HIV Infection in New York State
HIV Care Outcomes Among Women
November, 2015
Carol-Ann Swain
Bureau of HIV/AIDS Epidemiology
AIDS Institute
November, 2015
Presentation Outline
•
Epidemiology of HIV infection among females in New York State
•
HIV care outcomes
– Continuity of HIV care and HIV viral suppression
•
Summary
2
November, 2015
3
Newly Diagnosed HIV Cases Among Females by Year of HIV Diagnosis
New York State, 2003-2013
• 3,512 total new diagnoses in 2013
• 21% were female
2,000
1,800
1,619
1,600
1,395
Count
1,400
1,228
1,200
999
1,000
830
800
742
600
400
200
0
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
November, 2015
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Living Cases of HIV/AIDS: Females Residing in NYS at the End of 2013
•
There were 112,462 persons were living with diagnosed HIV infection (PLWDHI)
– 30% (n=33,185) were female
Females
• Race/ethnicity
– 54% Black; 31% Hispanic; 10% White
• Age
– 31% <30 years
– 35% 30-39 years
– 23% 40-49 years
– 11% 50+ years
• HIV transmission risk
– 80% heterosexual contact
– 17% injection drug use
•
Residence at the end of 2013
– 78% resided in NYC; 22% in areas outside of NYC
November, 2015
HIV Care Outcomes
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Cascade of HIV Care Among Females
Persons Residing in NYS† at End of 2013
0
10,000
20,000
30,000
Estimated HIV Infected Personsǂ
Cases w/continuous care during the
year**
Virally suppressed at test closest to
end-of-year***
50,000
60,000
37,500
Persons Living w/ Diagnosed HIV
Infection
Cases w/any HIV Care during the
year*
40,000
33,200
26,700
23,300
21,000
81% of PLWDHI
70% of PLWDHI
63% of PLWDHI
79% of cases w/any care
ǂ 11.4% are infected and unaware, based on CDC estimate; * Any VL or CD4 test during the
year; ** At least 2 tests, at least 3 months apart; *** Non-detectable viral load or viral load
≤200/ml
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New York State HIV Care Measures and NHAS Targets, Females
Newly Diagnosed (a), PLWDHI (b)
100%
90%
83% 85% 85%
80%
80%
67% 70%
63% 63%
60%
40%
20%
0%
Linked to Care (a)
NYS 2013
Retained in Care (b)
NYS Females, 2013
Virally Suppressed (b)
NHAS Targets*
*The NHAS linkage to care proportion is based on the 2015 target; retention in care and HIV viral
suppression are the updated 2020 targets.
Linkage to care within 90 days; Retained in care- ≥2 visits/year, ≥3 months apart; Virally Suppressedviral load ≤ 200 copies/ml or non-detectable.
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Females: Viral Suppression by Race/Ethnicity*, NYS 2013
80%
%virally suppressed
69%
60%
60%
69%
68%
64%
50%
40%
20%
0%
White
Black
Hispanic
Asian/Pac Isl
Native Am.**
*Based on most recent address, regardless of where diagnosed. Excludes persons with AIDS with no evidence
of care for 5 years and persons with diagnosed HIV (non-AIDS) with no evidence of care for 8 years.
**16 women were Native Am.
Multirace
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Females: Viral Suppression by Age*, NYS 2013
80%
73%
%virally suppressed
68%
60%
60%
56%
53%
49%
44%
40%
20%
0%
13-19
20-24
25-29
30-39
40-49
50-59
*Based on most recent address, regardless of where diagnosed. Excludes persons with AIDS with no evidence
of care for 5 years and persons with diagnosed HIV (non-AIDS) with no evidence of care for 8 years.
60+
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Data Summary
•
New diagnoses among women declined by almost 60% in the decade prior
to 2013
HIV care outcomes
•
Linkage within 3 months of diagnosis meets the 2015 NHAS target
•
Retention in care and HIV viral suppression are below the 2020 NHAS
targets
HIV viral suppression
•
Minorities represent the largest proportion of HIV-infected women but a
lower proportion are suppressed compared to white women
•
Relatively low among women aged 20-29 years
November, 2015
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Thank you.
Carol-Ann Swain
[email protected]
518-474-4284
For more data on HIV in New York State, please visit
http://www.health.ny.gov/diseases/aids/statistics/
Data requests to:
[email protected]
*Thank you to the staff of BHAE for their efforts in assuring the quality and completeness of the
NYS HIV Surveillance Registry*