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2006 Indiana HIV Incidence

2006 Indiana HIV Incidence. Richard T. Passey Indiana State Department of Health Office of Clinical Data and Research HIV Incidence Surveillance. Need for HIV Incidence Surveillance. Gives cutting edge picture of epidemic Targets at risk populations for prevention and testing

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2006 Indiana HIV Incidence

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  1. 2006 Indiana HIV Incidence Richard T. Passey Indiana State Department of Health Office of Clinical Data and Research HIV Incidence Surveillance

  2. Need for HIV Incidence Surveillance Gives cutting edge picture of epidemic Targets at risk populations for prevention and testing Planners redistribute resources

  3. New Infection of HIV Is Difficult to Pinpoint in Time • How do we pinpoint when someone becomes infected? • Asymptomatic window period • Individual’s testing pattern is essential

  4. Incidence Defined The number of NEW INFECTIONS in a given time period; usually one year

  5. HIV Incidence Defined • Not just new HIV diagnoses • Incidence is NEW HIV INFECTIONS • Excludes those with HIV infections longer than one year • May be higher or lower than new HIV diagnoses • Accounts for HIV not yet tested: about 25% • Not changed by increased or decreased testing rates

  6. 2006 National HIV Incidence Calculation • First Method: Point Estimate for 2006 (Reference JAMA Article) • Laboratory Test (STARHS/BED) • Can classify infection as less than 156 days • Not for individual; for population surveillance • Testing and Treatment History • Core HIV Surveillance Data

  7. 2006 U.S. HIV Incidence Estimation Point Estimate 56,300 22.8/100,000 rate 40% Higher than Previous Estimate 40,000 16.2/100,000

  8. 2006 U.S. HIV Incidence by Gender 73% Male 34.3/100,000 rate 27% Female 11.9/100,000 rate

  9. 2006 U.S. HIV Incidence by Transmission 53% Men that have Sex with Men (MSM) 12% Injection Drug User (IDU) 4% MSM/IDU 31% Heterosexual

  10. 2006 National HIV Incidence Age 13-2934% 26.8/100,000 30-3931% 42.6/100,000 40-49 24% 30.7/100,000 50-9910% 6.5/100,000

  11. National HIV Incidence by Race/Ethnicity • 35% White • Rate 11.5/100,000 • 17% Hispanic • Rate 29.3/100,000 • Almost three times the rate of white individuals • 45% Black Individuals • Rate of 83.7/100,00 for Black • Seven times the rate of white individuals

  12. Artist’s Depiction of HIV Virus Particle

  13. 2006 National HIV Incidence Calculation • Second Method Confirmatory for STARHS • Statistical Back Calculation Approach • Looked at HIV incidence since 1970’s

  14. HIV Incidence by Back Calculation for U.S. • Incidence first noticed in 1977 • Peaked mid 80’s at 130,000 • Low point early 1990’s at 49,000 • Second peak late 90’s at 58,000 • Since 2000 stayed at roughly 55,000

  15. One Area of Success Overall HIV incidence among IDU has decreased 80% in the U.S. From 35,000 in 1990 to 6,600 in 2006

  16. Conclusions for National HIV Incidence Racial Disparities are Greater than Expected Incidence Rate is 40% Higher than Expected and has been for Years Young, Black, MSM at Most Risk

  17. Prevention, and Testing Plan

  18. Indiana 2006 HIV Incidence New Statewide Calculation is Cutting Edge • STARHS Lab Test • Core HIV Surveillance • Testing and Treatment History

  19. Indiana 2006 HIV Incidence(New Infections) • Local Estimate is 639 • CDC Estimate is 700

  20. Indiana HIV Diagnosis Compared to Incidence (Infected) for 2006 • 519 Diagnosed with HIV/AIDS • 10.0 per 100,000 • 323 Diagnosed with HIV not AIDS • 6.2 per 100,000 • 639 Incidence for HIV not AIDS • 12.3 per 100,000 (double) • 700 Incidence for HIV not AIDS • 13.5 per 100,000

  21. Indiana 2006 HIV Incidence Stratified by Gender • Women 6.9/100,000 HIV incidence rate • 29% (187) new HIV infections (incidence) • Men 17.5/100,000 HIV incidence rate • 71% (452) new HIV infections

  22. Indiana 2006 HIV Incidence Stratified by Race • White 60% of 2006 incidence • Rate is 8.2/100,000 • Other (Minorities) 40% of incidence • Rate is 45.8/100,000 • 5.6 times higher rate for other than white

  23. Indiana 2006 HIV Incidence Stratified by Age 13-2941%17.3/100,000 30-3935%26.3/100,000 40+25%5.6/100,000

  24. Indiana 2006 HIV Incidence Stratified by Transmission • MSM 55% of incidence in 2006 • Other 45% • Could not be further separated • Includes IDU, Heterosexual, and No Reported Risk

  25. Conclusions on Indiana Statewide HIV Incidence HIV Incidence Rate Double that of HIV Diagnosis Rate Racial Disparities are Alarming Young Minority MSM at Greatest Risk

  26. Bibliography • Estimation of HIV Incidence in the United States, Irene Hall et. al., JAMA, August 6, 2008, vol. 300, No. 5 • Estimating HIV Incidence in the United States from HIV/AIDS Surveillance Data and Biomarker HIV Test Results, John Karon et al., Statistics in Medicine 2008 • Morbidity and Mortality Weekly Report, Prejean, J et. al., (www.cdc.gov/mmwr) Sept.12, 2008 vol. 57,no. 36 pp. 485-489.

  27. Images of HIV Virus Particles: • Russell Knightly Media • Custom Medical Stock Photo (CMSP) • AIDS Pathology • Department of Microbiology University Otago, New Zealand • Taken from www.virology.net/BIG_Virology/BVretro.html

  28. Cartoons • www.un.org/events/aids/2006/exhibit.asp United Nations World AIDS Day HIV/AIDS Cartoon Exhibition Dec. 1, 2006 • www.dance4life.com/en_4life/en_cartoonsMade by the World Health Organization, UN AIDS and the Office of the High Commissioner for Human Rights

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