office of aids california department of public health hiv/aids among african- americans in...

Office of AIDSOffice of AIDSCalifornia Department of Public HealthCalifornia Department of Public Health

HIV/AIDS Among African-HIV/AIDS Among African-

Americans in California: Americans in California:

Epidemiologic Data and Research Epidemiologic Data and Research

OverviewOverview

Christopher Krawczyk, Ph.D.Christopher Krawczyk, Ph.D.Chief – HIV Prevention Research and Chief – HIV Prevention Research and

Evaluation SectionEvaluation Section

General Population StatisticsGeneral Population Statistics

CaliforniaCalifornia USAUSAFemale (%)Female (%) 50.150.1 50.750.7

White/non-Hispanic (%)White/non-Hispanic (%) 43.843.8 66.966.9

Black/non-Hispanic (%)Black/non-Hispanic (%) 6.76.7 12.812.8

Hispanic/Latino (%)Hispanic/Latino (%) 35.235.2 14.414.4

Amer. Indian/AK Native (%)Amer. Indian/AK Native (%) 1.21.2 1.01.0

Asian (%)Asian (%) 12.212.2 4.34.3

Native Hawaiian/ Pac. Isl. (%)Native Hawaiian/ Pac. Isl. (%) 0.40.4 0.20.2

U.S. Census Bureau. State & County QuickFacts

New HIV Diagnoses, 2005 – All CasesNew HIV Diagnoses, 2005 – All Cases

Asian/Pacific Islander

3%

Hispanic 35%

American Indian/ Alaska Native

<1%

Black 20%

White 39%

No. = 3,312

CaliforniaCalifornia CDC – 33 StatesCDC – 33 States

CDPH, Office of AIDS. HIV/AIDS Case Registry. CDC, HIV/AIDS Among African-Americans. www.cdc.gov




Rate DisparityRate Disparity

California New HIV Diagnoses, 2005 - California New HIV Diagnoses, 2005 - MalesMales


3%

Hispanic 36%


<1%

Black 18%

White 42%

No. = 2842

HIV NumberHIV Number HIV RateHIV Rate

CDPH, Office of AIDS. HIV/AIDS Case Registry.

Hispanic 21.0


5.3


19.8

Black 55.9White

17.0

Total = 19.2

California New HIV Diagnoses, 2005 - California New HIV Diagnoses, 2005 - FemalesFemales


3%

Hispanic 33%


1%

Black 36%

White 25%

No. = 470



Hispanic 3.4


0.6American Indian/ Alaska Native

7.4

Black 17.9

White 1.6

Total = 3.1

HIV and AIDS rates, California (2005)HIV and AIDS rates, California (2005)

0

20

40

60

80

100

120

Hispanic Asian AA White Hispanic Asian AA White

Cas

es p

er 1

00,0

00 p

opul

atio

n

HIV

AIDS

Men Women

Data sources: California Department of Public Health, Office of AIDS, HIV/AIDS Case Registry; data as of March 31, 2006; State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail 2000-2050, Sacramento, California, July 2007.

California New HIV/AIDS Diagnoses, California New HIV/AIDS Diagnoses, 2005. Aged 13 to 19 Years of Age2005. Aged 13 to 19 Years of Age


1%

Hispanic 45%


0%

Black 27%

White 19%

No. = 116



Hispanic 3.1


0.2


0.0

Black 10.8

White 1.5

Total = 2.7

Unknown 8%




Risk FactorsRisk Factors

African American Risks Reported African American Risks Reported in State Funded Test Sitesin State Funded Test Sites

19,339 African American 19,339 African American tests (2006)tests (2006)

% HIV % HIV PositivePositive

% of AA Tests% of AA Tests

HIV-infected sex partnerHIV-infected sex partner 5.4%5.4% 4.4%4.4%

Men who have sex with menMen who have sex with men 4.3%4.3% 12.7%12.7%

MSM and inject drugsMSM and inject drugs 3.1%3.1% 1.3%1.3%

Sex for drugs or moneySex for drugs or money 2.0%2.0% 12.8%12.8%

Hepatitis C diagnosisHepatitis C diagnosis 2.0%2.0% 4.7%4.7%

Injection drug userInjection drug user (non-MSM)(non-MSM) 1.9%1.9% 8.1%8.1%

Sexually transmitted infectionSexually transmitted infection 1.8%1.8% 17.8%17.8%

African American Risks Reported African American Risks Reported in State Funded Test Sitesin State Funded Test Sites

2006: 19,339 African 2006: 19,339 African American testsAmerican tests

% HIV % HIV PositivePositive

% of AA % of AA TestsTests

IDU sex partnerIDU sex partner 1.7%1.7% 12.2%12.2%

Transgender sex partnerTransgender sex partner 1.6%1.6% 2.2%2.2%

Stimulant drug useStimulant drug use 1.6%1.6% 32.7%32.7%

Transfusion, job relatedTransfusion, job related 1.6%1.6% 3.2%3.2%

Use drugs with sexUse drugs with sex 1.4%1.4% 57.7%57.7%

Sex worker sex partnerSex worker sex partner 1.3%1.3% 11.4%11.4%

No identifiable risk or No identifiable risk or unknownunknown

0.9%0.9% 23.2%23.2%

Mode of Exposure, 2005 African-Mode of Exposure, 2005 African-American MalesAmerican Males

Heterosexual 9%

IDU 8%

MSM-IDU 3%

Other/NIR 27%

MSM 54%

No. = 2842

HIV CaliforniaHIV California HIV/AIDS CDC – 33 StatesHIV/AIDS CDC – 33 States

CDPH, Office of AIDS. HIV/AIDS Case Registry. CDC. Fact Sheet: HIV/AIDS among African Americans. June 2007

Mode of Exposure, 2005 African-Mode of Exposure, 2005 African-American FemalesAmerican Females

Heterosexual 56%

IDU 18%

Other/NIR 26%

No. = 470

HIV CaliforniaHIV California HIV/AIDS CDC – 33 StatesHIV/AIDS CDC – 33 States

CDPH, Office of AIDS. HIV/AIDS Case Registry. CDC. Fact Sheet: HIV/AIDS among African Americans. June 2007

Female HIV Positivity by Risk GroupsFemale HIV Positivity by Risk GroupsHierarchical Risk GroupsHierarchical Risk Groups WhiteWhite African African

AmericanAmericanLatinaLatina

HIV+ partner* HIV+ partner* 3.573.57 8.098.09 5.015.01

IDUIDU 0.800.80 3.583.58 0.650.65

Sex with IDU*Sex with IDU* 0.300.30 1.811.81 0.710.71

Sex for drugs/$Sex for drugs/$ 0.780.78 1.871.87 0.800.80

MSM partner*MSM partner* 0.400.40 1.291.29 0.780.78

Multiple partnersMultiple partners 0.210.21 0.660.66 0.340.34

Monogamous partnershipMonogamous partnership 0.200.20 0.720.72 0.330.33

No risk reportedNo risk reported 0.580.58 2.212.21 1.211.21

Unknown risk Unknown risk (missing/declined)(missing/declined) 1.011.01 2.962.96 1.071.07

Prepared by: Prevention Research and Evaluation Section, California DPH, Office of AIDS.

*does not include oral sex

HIV+




Transgender PeopleTransgender People

Transgender PeopleTransgender People

2003 HIV Counseling & Testing Data:2003 HIV Counseling & Testing Data: 1203 tests among self-identified transgenders1203 tests among self-identified transgenders 36 of 126 AA transgender tests were positive36 of 126 AA transgender tests were positive Positivity: 28.6%Positivity: 28.6%




Geographic InfluenceGeographic Influence

African-American MSM at OA Funded African-American MSM at OA Funded C&T Sites – Geographic RoleC&T Sites – Geographic Role

Tier 2 10%

Tier 3 3%

Tier 1

87%

No. = 8307

TestedTested


Tier 1Tier 1 Tier 2Tier 2

AlamedaAlameda BerkeleyBerkeley

Contra CostaContra Costa FresnoFresno

Long BeachLong Beach KernKern

Los AngelesLos Angeles OrangeOrange

RiversideRiverside PasadenaPasadena

SacramentoSacramento San JoaquinSan Joaquin

San BernardinoSan Bernardino San MateoSan Mateo

San DiegoSan Diego Santa ClaraSanta Clara

San FranciscoSan Francisco

SolanoSolano

African-American MSM at OA Funded African-American MSM at OA Funded C&T Sites – Geographic RoleC&T Sites – Geographic Role

Tier 2 10%

Tier 3 3%

Tier 1

87%

No. = 8307

TestedTested PositivePositive

Tier 1

90.5%

Tier 2 7.9%

Tier 3 3%

Tier 1

90.5%

Tier 2 7.9%

Tier 3 1.6%


No. = 621

Proportion of HIV+ Females Proportion of HIV+ Females Concentrated in Urban AreasConcentrated in Urban Areas


81% 72% 56%

African American Latina White

Female HIV-positivity: Urban vs. Non-urbanFemale HIV-positivity: Urban vs. Non-urban

0.46

1.5

0.57

0.37

0.94

0.43

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

white African Am Latina

urban

non-urban


P<.01




Delayed HIV DiagnosisDelayed HIV Diagnosis

Time to AIDS diagnosis (in months) Time to AIDS diagnosis (in months) from first HIV diagnosis in 2005from first HIV diagnosis in 2005

Source: California Department of Public Health, Office of AIDS, HIV/AIDS Case Registry; data as of March 31, 2006.

* Averaged over all race/ethnicities.

MenMen WomenWomen

nn MedianMedian7575thth

PercentilePercentile nn MedianMedian7575thth

PercentilePercentile

BlackBlack 444444 33 5959 170170 11 3737

AsianAsian 6969 00 2020 Excluded – small nExcluded – small n

HispanicHispanic 922922 00 1212 156156 1.51.5 4040

WhiteWhite 959959 44 6363 119119 3030 8484

TotalTotal 11 3636 22 52.552.5




HIV/AIDS CareHIV/AIDS Care

Program YearTotal

(n)

Total AA(n)

AA(%)

AA Aged 15-25(%)

AA AIDS

non-HIV(%)

AA MSM(%)

AA Female

(%)

ADAPFY

06/0731,221 4,392 14.1 3.4 40.3 n/a 15.0

CMPFY

05/061,760 339 19.3 2.9 n/a n/a 30.0

EIPFY

05/068,655 1,714 19.8 4.3 n/a 14.8 32.6

CSP/CADRCY

200641,191 9,037 21.9 n/a n/a n/a n/a

CARE/HIPPFY

06/07337 36 10.7 0.0 n/a n/a 25.0

- CMP age range is 13-24

- CSP numbers include duplicated clients

Care Program Client Statistics




Office of AIDS ResearchOffice of AIDS Research

Office of AIDS Research - MalesOffice of AIDS Research - Males

National HIV Behavioral Surveillance (NHBS) ProjectNational HIV Behavioral Surveillance (NHBS) Project Partners ProjectPartners Project

Health Evaluation of Young Men (HEY Man) StudyHealth Evaluation of Young Men (HEY Man) Study Interpersonal/Social HIV Risk Among African American and Interpersonal/Social HIV Risk Among African American and

White Male InmatesWhite Male Inmates Developing a Tailored Case Management Intervention for Developing a Tailored Case Management Intervention for

MSM (HOLLA)MSM (HOLLA) HIV Prevention for African American Down Low Men HIV Prevention for African American Down Low Men

(BRUTHAS)(BRUTHAS) HIV Prevention for African-American MSM Who Do Not HIV Prevention for African-American MSM Who Do Not

Identify as Gay (MAALES)Identify as Gay (MAALES) Community Collaborative award for African-American MSM Community Collaborative award for African-American MSM

or African-American MSM who do not identify as gayor African-American MSM who do not identify as gay

Office of AIDS Research - FemalesOffice of AIDS Research - Females

National HIV Behavioral Surveillance (NHBS) National HIV Behavioral Surveillance (NHBS) ProjectProject Partners ProjectPartners Project

Females of African American Legacy Females of African American Legacy Empowering Self (FemAALES) Project: Empowering Self (FemAALES) Project: Reducing HIV Risk Behaviors and Increasing Reducing HIV Risk Behaviors and Increasing Sexual Communication Skills in African Sexual Communication Skills in African American Women with At-Risk Male PartnersAmerican Women with At-Risk Male Partners

CHOICE Website – Intervention CHOICE Website – Intervention DisseminationDissemination




Thank YouThank You

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