Georgia HIV/AIDS Surveillance Summary. Data Through December 31, 2010

Transcription

1 Georgia HIV/AIDS Surveillance Summary Data Through December 31, 2010 HIV/AIDS Epidemiology Section Division of Health Protection Georgia Department of Public Health

2 Table of Contents Acknowledgements... 3 Executive Summary... 4 Technical Notes... 6 TABLE HIGHLIGHTS Persons Newly Diagnosed with HIV Infection (not AIDS), Georgia, Persons Newly Diagnosed with AIDS, Georgia, Persons Living with HIV (not AIDS), 2010, Georgia Persons Living with AIDS, 2010, Georgia Cumulative HIV (not AIDS) Cases, 2010, Georgia Cumulative AIDS Cases, 2010 Georgia Unmet HIV Need, 2010 Georgia Table 1: Distribution of the General Population by Race/Ethnicity, Georgia, Table 2: Newly Diagnosed HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, Table 3: Newly Diagnosed HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, Table 4: Newly Diagnosed HIV (not AIDS) and AIDS by Public Health District of Residence at Diagnosis, Georgia, Table 5: Persons Living with HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, Table 6: Persons Living with HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, Table 7: Persons Living with HIV (not AIDS) and AIDS by Current Public Health District of Residence, Georgia, Table 8: Cumulative Cases of HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, Table 9: Cumulative Cases of HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, Table 10: Cumulative Cases of HIV (not AIDS) and AIDS by Public Health District of Residence at Diagnosis, Georgia, Table 11: Demographic Characteristics of Individuals with Unmet Need by HIV/AIDS Status, Georgia, Georgia HIV/AIDS Surveillance Summary 2

3 HIV/AIDS Surveillance Summary, Georgia, 2010 Acknowledgements Georgia Department of Public Health Brenda Fitzgerald, MD, Commissioner Division of Health Protection J. Patrick O Neal, MD, Director Epidemiology Program Cherie L. Drenzek, DVM, MS, Director HIV/HIDS Epidemiology Section Y. Omar Whiteside, MSPH, Senior Epidemiologist Deepali Rane, MBBS, MPH, Epidemiologist Alfred Pennisi, MA, MPH, Data Manager Terry Easton, PhD, Ethnographer 2010 Georgia HIV/AIDS Surveillance Summary 3

4 Executive Summary HIV/AIDS remains an important public health problem in Georgia. In 2010, there were 2,037 persons newly diagnosed with HIV (not AIDS) or AIDS. Of these, the majority of individuals were male (75%). Persons who were newly diagnosed with HIV (not AIDS) were, on average, younger than those who were newly diagnosed with AIDS. Black/Non-Hispanics accounted for the majority of newly diagnosed HIV (not AIDS) and AIDS cases among all races/ethnicities. As of 2010, there were 41,986 persons in Georgia living with HIV/AIDS. Of these individuals, male-to-male sexual contact was the most commonly reported transmission category. Similar to the newly diagnosed cases, the majority of prevalenct cases occurred in Black/Non-Hispanics. Among women, individuals with missing risk information or who did not meet one of the Centers for Disease Control and Prevention (CDC)-defined transmission categories and heterosexual contact were the two most commonly reported transmission categories. The majority of individuals who were living with HIV/AIDS in Georgia were male (74%). As of 2010, there were 52,725 cumulative cases of HIV/AIDS in Georgia. Males comprised the majority of these cases. Individuals years of age were the majority of cases. Blacks/Non-Hispanics accounted for the majority of cumulative HIV/AIDS cases. Male-to-male sexual contact was the most frequently reported transmission category for males while the majority of female cases were missing risk information or did not meet one of the CDC-defined transmission categories. In 2010, Georgia continued to be affected by HIV/AIDS. Understanding the epidemiology of HIV/AIDS in Georgia is extremely important as we move toward 2010 Georgia HIV/AIDS Surveillance Summary 4

5 reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities. 1 1 The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States. Washington, DC: The White House, Georgia HIV/AIDS Surveillance Summary 5

6 Technical Notes Georgia statutes and regulations require physicians and laboratories to report all cases of HIV (Human Immunodeficiency Virus) infection and AIDS (Acquired Immunodeficiency Syndrome) to the Georgia Department of Public Health (GDPH). 2 The information is used to monitor the HIV/AIDS epidemic in Georgia and to help guide program planning and evaluation. The data presented in the accompanying tables are based on confidential case reports collected through the GDPH HIV/AIDS Reporting System. Cases are counted if they meet the Centers for Disease Control and Prevention (CDC) surveillance case definitions for HIV infection. 3 This report includes surveillance data through December 31, 2010, by diagnostic category for persons living with HIV (not AIDS) and AIDS, newly diagnosed cases, and cumulative cases. The data are displayed by date of diagnosis and are not adjusted for reporting delays or incomplete reporting. Persons residing in correctional facilities are included in this report and may inflate rates in certain geographic regions where there are large numbers of HIV-positive inmates. Tables depicting Persons Living with HIV (not AIDS) and AIDS comprise persons with a Georgia residence as of the latest information available for them in the Georgia HIV/AIDS surveillance system regardless of where the persons were diagnosed. Persons represented in the Newly Diagnosed and Cumulative tables were diagnosed in Georgia. Because of the difference in residency 2 Department of Public Health, Rules and Regulations (2003); Official Code of Georgia Annotated (OCGA) (2011). 3 Centers for Disease Control and Prevention. Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged <18 Months and for HIV Infection and AIDS Among Children Aged 18 Months to <13 Years United States, MMWR December 5, 2008/57(RR-10): Georgia HIV/AIDS Surveillance Summary 6

7 criteria and the influx of cases to Georgia, the number of persons living with HIV (not AIDS) may sometimes be higher than cumulative HIV (not AIDS) cases. Unlike name-based AIDS reporting which began in the early 1980s, name-based HIV (not AIDS) reporting began on December 31, Since the HIV (not AIDS) surveillance system is still rather new in Georgia, and there are known delays with case reporting, we expect that numbers will continue to increase as additional case reports are received. Concentrated solicitation of case reports by GDPH staff in 2010 likely contributed to the rise in reported cases of HIV (not AIDS) in Georgia and consequently led to a more accurate representation of the epidemic in Georgia than previously described; however, this should not necessarily be interpreted as an indication of increased HIV transmission. Additionally, not everyone is aware of his or her infection, so this report underestimates the true number of persons infected with HIV/AIDS in Georgia. Definitions of Measures: Newly diagnosed cases of HIV/AIDS (incidence) are individuals who were reported to the Georgia Department of Public Health were diagnosed with HIV or AIDS between January 1, 2010-December 31, Persons living with HIV/AIDS (prevalence) are individuals who were diagnosed with HIV/AIDS and were alive as of December 31, Cumulative cases of HIV/AIDS include those individuals who were diagnosed with HIV/AIDS who were living and those were dead as of December 31, Note on HIV Transmission Categories: The transmission categories presented in this report follow the standards created by the CDC and have been used for many years. According to the CDC, Transmission category is the term for the classification of cases 2010 Georgia HIV/AIDS Surveillance Summary 7

8 that summarizes a person s possible HIV risk factors; the summary classification results from selecting, from the presumed hierarchical order of probability, the one risk factor most likely to have been responsible for transmission. For surveillance purposes, cases HIV (not AIDS), and AIDS are counted only once in the hierarchy of transmission categories. Persons with more than one reported risk factor for HIV infection are classified in the transmission category according to the behavior that is most likely to have resulted in transmission. The exception is men who report sexual contact with other men and injection drug use; this group makes up a separate transmission category. Persons whose transmission category is classified as heterosexual contact are persons who report specific heterosexual contact with a person known to have, or be at high risk for, HIV infection (e.g., an injection drug user). The term high-risk is not included in the transmission category label for heterosexual contact in the tables because heterosexual contact itself is the risk factor most likely to have been responsible for transmission. However, the table footnote regarding this category clarifies how the data are defined: heterosexual contact with a person known to have, or to be at high risk for, HIV infection. Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as either no risk factor reported or identified. 4 These cases are categorized as NIR (no identified risk). Current Address: Current address is used to determin the number of Persons Living with HIV Infection. Current address is determined using the date of the most recently entered residential address into the Georgia HIV/AIDS surveillance system. 4 Centers for Disease Control and Prevention. HIV Surveillance Report, 2009; vol Published February Accessed September 7, Georgia HIV/AIDS Surveillance Summary 8

9 Vital Status: Persons are assumed to be alive unless otherwise documented or reported. Rates: Denominators for population rates are based on the 2010 U.S. Census. Rates are per 100,000 population. Rates based on estimated numbers less than 12 should be interpreted with caution because the estimates have relative standard errors greater than 30% and are considered unreliable. Reporting Period: Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. Unmet Need: Unmet need is defined as the absence of any reported viral load, CD4 laboratory tests, or antiretroviral therapy for persons reported to be HIV-positive in the Georgia HIV/AIDS surveillance system from January 1, 2010-December 31, For the purposes of this analysis, unmet need for primary medical care is defined as no evidence of a viral load or CD4 laboratory test from January 1, 2010-December 31, Percentages: Total percentages may not add up to 100% due to rounding and represent the percentage of the total. Data Limitations: Data are derived from Georgia s HIV/AIDS surveillance system and may be underestimated due to factors related to timeliness and completeness. Completeness of case ascertainment for a diagnosis year is measured 12 months after the diagnosis year by comparing the number of cases diagnosed and reported to the surveillance system for a given year to the number of cases expected to be diagnosed during that year. 5 Timeliness is defined as the number of expected cases that have not 5 Centers for Disease Control and Prevention and Council of State and Territorial Epidemiologists. Technical Guidance for HIV/AIDS Surveillance Programs, Volume 1: Policies and Procedures. Atlanta, GA: Centers for Disease Control and Prevention; Georgia HIV/AIDS Surveillance Summary 9

10 been reported at a given time point added to the proportion of cases that are not reported in a timely manner. 5 Consequently, please interpret results with caution Georgia HIV/AIDS Surveillance Summary 10

11 TABLE HIGHLIGHTS Table 1. Distribution of the General Population by Race/Ethnicity, Georgia, 2010 There were 9,687,653 persons living in Georgia in Of these individuals, the majority were White, Non-Hispanic (56%). The largest minority group in the state was Black, Non-Hispanic (30%). Individuals who were Hispanic/Latino comprised 9% of the state s population. The smallest racial/ethnic groups in the state were Asian, Non-Hispanic (3%); American Indian/Alaskan Native, Non-Hispanic (<1%); Native Hawaiian/Pacific Islander, Non-Hispanic (<1%); and Multiracial/Other, Non-Hispanic (<1%) Georgia HIV/AIDS Surveillance Summary 11

12 Tables 2 to 4. Persons Newly Diagnosed with HIV Infection (not AIDS) and AIDS, Georgia, 2010 Persons Newly Diagnosed with HIV Infection (not AIDS), 1 Georgia, 2010 There were 1,294 persons newly diagnosed with HIV (not AIDS) in Georgia during The majority of persons newly diagnosed with HIV (not AIDS) were male (74%). Females accounted for a higher percentage of new HIV (not AIDS) diagnoses (26%) than new AIDS diagnoses (24%). Persons newly diagnosed with HIV (not AIDS) during 2010 were most frequently years of age at the time of diagnosis (22%). There were racial/ethnic disparities among persons newly diagnosed with HIV (not AIDS) in Georgia in o Black/Non-Hispanics accounted for 78% of new HIV (not AIDS) diagnoses and comprised 31% of Georgia s population. 2 o White/Non-Hispanics accounted for 17% of new HIV (not AIDS) diagnoses and comprised 60% of Georgia s population. 2 o Hispanics/Latinos of all races accounted for 4% of new HIV (not AIDS) diagnoses and comprised 9% of Georgia s population. 2 Among males newly diagnosed with HIV (not AIDS) in 2010, 59% of cases had missing risk information or did not meet a CDC-defined transmission category. Thirty-nine percent reported male-to-male sexual contact. Among females newly diagnosed with HIV (not AIDS) in 2010, 86% of cases were missing risk information or did not meet a CDC-defined transmission category. The second most common transmission category (13%) was heterosexual contact 3. The overall state incidence rate for HIV (not AIDS) in 2010 was 13.2 cases per 100,000 population. In 2010, several Health Districts had HIV (not AIDS) incidence rates that exceeded the state rate: DeKalb (37.3 per 100,000 population), Clayton (34.7 cases per 100,000), Fulton (28.2 cases per 100,000), South (18.9 cases per 100,000), West Central (19.1 cases per 100,000), Southwest (17.7 cases per 100,000), Coastal (15.6 cases per 100,000), and South (15.1 cases per 100,000). 1 Persons Newly Diagnosed with HIV Infection (not AIDS) refers to persons living with HIV (not AIDS) that meet the CDC surveillance case definition for HIV (not AIDS) and were diagnosed in Georgia in Georgia 2010 population obtained from 2010 US Census. Rates are per 100,000 population. 3 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV Georgia HIV/AIDS Surveillance Summary 12

13 Persons Newly Diagnosed with AIDS, 1 Georgia, 2010 There were 743 persons newly diagnosed with AIDS in Georgia during The majority (76%) of persons newly diagnosed with AIDS in Georgia were male. Persons newly diagnosed with AIDS in 2010 were most frequently years of age at the time of diagnosis (30%). New AIDS cases showed an older age distribution than new HIV (not AIDS) cases. There were racial/ethnic disparities among persons newly diagnosed with AIDS in Georgia in o Black/Non-Hispanics accounted for 78% of new AIDS diagnoses and comprised 31% of Georgia s population. 2 o White/Non-Hispanics accounted for 14% of new AIDS diagnoses and comprised 60% of Georgia s population. 2 o Hispanic/Latinos of all races accounted for 6% of new AIDS diagnoses and comprised 9% of Georgia s population. 2 Among males, 48% of new AIDS cases were individuals who were missing risk information or did not meet one of the CDC-defined transmission categories. The second most commonly reported transmission category was male-to-male sexual contact (44%). Among females, the majority of new AIDS cases (79%) were missing risk information or did not meet one of the CDC-defined transmission categories. The second most commonly reported transmission category (31%) was heterosexual contact 3. The overall state incidence rate for AIDS in 2010 was 7.5 cases per 100,000 population. In 2010, several Health Districts had AIDS incidence rates that exceeded the state rate: Clayton (24.7 per 100,000 populations), DeKalb (23.1 cases per 100,000), Fulton (17.8 cases per 100,000), South Central (9.7 cases per 100,000), South (8.7 cases per 100,000), and Coastal (8.2 cases per 100,000). 1 Persons Newly Diagnosed with AIDS refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. 2 Georgia 2010 population obtained from 2010 US Census. Rates are per 100,000 population. 3 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV Georgia HIV/AIDS Surveillance Summary 13

14 Tables 5 to 7. Persons Living with HIV (not AIDS) and AIDS, 2010, Georgia Persons Living with HIV (not AIDS), , Georgia There were 18,535 persons living with HIV (not AIDS) in Georgia as of December 31, The majority (71%) of persons living with HIV (not AIDS) were male. Among persons living with HIV (not AIDS) in Georgia in 2010, the most frequently reported age category was years (31%). There were racial/ethnic disparities among persons living with HIV (not AIDS) in Georgia in o Black/Non-Hispanics accounted for 72% of persons living with HIV (not AIDS) and comprised 31% of Georgia s population. 2 o White/Non-Hispanics accounted for 22% of persons living with HIV (not AIDS) and comprised 60% of Georgia s population. 2 o Hispanic/Latinos of all races accounted for 4% of persons living with HIV (not AIDS) and comprised 9% of Georgia s population. 2 Among males living with HIV (not AIDS), male-to-male sexual contact was the most commonly reported transmission category (51%). Thirty-eight percent of persons living with HIV (not AIDS) were missing risk information or did not meet one of the CDC-defined transmission categories. Among females living with HIV (not AIDS), 69% were missing risk information or did not meet one of the CDC-defined transmission categories. The second most common transmission category (22%) was heterosexual contact 3. The overall state prevalence rate for HIV (not AIDS) in 2010 was cases per 100,000 population. In 2010, several Health Districts had HIV (not AIDS) prevalence rates that exceeded the state rate: DeKalb (510.2 cases per 100,000), Fulton (476.5 cases per 100,000), Clayton (365.8 cases per 100,000), South Central (233.1 cases per 100,000), East Central (198.9 cases per 100,000), South (190.6 cases per 100,000), and Southwest (190.2 cases per 100,000). 1 Persons Living with HIV (not-aids) refers to persons living with HIV (not-aids) as of December 31, 2010, who were currently residing in Georgia regardless of their state of residence at the time of HIV (not-aids) diagnosis. Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. Persons are assumed to be alive unless otherwise documented or reported. 2 Georgia 2010 population obtained from 2010 US Census. Rates are per 100,000 population. 3 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV Georgia HIV/AIDS Surveillance Summary 14

15 Persons Living with AIDS, , Georgia There were 23,451 persons living with AIDS in Georgia as of December 31, Among persons living with AIDS in Georgia in 2010, the majority (77%) were male. Among persons living with AIDS in Georgia in 2010, most individuals (39%) were years of age. There were racial/ethnic disparities among persons living with AIDS in Georgia in o Black/Non-Hispanics accounted for 69% of persons living with AIDS and comprised 31% of Georgia s population. 2 o White/Non-Hispanics accounted for 24% of persons living with AIDS and comprised 60% of Georgia s population. 2 o Hispanic/Latinos of all races accounted for 5% of persons living with AIDS and comprised 5% of Georgia s population. 2 Among males living with AIDS in Georgia in 2010, male-to-male sexual contact was the most commonly reported transmission category (55%). Twenty-three percent of males living with AIDS were missing risk information or did not meet one of the CDC-defined transmission categories. Among females living with AIDS in Georgia in 2010, 48% were missing risk information or did not meet one of the CDC-defined transmission categories. The second most commonly reported transmission category (36%) was heterosexual contact. The overall state prevalence rate for AIDS in 2010 was cases per 100,000 population. In 2010, several Health Districts had AIDS prevalence rates that exceeded the state rate: Fulton (798.7 cases per 100,000 population), DeKalb (593.2 cases per 100,000 population), Clayton (386.6 cases per 100,000 population), and East Central (241.4 cases per 100,000 population). 1 Persons Living with AIDS refers to persons living with AIDS as of December 31, 2010, who were currently residing in Georgia regardless of their state of residence at the time of AIDS diagnosis. Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. Persons are assumed to be alive unless otherwise documented or reported. 2 Georgia 2010 population obtained from 2010 US Census. Rates are per 100,000 population Georgia HIV/AIDS Surveillance Summary 15

16 Tables 8 to 10. Cumulative HIV Infection (not AIDS) and AIDS Cases, 2010, Georgia Cumulative HIV (not AIDS) Cases, , Georgia There were 16,608 cumulative HIV (not AIDS) cases diagnosed in Georgia as of December 31, The majority (70%) of cumulative HIV (not AIDS) cases were male. Among cumulative HIV (not AIDS) cases, the most frequent age category was years (31%). There were racial/ethnic disparities among cumulative HIV (not AIDS) cases in Georgia in o Black/Non-Hispanics accounted for 73% of cumulative HIV (not AIDS) cases and comprised 31% of Georgia s population. 2 o White/Non-Hispanics accounted for 22% were of cumulative HIV (not AIDS) cases and comprised 60% of Georgia s population. 2 o Hispanic/Latinos of all races accounted for 4% of all HIV (not AIDS) cases and comprised 9% of Georgia s population. 2 Among males, the reported transmission category for 48% of cumulative HIV (not AIDS) cases was male-to-male sexual contact. Forty-one percent were missing risk information or did not meet one of the CDC-defined transmission categories. Among females, 71% of cumulative HIV (not AIDS) cases were missing risk information or did not meet one of the CDC-defined transmission categories. The second most commonly reported transmission category (21%) was heterosexual contact 3. The Fulton and DeKalb Health Districts had the two highest cumulative numbers of persons diagnosed with HIV (not AIDS) in Georgia (4,187 and 2,939 respectively). 1 Cumulative HIV Infection (not AIDS) Cases refers to the total number of persons with HIV diagnosed in Georgia as of December 31, 2009, regardless of their current residence or vital status. Numbers are based on data entered through June 30, 2010, and are not adjusted for reporting delays. 2 Georgia 2010 population obtained from 2010 US Census. Rates are per 100,000 population. 3 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV Georgia HIV/AIDS Surveillance Summary 16

17 Cumulative AIDS Cases, 2010 Georgia There were 36,117 cumulative AIDS cases 1 diagnosed in Georgia as of December 31, The majority (79%) of cumulative AIDS cases were male. Among cumulative AIDS cases, the most frequently reported age category was years of age (42%). There were racial/ethnic disparities among cumulative AIDS cases in Georgia in o Black/Non-Hispanics accounted for 66% of cumulative AIDS cases and comprised 31% of Georgia s population. 2 o White/Non-Hispanics accounted for 29% of cumulative AIDS cases and comprised 60% of Georgia s population. 2 o Hispanic/Latinos of all races accounted for 3% of cumulative AIDS cases and comprised 9% of Georgia s population. 2 Among males, male-to-male sexual contact was the most commonly reported transmission category (55%) among cumulative AIDS cases. Nineteen percent were missing risk information or did not meet one of the CDC-defined transmission categories. Among females, 42% of cumulative AIDS cases were missing risk information or did not meet one of the CDC-defined transmission categories. The second most commonly reported transmission category (38%) was heterosexual contact 3. The Fulton and DeKalb Health Districts had the two highest cumulative numbers of persons diagnosed with AIDS in Georgia (14,141 and 5,692 respectively). 1 Cumulative AIDS Cases refers to the total number of persons diagnosed in Georgia with AIDS as of December 31, 2010, regardless of their current residence or vital status. Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. 2 Georgia 2010 population obtained from 2010 US Census. Rates are per 100,000 population. 3 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV Georgia HIV/AIDS Surveillance Summary 17

18 Table 11. Unmet Need by HIV/AIDS Status, 2010 Georgia Defining Unmet Need The U.S. Department of Health and Human Service s Health Resources and Services Administration (HRSA) recommends that HIV viral load and CD4 count be performed at least every 3-4 months in HIV-positive individuals. 1 HRSA defines an individual as having an unmet need if they are living with HIV/AIDS, are aware of their status, and are not receiving regular primary care. An individual with HIV or AIDS is considered to have an unmet need for care (or to be out of care) when there is no evidence that s/he received any of the following three components of HIV primary care during a defined 12-month time frame: o Viral load (VL) testing o CD 4 count 2 o Provision of antiretroviral therapy 3 Unmet HIV Need, Georgia The majority with unmet HIV need were male (76%). The most frequent age group (38%) with unmet HIV need was 45 years of age or older. There were racial/ethnic disparities among individuals with unmet HIV need in Georgia in o Black/Non-Hispanics accounted for 77% of individuals with unmet HIV need. o White/Non-Hispanics accounted for 12% of individuals with unmet HIV need. o Hispanic/Latinos of all races accounted for 3% of individuals with unmet HIV need. Among all transmission categories, 51% of individuals were missing risk information or did not meet one of the CDC-defined transmission categories. Forty-three percent of individuals with unmet HIV need reported male-to-male sexual contact. 1 U.S. Department of Health and Human Services Health Resource Services Administration HIV/AIDS Bureau. Guide for HIV/AIDS Clinical Care. Published January Accessed September 7, Unmet Need for HIV Primary Care in the Atlanta Eligible Metropolitan Area, Published December Accessed September 7, A Practical Guide to Measuring Unmet Need for HIV Related Primary Medical Care: Using the Unmet Need Framework. Fty://ftp.hrsa.gov/hab/unmetneedpracticalguide.pdf. Accessed September 7, For the purposes of this analysis, unmet need for primary medical care is defined as no evidence of a viral load or CD4 laboratory test within the 12 month report period Georgia HIV/AIDS Surveillance Summary 18

19 Unmet AIDS Need, 2010 Georgia The majority with unmet AIDS need (81%) were male. The most frequent age group with unmet AIDS need was 45 years of age or older. There were racial/ethnic disparities among individuals with unmet AIDS need in Georgia in 2010: o Black/Non-Hispanics accounted for 72% of individuals with unmet AIDS need. o White/Non-Hispanics accounted for 18% of individuals with unmet AIDS need. o Hispanic/Latinos of all races accounted for 5% of individuals with unmet AIDS need. Among all transmission categories, most individuals with unmet AIDS need reported male-to-male sexual contact (43%). Twenty-seven percent of individuals with unmet AIDS need were missing risk information or did not meet one of the CDC-defined transmission categories (27%) Georgia HIV/AIDS Surveillance Summary 19

20 Table 1: Distribution of the General Population by Race/Ethnicity, Georgia, 2010 Race/Ethnicity Number 1 (%) White, Non-Hispanic 5,413,920 (56) Black, Non-Hispanic 2,910,800 (30) Hispanic/Latino, Any Race 853,689 (9) Asian, Non-Hispanic 311,692 (3) American Indian/Alaskan Native, Non-Hispanic 21,279 (<1) Native Hawaiian/Pacific Islander, Non-Hispanic 5,152 (<1) Multiracial/Other, Non-Hispanic 171,121 (<1) Total 9,687,653 1 Population estimates are based on data obtained from the 2010 U.S. Census Georgia HIV/AIDS Surveillance Summary 20

21 Table 2: Newly Diagnosed HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Gender Count 3 Percent 4 Count Percent Count Percent Male , Female Age at Diagnosis (yr) Count Percent Count Percent Count Percent <13 4 < < Race/Ethnicity Count Percent Count Percent Count Percent White, Non-Hispanic Black, Non-Hispanic 1, , Hispanic/Latino, Any Race American Indian/Alaskan Native, Non-Hispanic 1 < <1 Asian/ Hawaiian/Pacific Islander, Non-Hispanic 9 < <1 Multiracial/Unknown/Others, Non-Hispanic 6 <1 3 <1 9 <1 Total 1, ,037 1 Persons Newly Diagnosed with HIV infection (not AIDS) refers to reported cases that meet the CDC surveillance case definition from HIV (not AIDS) and were diagnosed in Georgia in Persons Newly Diagnosed with AIDS refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in Numbers are based on data reported through June 30, 2011, and are not adjusted for reporting delays. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the total Georgia HIV/AIDS Surveillance Summary 21

22 Table 3: Newly Diagnosed HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Males Count 3 Percent 4 Count Percent Count Percent MSM IDU 7 < <1 MSM and IDU 3 < <1 Heterosexual Perinatal 1 <1 1 <1 2 <1 NIR Subtotal ,527 Females Count Percent Count Percent Count Percent IDU 3 < Heterosexual Other Perinatal NIR Subtotal Total 1, ,037 MSM, men who have sex with men IDU, intravenous drug users NIR, no identified risk 1 Persons Newly Diagnosed with HIV infection (not AIDS) refers to reported cases that meet the CDC surveillance case definition for HIV (not AIDS) and were diagnosed in Georgia in Persons Newly Diagnosed with AIDS refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in Numbers are based on data reported through June 30, 2011, and are not adjusted for reporting delays. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the total. 5 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV. 6 Other includes hemophilia, blood transfusion, transplant and pediatric Georgia HIV/AIDS Surveillance Summary 22

23 Table 4: Newly Diagnosed HIV (not AIDS) and AIDS by Public Health District of Residence at Diagnosis, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Public Health District Count 3 Rate 4 Count Rate Count Rate 1-1 Northwest (Rome) North Georgia (Dalton) North (Gainesville) Cobb-Douglas Fulton Clayton (Jonesboro) East Metro (Lawrenceville) DeKalb LaGrange South Central (Dublin) North Central (Macon) East Central (Augusta) West Central (Columbus) South (Valdosta) Southwest (Albany) Coastal (Savannah) Southeast (Waycross) Northeast (Athens) GA Cases with Unknown Health District Total 1, , Note: Case counts include incarcerated persons and may inflate rates in certain geographic regions where there are large concentrations of HIV-positive inmates. 1 Persons Newly Diagnosed with HIV infection (not AIDS) refers to reported cases that meet the CDC surveillance case definition for HIV (not AIDS) and were diagnosed in Georgia in Persons Newly Diagnosed with AIDS refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in Numbers are based on data reported through June 30, 2011, and are not adjusted for reporting delays. 3 Rates are calculated as the number of cases per 100,000 population and are based on Georgia 2010 population estimates obtained from the 2010 U.S. Census Georgia HIV/AIDS Surveillance Summary 23

24 Table 5: Persons Living with HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Gender Count 3 Percent 4 Count Percent Count Percent Male 13, , , Female 5, , , Age as of December 31, 2010 (years) 5 Count Percent Count Percent Count Percent < <1 22 <1 169 < <1 345 < , , , , , , , , , , , , , , , ,668 9 Race/Ethnicity Count Percent Count Percent Count Percent White, Non-Hispanic 4, , , Black, Non-Hispanic 13, , , Hispanic/Latino, Any Race , ,889 4 American Indian/Alaskan Native, Non-Hispanic 28 <1 26 <1 54 <1 Asian/ Hawaiian/Pacific Islander, Non-Hispanic 82 <1 78 <1 160 <1 Multiracial/Unknown/Others, Non-Hispanic Total 18,535 23,451 41,986 1 Persons living with HIV (not AIDS) refers to persons who, as of December 31, 2010, were living with HIV (not AIDS) and residing in Georgia, regardless of their state of residence at the time of HIV (not AIDS) diagnosis. Persons are assumed to be alive unless otherwise documented or reported. 2 Persons living with AIDS refers to persons who, as of December 31, 2010, were living with AIDS and residing in Georgia, regardless of their state of residence at the time of AIDS diagnosis. 3 Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. Persons are assumed to be alive unless otherwise documented or reported. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the total. 5 Excludes 1 person with incomplete birth date information Georgia HIV/AIDS Surveillance Summary 24

25 Table 6: Persons Living with HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Males Count 3 Percent 4 Count Percent Count Percent MSM 6, , , IDU , ,966 6 MSM and IDU , ,558 5 Heterosexual , ,704 5 Perinatal 89 <1 64 <1 153 <1 Other 6 5 <1 78 <1 83 <1 NIR 4, , , Subtotal 13,138 18,007 31,145 Females Count Percent Count Percent Count Percent IDU , Heterosexual 1, , , Perinatal Other 14 <1 31 <1 45 <1 NIR 3, , , Subtotal 5,397 5,444 10,841 Total 18,535 23,451 41,986 MSM, men who have sex with men IDU, intravenous drug users NIR, no identified risk 1 Persons living with HIV (not AIDS) refers to persons who, as of December 31, 2009, were living with HIV (not AIDS) and residing in Georgia, regardless of their state of residence at the time of HIV (not AIDS) diagnosis. Persons are assumed to be alive unless otherwise documented or reported. 2 Persons living with AIDS refers to persons who, as of December 31, 2009, were living with AIDS and residing in Georgia, regardless of their state of residence at the time of AIDS diagnosis. Persons are assumed to be alive unless otherwise documented or reported. 3 Numbers are based on data entered through June 30, 2010, and are not adjusted for reporting delays. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the total. 5 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV. 6 Other includes hemophilia, blood transfusion, transplant and pediatric transmission Georgia HIV/AIDS Surveillance Summary 25

26 Table 7: Persons Living with HIV (not AIDS) and AIDS by Current Public Health District of Residence, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Public Health District Count 3 Rate 4 Count Rate Count Rate 1-1 Northwest (Rome) North Georgia (Dalton) North (Gainesville) Cobb-Douglas 1, , , Fulton 4, , , Clayton (Jonesboro) , , East Metro (Lawrenceville) , , DeKalb 3, , , La Grange , South Central (Dublin) North Central (Macon) , East Central (Augusta) , , West Central (Columbus) , South (Valdosta) Southwest (Albany) , Coastal (Savannah) , , Southeast (Waycross) Northeast (Athens) GA Cases with Unknown Health District Total 18, , , Note: Case counts include incarcerated persons and may inflate rates in certain geographic regions where there are large concentrations of HIV-positive inmates. 1 Persons Living with HIV (not AIDS) refers to persons living with HIV (not AIDS) as of December 31, 2010, who were currently residing in Georgia regardless of their state of residence at the time of HIV (not AIDS) diagnosis. Persons are assumed to be alive unless otherwise documented or reported. 2 Persons Living with AIDS refers to persons living with AIDS as of December 31, 2010, who were currently residing in Georgia regardless of their state of residence at the time of AIDS diagnosis. Persons are assumed to be alive unless otherwise documented or reported. 3 Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. 4 Rates are calculated as the number of cases per 100,000 population and are based on Georgia 2010 population estimates obtained from the 2010 U.S. Census Georgia HIV/AIDS Surveillance Summary 26

27 Table 8: Cumulative Cases of HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Gender Count 3 Percent 4 Count Percent Count Percent Male 11, , , Female 4, , , Age as of December 31, 2010 (years) 5 Count Percent Count Percent Count Percent < <1 462 < <1 1, , , , , , , , , , , , , , , , , ,417 3 Race/Ethnicity Count Percent Count Percent Count Percent White, Non-Hispanic 3, , , Black, Non-Hispanic 12, , , Hispanic/Latino, Any Race , ,863 4 American Indian/Alaskan Native, Non-Hispanic 18 <1 23 <1 41 <1 Asian/ Hawaiian/Pacific Islander, Non-Hispanic 65 <1 83 <1 148 <1 Multiracial/Unknown/Others, Non-Hispanic Total 16,608 36,117 52,725 1 Cumulative HIV (not AIDS) cases refers to the total number persons with HIV diagnosis in Georgia as of December 31, 2010, regardless of their current residence or vital status. 2 Cumulative AIDS cases refers to the total number of persons diagnosed in Georgia with AIDS as of December 31, 2010, regardless of their current residence or vital status. 3 Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the total. 5 Age at diagnosis excludes persons with incomplete birth date information: HIV (n=11), AIDS (n=0) Georgia HIV/AIDS Surveillance Summary 27

28 Table 9: Cumulative Cases of HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Males Count 3 Percent 4 Count Percent Count Percent MSM 5, , , IDU , MSM and IDU , ,179 4 Heterosexual , ,378 5 Perinatal 63 <1 116 <1 179 <1 Other 6 9 <1 211 <1 220 <1 NIR 4, , , Subtotal 11,685 28,679 40,364 Females Count Percent Count Percent Count Percent IDU , , Heterosexual 1, ,804 <1 3, Perinatal Other 16 <1 71 <1 87 <1 NIR 3, , , Subtotal 4,923 7,438 12,361 Total 16,608 36,117 52,725 MSM, men who have sex with women IDU, intravenous drug users NIR, no identified risk 1 Cumulative HIV (not AIDS) cases refers to the total number persons with HIV diagnosis in Georgia as of December 31, 2010, regardless of their current residence or vital status. 2 Cumulative AIDS cases refers to the total number of persons diagnosed in Georgia with AIDS as of December 31, 2010 regardless of their current residence or vital status. 3 Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the total. 5 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and/or person with AIDS or documented HIV. 6 Other includes hemophilia, blood transfusion, transplant and pediatric transmission Georgia HIV/AIDS Surveillance Summary 28

29 Table 10: Cumulative Cases of HIV (not AIDS) and AIDS by Public Health District of Residence at Diagnosis, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Public Health District Count 3 Count Count 1-1 Northwest (Rome) North Georgia (Dalton) North (Gainesville) Cobb-Douglas 907 1,627 2, Fulton 4,187 14,141 18, Clayton (Jonesboro) 768 1,089 1, East Metro (Lawrenceville) 703 1,216 1, DeKalb 2,939 5,692 8,631 4 La Grange , South Central (Dublin) North Central (Macon) 962 1,394 2,356 6 East Central (Augusta) 856 1,777 2,633 7 West Central (Columbus) 674 1,181 1, South (Valdosta) , Southwest (Albany) 623 1,264 1, Coastal (Savannah) 948 2,041 2, Southeast (Waycross) , Northeast (Athens) GA Cases with Unknown Health District Total 16,608 36,117 52,725 Note: Case count includes incarcerated persons and may inflate rates in certain geographic regions where there are large concentrations of HIV-positive inmates. 1 Cumulative Cases of HIV (not AIDS) refers to the total number persons with HIV diagnosis in Georgia as of December 31, 2010, regardless of their current residence or vital status. 2 Cumulative AIDS cases refers to the total number of persons diagnosed in Georgia with AIDS as of December 31, 2010, regardless of their current residence or vital status. 3 Numbers are based on data entered through June 30, 2011, and are not adjusted for reporting delays Georgia HIV/AIDS Surveillance Summary 29

30 Table 11: Demographic Characteristics of Individuals with Unmet Need by HIV/AIDS Status, Georgia, 2010 HIV (not AIDS) 1 AIDS 2 Total Gender Count Percent 3 Count Percent Count Percent Male 4, , , Female 1, , , Subtotal 4 6,315 9,479 15,794 Age as of December 31, 2010 (years) Count Percent Count Percent Count Percent <13 N/A N/A N/A N/A N/A N/A <1 21 <1 73 < , , , , , , , , , , , Subtotal 10,365 13,895 24,260 Race/Ethnicity Count Percent Count Percent Count Percent White, Non-Hispanic , , Black, Non-Hispanic 4, , , Hispanic/Latino, Any Race Others/Unknown Subtotal 5,742 8,679 14,421 Transmission Category MSM 2, , , IDU , ,533 7 MSM and IDU Heterosexual , ,439 8 Perinatal N/A N/A N/A N/A N/A N/A Other 5 N/A N/A N/A N/A N/A N/A NIR 4, , Subtotal 8,669 12,002 20,671 Note: MSM, men who have sex with men IDU, intravenous drug users NIR, no identified risk Unmet need is defined as the absence of any viral load or CD4 laboratory tests for persons reported in Georgia HIV/AIDS surveillance systems as of December 31, Persons Living with HIV/non-AIDS (PLWH non-aids/aware): the number of persons living with HIV/non-AIDS and reported in Georgia HIV/AIDS surveillance systems as of December 31, It is presumed that all people living with AIDS are aware of their status. 2 AIDS status is defined as 1) Persons Living with AIDS (PLWA): the number of persons living with CDC-defined AIDS and reported in Georgia HIV/AIDS surveillance systems as of December 31, It is presumed that all people living with AIDS are aware of their status. 3 Total percentages may not add up to 100% due to rounding and represent the percentage of the total. 4 Subtotals may not be equal due to missing information. 5 Other includes hemophilia, blood transfusion, transplant, and pediatric transmission Georgia HIV/AIDS Surveillance Summary 30