The Upper Manhattan Experience: HIV Epidemiology

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The Experience: HIV Epidemiology M. Monica Sweeney, MD, MPH Assistant Commissioner Bureau of HIV/AIDS Prevention & Control Collaborative Meeting April 10, 2012

ZIP Codes - Extended

The HIV/AIDS Epidemic In NYC

Treatment Cascade PLWHA, 2010 13,410 PLWHA in 2010 8,848 Evidence of Care in 2011 (CD4 or Viral Load Test) 8,654 => 1 Viral Load Test Reported in 2011 6,506 Viral Load Suppression<=400 copies/ml) at Last Viral Load Test

HIV/AIDS in * and - Extended**, 2010 Basic Statistics 432 new HIV diagnoses (12.41% of diagnoses in NYC) 346 HIV without AIDS (80.1%) 86 concurrent with AIDS (19.9%) 13,410 persons living with HIV/AIDS (PLWHA), accounting for 12.10% of all PLWHA in NYC 5,254 HIV only (39.2%) 8,156 AIDS (60.8%) -Extended 519 new HIV diagnoses (14.9% of diagnoses in NYC) 414 HIV without AIDS (79.8%) 105 concurrent with AIDS (20.2%) 17,610 persons living with HIV/AIDS (PLWHA), accounting for 15.9% of all PLWHA in NYC 6,987 HIV only (39.7%) 10,623 AIDS (60.3%) * includes parts of the Upper West Side, Central Harlem-Morningside Heights, Washington Heights-Inwood, and East Harlem: 10025, 10026, 10027, 10029, 10030, 10031, 10032, 10033, 10034, 10035, 10037, 10039, 10040. * Extended** includes all zip codes in and additional participating providers in zip codes 10019, 10022, 10023, 10024, 10021, 10028, 10128

HIV/AIDS in and - Extended, 2010 Basic Statistics... continued 432 Newly Diagnosed - Transmission Risk 51.9% MSM (224) 2.8% IDU (12) 17.4% Heterosexual (75) 0.2% Perinatal (1) 27.8 % Unknown (120) 13,410 Persons Living with HIV/AIDS - Transmission Risk 33.3% MSM (4,459) 20.0% IDU (2,687) 18.8% Heterosexual (2,526) 2.4% Perinatal (317) 0.2% Other (25) 25.3% Unknown (3,396) -Extended 519 Newly Diagnosed - Transmission Risk 54.5% MSM (283) 3.3% IDU (17) 14.8% Heterosexual (77) 0.2% Perinatal (1) 27.2% Unknown (141) 17,610 Persons Living with HIV/AIDS - Transmission Risk 41.2% MSM (7,257) 17.4% IDU (3,064) 15.9% Heterosexual (2,800) 1.9% Perinatal (332) 0.2% Other (32) 23.4% Unknown (4,125)

<20, 1.6% PLWHA in, 2010 Age and Sex (compared to NYC) 20-29, 7.3% AGE SEX 60+, 13.5% 30-39, 15.4% Female 29% 50-59, 29.2% 40-49, 33% Male 71% <20, 1.5% 20-29, 7.3 NYC 60+ 12.7% 30-39 15% Female 29% 50-59 29% 40-49 34.5% Male 71%

PLWHA and NYC, 2010 Race/Ethnicity (percentage) NYC Unknown, 0.4 Asian/PI, 1.6 Native American, 0.2 Asian/PI, 0.7 Native American, 0.3 Unknown, 0.1 White, 20.5 White, 12.7 Black, 44.7 Black, 52.2 Hispanic, 32.5 Hispanic, 33.9

Per 100,000 HIV/AIDS Prevalence Rates by Age Group, NYC and Upper Manhattan 2010 5,278 5,294 5000 NYC 4000 3,416 3,225 3000 2,264 Rate: 2214/100,000 2000 1,788 1000 0 53 25 311 184 833 588 1,335 1,030 0-12 13-19 20-29 30-39 40-49 50-59 60+ Age group (years) NYC Overall Rate: 1375/100,000

Per 100,000 HIV/AIDS Prevalence Rates by Race/Ethnicity, NYC and 2010 5000 4000 3000 2000 1000 0 4,410 NYC 3,239 2,708 1,615 1,567 1,492 840 1,356 372 177 226 152 Rate: 2214/100,000 NYC Overall Rate: 1375/100,000

Per 1,000 Crude Death Rates among PWHA by Race/Ethnicity, NYC and 2010 60 50 NYC 51.3* 40 30 20 10 17.5 18.2 15.8 16.9 9.6 8.1 9.9* 7.1 15.4* 2.1* Rate:16.5/1000 NYC Rate:15.1/1000 0 Rates based on numerators <=10 are marked with an asterisk (*) and should be interpreted with caution

Per 1,000 Crude Death Rates Among PWHA by Age Group, NYC and 2010 40 NYC 35 34.2 30 30.1 25 20 19.819.3 Rate: 16.5/1000 15 10 5 5.7* 3* 3.2 3.1* 8.2 7.1 11.9 14 NYC Overall Rate: 15.1/1000 0 0* 0* 0-12 13-19 20-29 30-39 40-49 50-59 60+ Age group (years) Rates based on numerators <=10 are marked with an asterisk (*) and should be interpreted with caution

New HIV Diagnoses in, 2010 Age and Foreign Born Region of Birth 60+, 5.3% <20, 3.9% Europe, 3.7% Middle East, 1.9% Other or Unknown Region, 0.9% 50-59, 12% 20-29, 30.8% South America, 14% Africa, 15.9% Asia, 3.7% 40-49, 22.7% Central America, 12.1% 30-39, 25.2% Caribbean, 47.7% AGE Foreign Born Individuals by Region of Birth

New HIV Diagnoses, and Upper Manhattan-Extended 2010, Provider Type (percentage) -Extended Inpatient Facility, 0.2 Other Facility, 3.5 Unknown, 0.8 Inpatient Facility, 0.2 Other Facility, 3.7 Unknown, 0.5 Outpatient Facility, 22 DAC Hospital, 35.5 Outpatient Facility, 23.4 DAC Hospital, 39.6 STD Clinic, 14.5 Private MD, 21.2 Non-DAC Hospital, 2.5 STD Clinic, 14.1 Private MD, 17.4 Non-DAC Hospital, 1.2