office of aids california department of public health hiv/aids among african- americans in...
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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
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:
Rate DisparityRate Disparity
California New HIV Diagnoses, 2005 - California New HIV Diagnoses, 2005 - MalesMales
Asian/Pacific Islander
3%
Hispanic 36%
American Indian/ Alaska Native
<1%
Black 18%
White 42%
No. = 2842
HIV NumberHIV Number HIV RateHIV Rate
CDPH, Office of AIDS. HIV/AIDS Case Registry.
Hispanic 21.0
Asian/Pacific Islander
5.3
American Indian/ Alaska Native
19.8
Black 55.9White
17.0
Total = 19.2
California New HIV Diagnoses, 2005 - California New HIV Diagnoses, 2005 - FemalesFemales
Asian/Pacific Islander
3%
Hispanic 33%
American Indian/ Alaska Native
1%
Black 36%
White 25%
No. = 470
HIV NumberHIV Number HIV RateHIV Rate
CDPH, Office of AIDS. HIV/AIDS Case Registry.
Hispanic 3.4
Asian/Pacific Islander
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
Asian/Pacific Islander
1%
Hispanic 45%
American Indian/ Alaska Native
0%
Black 27%
White 19%
No. = 116
HIV NumberHIV Number HIV RateHIV Rate
CDPH, Office of AIDS. HIV/AIDS Case Registry.
Hispanic 3.1
Asian/Pacific Islander
0.2
American Indian/ Alaska Native
0.0
Black 10.8
White 1.5
Total = 2.7
Unknown 8%
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:
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+
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:
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%
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:
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
Prepared by: Prevention Research and Evaluation Section, California DPH, Office of AIDS.
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%
Prepared by: Prevention Research and Evaluation Section, California DPH, Office of AIDS.
No. = 621
Proportion of HIV+ Females Proportion of HIV+ Females Concentrated in Urban AreasConcentrated in Urban Areas
Prepared by: Prevention Research and Evaluation Section, California DPH, Office of AIDS.
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
Prepared by: Prevention Research and Evaluation Section, California DPH, Office of AIDS.
P<.01
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:
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
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
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:
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 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:
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
CHOICE Website – Intervention CHOICE Website – Intervention DisseminationDissemination
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:
Thank YouThank You