn more about the resources available to persons living with HIV visit:www.floridaaids.org
1-800-FLA-AIDS (352-2437) English1-800-545-SIDA (545-7432) Spanish1-800-AIDS-101 (243-7101) Haitian Creole1-800-503-7118 Hearing/Speech Impairedwww.211bigbend.org/flhivaidshotlineText ‘FLHIV’ or ‘flhiv’ to 898211For more information contact:DiseaseControl@flhealth.govSlide77
HIV/AIDS surveillance data are frozen on June 30, following the end of each calendar year. These are the same data used for Florida CHARTS and all grant-related data.
www.floridacharts.com/charts/CommunicableDiseases/default.aspx
Florida HIV/AIDS Surveillance Data ContactsLorene Maddox, MPHSurveillance Data Analysis Manager Florida Department of HealthPhone: 850-901-6968Email:
Lorene.Maddox@flhealth.gov Emma Spencer, MPH, PhDSurveillance Program ManagerFlorida Department of HealthPhone: 850-245-4432Email:
Emma.Spencer@flhealth.gov Danielle Curatolo, MPHResearch AnalystFlorida Department of HealthPhone: 850-901-6983Email: Danielle.Curatolo@flhealth.govAshleigh Tiller
Data Reports CoordinatorFlorida Department of HealthPhone: 850-901-6984Email: Ashleigh.Tiller@flhealth.gov
To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.