Lawrence J DAngelo MD MPH Director Burgess and Youth Pride Clinics Division of Adolescent and Young Adult Medicine Childrens National Medical Center Professor of Pediatrics Medicine Epidemiology Prevention and Community Health ID: 742013
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HIV Infection in Women in Our Community: The Continuum of Care
Lawrence J. D’Angelo, M.D., M.P.H.Director, Burgess and Youth Pride ClinicsDivision of Adolescent and Young Adult MedicineChildren’s National Medical CenterProfessor of Pediatrics, Medicine, Epidemiology, Prevention and Community HealthGeorge Washington UniversityWashington, D.C.Slide2
I Have No Disclosures
Lawrence J. D’Angelo, MD, MPHDivision of Adolescent and Young Adult MedicineChildren’s National Health SystemProfessor of Pediatrics, Medicine, Epidemiology and PreventionGeorge Washington UniversitySlide3Slide4
Diagnoses
of HIV Infection among Female Adults and Adolescentsby Race/Ethnicity, 2015—United States
Note.
Data include persons with a diagnosis of HIV infection regardless of stage of
disease
at
diagnosis.
Data for the year 2015 are preliminary and based on 6 months reporting
delay.
Rates
are per 100,000 population.
a
Hispanics/Latinos can be of any race
.Slide5
Diagnoses of
HIV Infection Among Persons Aged 13 Years and Older, by Sex and Age Group, 2014 — United States and 6 Dependent AreasNote.
Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis. All displayed data have been statistically adjusted to account for reporting delays, but not for incomplete reporting. Slide6
Rates of Diagnoses of HIV Infection
among Female Adults and Adolescents 2015—United States and 6 Dependent AreasN = 7,498 Total Rate = 5.4
Note.
Data include persons with a diagnosis of HIV infection regardless of stage of disease at
diagnosis.
Data for the year 2015 are preliminary and based on 6 months reporting delay.Slide7
Rates of
Female Adults and Adolescents Living with Diagnosed HIV Infection Year-end 2014—United States and 6 Dependent AreasN = 235,813 Total Rate = 171.0
Note.
Data include persons with a diagnosis of HIV infection regardless of stage of disease at
diagnosis.
Data are based on address of residence as of December 31, 2014 (i.e., most recent known address). Slide8
Rates of
Female Adults and Adolescents Living with Diagnosed HIV Infection Ever Classified as Stage 3 (AIDS), Year-end 2014—United States and 6 Dependent Areas N = 126,340 Total Rate = 91.6
Note.
Data are based on address of residence as of December 31, 2014 (i.e., most recent known address). Slide9
HIV Seroprevalence in Attendees of
STD Clinics Baltimore, MD, February 1987-April 1987 % PositiveAge Males Females15-19 2.0 2.520-24 3.8 3.4 25-29 6.9 2.9> 30 11.4 4.3
Quinn, et al. NEJM; 1988, 318:197Slide10
HIV Infected Youth in Care
Burgess Clinic, Washington, D.C.May 2003115 Patients in Care67 (58%) are female and 48 (42%) are male43 (36%) acquired infection perinatallyPerinatally infected teens now largest source of new patients34% now defined as having AIDS (58% Perinatal, 21% Behavioral Acquisition)Slide11
HIV Infected Youth in Care
Burgess Clinic, Washington, D.C.(through April 15, 2006)151 Patients in Care80 (53%) female; 71 male (47%) 81 (54%) acquired infection perinatallyPerinatally infected teens now largest source of new patients48% of our patients defined as having AIDS Slide12
Burgess Clinic Demographics: The HIV Infected
Adolescent
(through April 15, 2009)
Clients
Female
Male
N=188
69(38%)
117 (62%)
Mode of Transmission
Number of Clients
Behaviorally Acquired
89 (45%)
Perinatally Acquired
94 (50%)
Sexual Assault
3 (2%)
Transfusion/ Blood Products (Suspected)
3 (2%)
Unknown
2 (1%)
Adolescent and Young Adults, ages 12-24Slide13
Adolescent Patients at SIS/Burgess Clinics
Children’s National Medical Center
Patient
Demographics – Through April 1, 2012
Clients
Female
Male
N=268
101 (38%)
167 (62%)
By age
Number of Clients
13-15
44 (16%)
16-18
54 (20%)
18-20
73 (27%)
21-24
97 (36%)
Total
268
Adolescent and Young Adults, ages 12-24Slide14
Newly Diagnosed HIV Infected Individuals by Gender, Washington, DC, 2011-2015Slide15
Individuals Living with HIV in Washington, DC, 2015 and infected females, by race and ethnicitySlide16
New HIV Infections in Washington, DC, 2010-2014, by GenderSlide17
HIV “Disease Stage” at time of first recorded lab, Washington, DC, 2015 Slide18
DOH/HAHSTA “Care Dynamics” report of certain care related factors Slide19
HIV Infection in Women in Our Community: The Continuum of Care
Despite overall improvement in infection rates, prevalence of infection in women in our community continues to increase and leads the nation.At time of diagnosis, women have a slight advantage in terms of preservation of immune status.Significant improvement has occurred for both women and men in their “care dynamics”.There are few systematic differences in HIV infection in men and woman in our community other than mode of transmission.Successful longterm management of HIV will put a premium on managing collateral health conditions