30
BURDEN OF HIV/AIDS IN BEXAR COUNTY San Antonio Metropolitan Health District October 11, 2017
1
BURDEN OF HIV/AIDS IN BEXAR COUNTY
San Antonio Metropolitan Health District
October 11, 2017
2
18.7
16.1
12.2
0
5
10
15
20
25
'08 '09 '10 '11 '12 '13 '14 '15 16HIV
Infe
ctio
ns
pe
r 1
00
,00
0 p
op
ula
tio
n
Year
Bexar County Texas US
New HIV Diagnoses Rates, 2008-2016
Source: 2016 Annual Report: Texas HIV Surveillance Report US estimated based on CDC number and US population
3
316
234 271 285
318 306 334 341
380 329
363 360
0
50
100
150
200
250
300
350
400
2005 '06 '07 '08 '09 '10 '11 '12 '13 14 '15 16
Nu
mb
er
of
Cas
es
Year
New HIV Diagnoses, Bexar County, 2005-2016
Source: Texas HARS database
4
New HIV Diagnoses by Age Group Bexar County, 2011-2016
0.3 0.2
32.9 29.5
35.8
47.3
26.4 25.3
14.6 9.9
0
10
20
30
40
50
60
2011 2012 2013 2014 2015 2016
0-14 15-24 25-34 35-44 45+
Source: Texas HARS database, 2016 File
5
New HIV Diagnoses by Race/Ethnicity Bexar County, 2011-2016
10.0 10.7
36.9 34.8
20.7 20.4
3.7
10.6
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
2011 2012 2013 2014 2015 2016
Rat
e p
er
10
0,0
00
po
pu
lati
on
Year
White Black Hispanic Other
Source: Texas HARS database, 2016 File
6
Percent of New HIV Diagnoses by Gender, Bexar County, 2016
Bexar County
89%
11%
Texas
83%
17%
Source: Texas HARS database, 2016 File
7
Percent of New HIV Diagnoses by Risk Factor, Bexar County & Texas, 2016
Bexar County
80%
6%
2% 11%
MSM IDU MSM/IDU Heterosexual
Texas
72%
6%
2%
20%
Source: Texas HARS database, 2016 File
8
9
Persons Living with HIV , Bexar County, 2016
• ~ 6,000 in Bexar County
• Majority are 45+ years of age (52.4%)
• 85% males
• Race/ethnicity
– 63% Hispanic
– 19% White, non-Hispanic
– 16% Black, non-Hispanic
10
11
HIV Mortality Rates, Bexar County, 2011-2015
2.9 3.1
2.8
3.4
3
0
0.5
1
1.5
2
2.5
3
3.5
4
0
10
20
30
40
50
60
70
2011 2012 2013 2014 2015
Number Rate
51 56 50 64 56
Source: CDC Wonder
12
New AIDS Diagnoses by Age Group San Antonio Transitional Grant Area, 2014-2016
0.2 0.0
3.1
5.3
13.8 14.8
11.5 11.7
6.5 5.8
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
2014 2015 20160-12 13-24 25-34 35-44 45+
Source: DSHS, ARIES
13
New AIDS Diagnoses by Race/Ethnicity San Antonio Transitional Grant Area, 2014-2016
2.8 3.5
5.3
15.4
8.5 7.9
0.0 0.0 0.0
5.0
10.0
15.0
20.0
25.0
2014 2015 2016
Rat
e p
er
10
0,0
00
po
pu
lati
on
Year
White Black Hispanic Other
Source: DSHS, ARIES
14
Percent of New AIDS Diagnosis by Gender, San Antonio TGA, 2016
84%
16%
Male Female
Source: DSHS, ARIES
15
Percent of New AIDS Diagnoses by Risk Factor, San Antonio TGA & Texas, 2016
San Antonio TGA
69.4%
10.8%
7.5%
12.3%
Texas
59.9%
8.8%
4.2%
26.3%
1.0%
MSM IDU MSM/IDU Heterosexual Pediatric
Source: DSHS, ARIES
16
HIV/AIDS Burden by Five Most Populous Texas Counties, 2016
County HIV Diagnoses AIDS People Living with HIV
Bexar 18.7 7.6 310.4
Dallas 31.7 16.2 673.1
Harris 26.3 13.1 538.1
Tarrant 15.0 6.1 266.3
Travis 20.2 6.7 393.2
Source: 2016 Annual Report: Texas HIV Surveillance Report
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HIV CLUSTER INVESTIGATON BEXAR COUNTY, 2017 HIV Clusters in Bexar County
18
Cluster Analyses Findings - Texas
• 16 Clusters in Texas – Molecular Clusters range from 5-34 cases in Texas – Several Clusters have cases linked in other states
• Five clusters in San Antonio* – Cluster 51 (27 persons) – Cluster 62 (17 persons) – Cluster 151 (16 persons) – Cluster 911 (11 persons) – Cluster 923 (19 persons)
*reported by DSHS on September 21, 2017
19
74%
0% 4%
22%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
MSM IDU MSM/
IDU
No Risk
Identified
Transmission Risk
11%
78%
11%
0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Race/Ethnicity
4%
63%
22%
4% 7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
13-19 20-29 30-39 40-49 50-59
Age in years
Cluster 51- San Antonio
20
Cluster 62 - San Antonio
12%
76%
12%
0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Race/Ethnicity
0%
82%
12% 6%
0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
13- 19 20- 29 30- 39 40- 49 50- 59
Age in years 94%
0% 0% 6%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
MSM IDU MSM/
IDU
No Risk
Identified
Transmission Risk
21
Cluster 151- San Antonio
13%
69%
13% 6%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Race/Ethnicity
31%
63%
6% 0% 0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
13- 19 20- 29 30- 39 40- 49 50- 59
Age in years 100%
0% 0% 0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
MSM IDU MSM/
IDU
No Risk
Identified
Transmission Risk
22
Cluster 911 - San Antonio
0%
91%
9%
0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Race/Ethnicity
9%
73%
18%
0% 0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
13- 19 20- 29 30- 39 40- 49 50- 59
Age in years 100%
0% 0% 0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
MSM IDU MSM/
IDU
No Risk
Identified
Transmission Risk
23
Cluster 923 - San Antonio
11%
89%
0% 0% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Black/
African
Hispanic/
Latino
White Asian
47% 47%
5% 0% 0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Age
13- 19
Age
20- 29
Age
30- 39
Age
40- 49
Age
50- 59
Age in years
89%
0% 0%
11%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
(MSM)
Male to
Male
Sexual Contact
(IDU)
Injection
Drug
MSM/
IDU
No Risk
Identified
Transmission Risk
24
Cluster Characteristics - San Antonio
• 100% Males
• Highest proportion of HIV new diagnosis in 20-29 year olds – 65%
• Highest proportion of HIV new diagnosis among Hispanics – 80%
• Highest proportion of HIV new diagnosis among MSM – 89%
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Comparison of San Antonio Clusters to Bexar County Newly Diagnosed HIV - Sex at Birth
Source: TX DSHS prt: Molecular HIV Surveillance: Genotyping and Cluster Identification
100%
San Antonio Clusters
Male Female
88%
12%
Bexar County
Male Female
26
Comparison of San Antonio Clusters to Bexar County Newly Diagnosed HIV - Race/Ethnicity
Source: TX DSHS prt: Molecular HIV Surveillance: Genotyping and Cluster Identification
10%
80%
9%
1%
San Antonio Clusters
Black\African American Hispanic\Latino
White Other
15%
67%
15%
2%
Bexar County
27
Comparison of San Antonio Clusters to Bexar County Newly Diagnosed HIV - Transmission Risk
Source: TX DSHS prt: Molecular HIV Surveillance: Genotyping and Cluster Identification
89%
0%
1%
10%
San Antonio Clusters
MSM IDU MSM\IDU No Risk Identified (NRI)
79%
6%
4% 11%
Bexar County
MSM IDU MSM/IDU Heterosexual
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No Drug Resistance
Drug Resistance Identified
Not Determined
Drug Resistance in Molecular Cluster Cases in Texas
Source: TX DSHS prt: Molecular HIV Surveillance: Genotyping and Cluster Identification
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San Antonio TGA HIV Treatment Cascade, 2016
6,343 4,978 4,547 3,878
86
78 72
61
0
20
40
60
80
100
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
HIV+ IndividualsLiving, 2015
At least 1 visit/lab Retained in Care Achieved ViralSuppression
Pe
rce
nta
ge
Nu
mb
er
Source: DSHS, ARIES
30
Email: [email protected] Phone: (210) 207-8805
https://www.sanantonio.gov/Health/News/HealthDataReports
