Southwest Region of Virginia

HIV/AIDS and STD TrendsData through 2006

Southwest Region •ALLEGHANY•AMHERST•APPOMATTOX•BEDFORD•BEDFORD CITY•BLAND•BOTETOURT•BRISTOL•BUCHANAN•CAMPBELL•CARROLL•CLIFTON FORGE•COVINGTON•CRAIG•DANVILLE•DICKENSON

•FLOYD•FRANKLIN CO.•GALAX•GILES•GRAYSON•HENRY•LEE•LYNCHBURG•MARTINSVILLE•MONTGOMERY•NORTON•PATRICK•PITTSYLVANIA•PULASKI•RADFORD

•ROANOKE CITY•ROANOKE CO.•RUSSELL•SALEM•SCOTT•SMYTH•TAZEWELL•WASHINGTON•WISE•WYTHE

Notes to Accompany Virginia HIV/AIDS TrendsAll data is reported as of December 31st, 2005 unless otherwise indicated.

HIV and AIDS reportingVirginia regulations require reporting of HIV and AIDS cases separately. As a result, a person canbe listed as either a Virginia HIV case, a Virginia AIDS case, or as both (HIV and AIDS). A personfirst diagnosed with HIV infection with no AIDS defining events will always be an HIV case. If at alater time, the patient is diagnosed as AIDS; the person will be listed as both an HIV and AIDScase. If a patient's initial diagnosis of HIV infection is accompanied with an AIDS defining event,the person will be listed as only an AIDS case.

UnduplicatedAs a result of Virginia reporting regulations for HIV and AIDS (see note above), an individualcould be reported twice, once as an HIV case and once as an AIDS case. An unduplicated reportwill count this individual only once. In the case of both HIV and AIDS diagnoses for one individual,age and place of residence at the time of diagnosis will derive from the HIV report. Unduplicated counts will be indicated.

LivingWhen active (e.g., review of charts at provider’s offices) or passive (e.g., receipt of death certificate from Division of Vital Records) surveillance indicates that a patient with HIV or AIDS has died, the reporting database is updated to reflect this information. Living counts will be indicated.

Notes to Accompany Virginia HIV/AIDS TrendsGeographyAll location information is based on the address that is reported to the Division at the time of report.

Report Date vs. Diagnosis DateTime frames are selected based on either the date of report or date of diagnosis. The report date is the date the morbidity is entered into the database. Diagnosis date is the date the disease was diagnosed by a health professional. Statistical reports prepared based on diagnosis dates are likely to change over time, given that disease reports sometimes involve time lags of varying degrees.

AIDS Case Definition ChangeOn January 1, 1993, the AIDS surveillance case definition for adolescents and adults was expanded to include three additional clinical conditions (pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer) as well as a laboratory marker of severeimmunosuppression in HIV-infected persons

HIV*/AIDS Trends Between 2005-2006, statewide increase (3%) in reported

HIV/AIDS Southwest Region saw a 18% decrease in reported

HIV/AIDS In the Southwest Region, Lynchburg showed the most

notable decrease (40%) In 2006, 44% of reported cases of HIV/AIDS in the

Southwest region were White, 46% Black and 7% were Hispanic and 3% reported another race

Majority of the reported cases of HIV/AIDS were male (76%)

*Includes those that may have progressed to AIDS

VirginiaHIV*/AIDS Cases by Region (N=34,585**)

**Data through 2006

Northwest6.3%

Southwest8.3%

Central24.4%

Northern27.3%

Eastern33.7%

*Includes those that may have progressed to AIDS

Southwest Region of Virginia (N=1,501)Cases of HIV/AIDS* (1996-2006)

90

49

6559

66

4943

61

95

111

7973

7874

67 70

27

66

82

94

41

62

0

20

40

60

80

100

120

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s_

Cases of HIV (n=724)

Cases of AIDS (n=777)

*Includes those that may have progressed to AIDS

People living with HIV(not AIDS)/AIDS Trends Number of people living with HIV(not

AIDS)/AIDS in Southwest Virginia at the end of 2006 ≈ 1409

8% of Virginia’s living total Most of cases are 32 years old 70% male 51% black

Number of People Living with HIV(not AIDS) or AIDS,

in Virginia, by Region, at the end of 2006 (N=18,107)

4376

58455261

1217 1408

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

5500

6000

6500

Rep

ort

ed L

ivin

g

Region

CentralEasternNorthernNorthwestSouthwest

Percentage of People Living with HIV (not AIDS), by Region (N=10,088*)

Northwest5.8%

Southwest7.6%

Central25.8%

Northern26.0%

Eastern34.8%

*Data through 2006

Percentage of People Living with AIDS, by Region, (N=8,031*)

Northwest7.9%

Southwest8.0%

Central22.1%

Northern32.8%

Eastern29.2%

*Data through 2006

Individuals Living with HIV(not AIDS)/AIDS in the Southwest Region of Virginia by Locality at the end of 2006 (N=1,409)

46 38 36 26 25 23 21 20 17 16 9 8 8 8 7 7 6 6 6 6 5 5 4 3 2 1

52151617212224263337

129

439

174

45

0

100

200

300

400

500RO

AN

OKE

LYN

CH

BU

RG

DAN

VIL

LE

PIT

TSYLV

AN

IA C

O.

HEN

RY C

O.

CAM

PBELL

CO

.

RO

AN

OKE C

O.

AM

HERST C

O.

MO

NTG

OM

ERY C

O.

MARTIN

SVIL

LE

FRAN

KLI

N C

O.

SALE

M

TAZEW

ELL

CO

.

BED

FO

RD

CO

.

PU

LASKI

CO

.

SM

YTH

CO

.

BRIS

TO

L

WIS

E C

O.

WASH

ING

TO

N C

O.

APPO

MATTO

X C

O.

BU

CH

AN

AN

CO

.

BO

TETO

URT C

O.

WYTH

E C

O.

LEE C

O.

CO

VIN

GTO

N

BED

FO

RD

GALA

X

GIL

ES C

O.

PATRIC

K C

O.

RU

SSELL

CO

.

ALL

EG

HAN

Y C

O.

GRAYSO

N C

O.

RAD

FO

RD

SCO

TT C

O.

CARRO

LL C

O.

CLI

FTO

N F

ORG

E

BLA

ND

CO

.

NO

RTO

N

FLO

YD

CO

.

DIC

KEN

SO

N C

O.

Locality

Rep

orte

d L

ivin

g_

Individuals Living with HIV(not AIDS)/AIDS in the Southwest Region of Virginia, by Race, at the end of 2006 (N=1,409)

8

714

31 4

652

0

200

400

600

800

Report

ed L

ivin

g

Race

Asian/Pacific Islander

BlackHispanic

UnknownWhite

Individuals Living with HIV(not AIDS)/AIDS in the Southwest Region of Virginia, by Risk at the end of 2006 (N=1,409)

4

324

162

500

7237 23 5

0

50

100

150

200

250

300

350

400

450

500

550

Report

ed L

ivin

g

Risk Factor

HemophiliaHeterosexual ContactInjecting Drug Use (IDU)Men Having Sex with Men (MSM)

MSM & IDUMultiple Heterosexual ContactsPediatricTransfusion

*282 cases unidentified risk or undetermined risk

Females Living with HIV(not AIDS)/AIDS in the Southwest Region of Virginia by Risk at the end of 2006 (N=417*)

226

1810

3

46

0

50

100

150

200

250

HeterosexualContact

Injecting Drug Use(IDU)

MultipleHeterosexual

Contacts

Pediatric Transfusion/BloodProducts

Risk Factor

Rep

orte

d L

ivin

g_ Females (n=417)

*114 cases unidentified risk or undetermined risk

Males Living with HIV(not AIDS)/AIDS in the Southwest Region by Risk at the end of 2006 (N=992*)

4

116

500

72

13 2

98

190

100

200

300

400

500

600

Hemophilia HeterosexualContact

Injecting DrugUse (IDU)

Men Having Sexwith Men(MSM)

MSM & IDU MultipleHeterosexual

Contacts

Pediatric Transfusion

Risk Factor

Rep

orte

d L

ivin

g_ Males (n=992)

*168 cases unidentified risk or undetermined risk

Total Early Syphilis* Trends Between 2005-2006, statewide increase (21%)

in reported syphilis Southwest Region reported syphilis doubled

between 2005-2006 In 2006, 52% of reported cases of Syphilis in the

Southwest region were white, 43% black Majority of the reported cases of Syphilis were

male (71%)

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis

or Early Latent Syphilis

Virginia

Total Early Syphilis* Cases by Region, 2006 (N=351)

Northwest5.1%

Southwest6.0%

Central17.1%

Northern26.8%

Eastern45.0%

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Southwest Health Region Cases of Total Early Syphilis* (1998-2006) 129

95

38

13 9 12 10

21

73

0

20

40

60

80

100

120

140

1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Southwest Health Region, by locality in 2006 (N=21)

4

3

2 2 2 2

1 1 1 1

2

0

1

2

3

4

5

6

7

8LY

NCH

BU

RG

RO

AN

OKE C

ITY

BED

FO

RD

DAN

VIL

LE

PIT

TSYLV

AN

IA

RO

AN

OKE C

O.

SALE

M

AM

HERST

BRIS

TO

L

FLO

YD

MO

NTG

OM

ERY

Locality

Rep

orte

d C

ases

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Southwest Health Region, by Race, in 2006 (N=21)

9

1

11

0123456789

101112131415

Report

ed C

ase

s

Race

Black Hispanic

White

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Southwest Health Region, by age in 2006 (N=21)

1 1

3

5

2

3

4

2

0

1

2

3

4

5

6

7

8

13 - 1

9

20 - 2

4

25 - 2

9

30 - 3

4

35 - 3

9

40 - 4

4

45 - 4

9

50+

Age

Rep

orte

d C

ases

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Gonorrhea Trends Between 2005-2006, statewide decrease (22%) in

reported gonorrhea. 34% decrease in reported Hispanic cases.

Southwest Region saw a 10% decrease in reported Gonorrhea

In the Southwest Region, Lynchburg showed the most notable increase (38%)

In 2006, 24% of reported cases of Gonorrhea in the Southwest region were White, 72% Black, and 2% were Hispanic

Majority of the reported cases of Gonorrhea were female (53%)

VirginiaGonorrhea Cases by Region, 2006 (N=6,474)

Northwest6.5%

Southwest15.1%

Central29.7%

Northern6.9%

Eastern41.8%

Southwest Health Region Cases Gonorrhea (1998-2006)

1021

12241343 1342

10971006

1087975

1228

0

200

400

600

800

1000

1200

1400

1600

1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s_

Individuals Reported with Gonorrhea in the Southwest Health Region, by Race, in 2006 (N=975)

5

698

15 7 13

237

0

100

200

300

400

500

600

700

800

Report

ed C

ase

s

Race

Asian/Pacific Islander

Black

Hispanic

Other

Unknown

White

Individuals Reported with Gonorrhea in the Southwest Health Region, by locality in 2006 (N=975)*

174

104

60 5739

26 20 19 18 15 14 10 9 8 7 6 6 6 6 5 4 4 3 3 3 3 2 2 2

310

12 11

0

50

100

150

200

250

300

350

ROANOKE C

ITY

LYNCHBURG

DANVIL

LE

ROANOKE C

O.

PIT

TSYLVANIA

CAM

PBELL

HENRY

SALEM

MONTGOM

ERY

BRIS

TOL

MARTIN

SVIL

LE

BEDFORD

AM

HERST

BOTETOURT

FRANKLIN

CO.

PULASKI

BEDFORD C

ITY

APPOM

ATTOX

ALLEGHANY

GALAX

TAZEW

ELL

WYTHE

WIS

E

SCOTT

WASHIN

GTON

CARROLL

COVIN

GTON

RADFORD

SM

YTH

GIL

ES

GRAYSON

PATRIC

K

Locality

Rep

orte

d C

ases

*Not shown: Localities with only one case

Individuals Reported with Gonorrhea in the Southwest Health Region, by Age, in 2006 (N=975)

3

262

300

157

8962 53

24 24

0

50

100

150

200

250

300

350

400

0-1

2

13-1

9

20 -

24

25 -

29

30 -

34

35 -

39

40 -

44

45 -

49

50+

Age

Rep

orte

d C

ases

Chlamydia Trends Between 2005-2006, statewide increase (6%) in reported

Chlamydia and 26% increase in reported Hispanic Cases Southwest Region saw a 2% increase in reported

Chlamydia In the Southwest Region, Danville showed the most

notable decrease (20%) and Lynchburg showed the most notable increase (36%)

In 2006 in the Southwest Region, 43% of reported cases of Chlamydia were white, 48% black and 5% were unknown

Majority of the reported cases of Chlamydia were female (75%)

VirginiaChlamydia Cases by Region, 2006 (N=24,081)

Northwest11.5%

Southwest11.9%

Central22.5%

Northern13.4%

Eastern40.6%

Southwest Health Region Cases Chlamydia (1998-2006)

18061926

2163

2686 2706 2748

30232830 2876

0

500

1000

1500

2000

2500

3000

3500

1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s

Individuals Reported with Chlamydia in the Southwest Health Region, by Race, in 2006 (N=2,876)

2 12

1370

788

157

1249

0

300

600

900

1200

1500

Report

ed C

ase

s

Race

American Indian/AlaskanNativeAsian/Pacific Islander

Black

Hispanic

Other

Unknown

White

Individuals Reported with Chlamydia in the Southwest Health Region, by locality in 2006 (N=2,876)

362

272

163137133119

94 84 80 71 69 55 50 48 44 43 39 32 31 27 26 25 24 20 17 17 15 15 14 13 11 10 9 7 6 3 3

567

65 56

0

50

100

150

200

250

300

350

400

450

500

550

600

ROANOKE C

ITY

LYNCHBURG

DANVIL

LE

PIT

TSYLVANIA

ROANOKE C

O.

HENRY

MONTGOM

ERY

CAM

PBELL

WIS

E

AM

HERST

BEDFORD

MARTIN

SVIL

LE

FRANKLIN

CO.

WASHIN

GTON

BRIS

TOL

APPOM

ATTOX

WYTHE

SALEM

RADFORD

SM

YTH

LEE

CARROLL

GRAYSON

TAZEW

ELL

PULASKI

GALAX

SCOTT

BOTETOURT

GIL

ES

DIC

KENSON

RUSSELL

COVIN

GTON

ALLEGHANY

PATRIC

K

BEDFORD C

ITY

FLOYD

NORTON

BUCHANAN

BLAND

CRAIG

Locality

Rep

orte

d C

ases

Individuals Reported with Chlamydia in the Southwest Region, by age in 2006 (N=2,876)

6

1113 1131

382

14053 23 13 15

0

100

200

300

400

500

600

700

800

900

1000

1100

1200

1300

0-1

2

13-1

9

20 -

24

25 -

29

30 -

34

35 -

39

40 -

44

45 -

49

50+

Age

Rep

ort

ed C

ase

s

Prepared by:

Carrie Dolan, MPHEpidemiologist

Lindsey Matthews, MPH (updated)

Division of Disease PreventionJuly 2007carrie.dolan@vdh.virginia.gov

*Data accessed from HIV/AIDS Reporting System (HARS) and Sexually Transmitted Disease Management Information System (STDMIS) July 2007