State of the HIV  Epidemic in Florida, 2017

State of the HIV Epidemic in Florida, 2017 - Description

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. . Technical Notes. ID: 744426 Download Presentation

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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. . Technical Notes.

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State of the HIV Epidemic in Florida, 2017




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Presentation on theme: "State of the HIV Epidemic in Florida, 2017"— Presentation transcript:

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 Deaths

Slide5

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 Categories

Slide6

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.htm

Slide7

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.htm

Slide8

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.htm

Slide9

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% decrease

Slide10

HIV Diagnoses by Year of Diagnosis, 1978–2017, Florida

Slide11

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 Florida

2007 – Expansion of electronic laboratory reporting (ELR)Key events to note in the HIV/AIDS epidemic

Slide12

HIV Trends in Florida

Slide13

HIV Diagnoses by Year of Diagnosis, 2008–2017, Florida

10 year % change (2008–2017) = 18% decrease

Slide14

AIDS Diagnoses by Year of Diagnosis, 2008–2017, Florida

10 year % change (2008–2017) = 51% decrease

Slide15

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 transmission

Slide19

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 1

Slide21

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, Florida

Slide24

Adult (Age 13+) HIV Diagnoses Among Asians and American Indians,

By Year of Diagnosis, 1982–2017, Florida

Slide25

Adult (Age 13+) HIV Diagnoses, by Age Group at Diagnosis and

Year of Diagnosis, 2008–2017, Florida

Slide26

Adult (Age 13+) HIV Diagnoses by Mode of Exposure and

Year of Diagnosis,

2008–2017,

Florida

Slide27

Adult (Age 13+) Male HIV Diagnoses, by Mode of Exposure and

Year of Diagnosis, 2008–2017, Florida

Slide28

Adult (Age 13+) Female HIV Diagnoses by Mode of Exposure and

Year of Diagnosis, 2008–2017, Florida

Slide29

Demographics of HIV Diagnoses

in Florida

Slide30

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 CHARTS

Slide33

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 CHARTS

Slide34

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 CHARTS

Slide35

Adult (Age 13+) HIV Diagnoses, by Sex and

Age Group at Diagnosis, Diagnosed in 2017, Florida

Slide36

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 Data

Slide44

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-infected

Slide47

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 6/30/2018

Slide48

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 7/24/2018

Slide49

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 HIV

Slide52

Adults (Age 13+) Living with HIV Year-end 2017, Florida, N=116,782

Slide53

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 Florida

Slide55

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 3/31/2018

Slide56

116,944

108,461

87,18471,955

Persons Living with HIV (PLWH) in Floridaalong the HIV Care Continuum in 2017

Slide57

4,949

3,336

Persons who Received an HIV Diagnosis in 2017 in Florida along the HIV Care Continuum4,370

Slide58

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 201740,907

Slide59

11,639

10,745

8,5705,950

Women of Childbearing Age (WCBA) Living with HIV in Florida, along the HIV Care Continuum in 2017

7,677

Slide60

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 2017

Slide62

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 inhibitors

Slide67

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 Prevention

Slide74

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.gov

Slide77

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.