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Fourth Quarter 2018

TABLE OF CONTENTS

Contents Page Surveillance Summary 1 Abbreviations 3 Louisiana: Persons Living with HIV Infection 4 Persons newly diagnosed with HIV 6 Persons newly diagnosed with AIDS 7 Persons diagnosed with Primary and Secondary Syphilis 8 Persons diagnosed with Early Latent Syphilis 9 Parish: Persons Living with HIV Infection 10 Persons diagnosed with Early Syphilis 11 Metro New Orleans: Persons Living with HIV Infection 12

Persons newly diagnosed with HIV and AIDS 14 Persons diagnosed with Early Syphilis 15

Metro Baton Rouge: Persons Living with HIV Infection 16 Persons newly diagnosed with HIV and AIDS 18 Persons diagnosed with Early Syphilis 19

Public Health Regions: Map & HIV/AIDS Counts 20 Region 1: Persons Living with HIV Infection 21 Region 2: Persons Living with HIV Infection 22 Region 3: Persons Living with HIV Infection 23 Region 4: Persons Living with HIV Infection 24 Region 5: Persons Living with HIV Infection 25 Region 6: Persons Living with HIV Infection 26 Region 7: Persons Living with HIV Infection 27 Region 8: Persons Living with HIV Infection 28 Region 9: Persons Living with HIV Infection 29 Regions 1-5: Persons newly diagnosed with HIV 30 Regions 6-9: Persons newly diagnosed with HIV 31 Regions 1-5: Persons newly diagnosed with AIDS 32 Regions 6-9: Persons newly diagnosed with AIDS 33 Regions 1-5: Persons diagnosed with Primary and Secondary Syphilis 34 Regions 6-9: Persons diagnosed with Primary and Secondary Syphilis 35 Regions 1-5: Persons diagnosed with Early Latent Syphilis 36 Regions 6-9: Persons diagnosed with Early Latent Syphilis 37 List of Figures Louisiana: 10-Year Trends Persons Living with HIV Infection (2008-2017) 5 Louisiana: 10-Year Trends New HIV Diagnoses (2008-2017) 6 Louisiana: 10-Year Trends New AIDS Diagnoses (2008-2017) 7 Louisiana: 10-Year Trends P&S Syphilis Diagnoses (2008-2017) 8 Louisiana: 8-Year Trends Early Latent Syphilis Diagnoses (2010-2017) 9 Surveillance Breakout 2019 National Women and Girl’s HIV/AIDS Awareness Day 38

Fourth Quarter 2018

* A syphilis diagnosis with less than one year duration is considered to be “early syphilis.” This designation covers the primary, secondary, and early non-P&S stages of syphilis. 1

Surveillance Summary

Data in this report includes cases diagnosed with HIV, AIDS, or Early Syphilis

In 2017, Louisiana ranked 4th in the nation for HIV case rates (22.1 per 100,000 population) and 10th in the estimated number of HIV cases. The Baton Rouge MSA ranked 5th and the New Orleans MSA ranked 4th for HIV case rates (26.9 and 27.0 per 100,000, respectively), among the large metropolitan areas in the nation. The most recent CDC HIV Surveillance Report (vol. 29) was released in November 2018 and provided the 2017 rankings.

According to the same report, Louisiana ranked 3rd highest in state AIDS case rates (10.8 per 100,000) and 10th in the number of estimated AIDS cases in 2017. The Baton Rouge metropolitan area ranked 2nd in AIDS case rates (15.3 per 100,000) and the New Orleans metropolitan area ranked 6th in AIDS case rates (12.5 per 100,000) in 2017 among the large metropolitan areas in the nation.

In 2017, Louisiana ranked 3rd in the nation for primary and secondary (P&S) syphilis case rates (14.5 per 100,000 population) according to the 2017 CDC STD Surveillance Report.

As of December 31, 2018, a total of 22,180 persons were living with HIV infection (PLWH) in Louisiana; of these individuals, 11,180 persons (50%) have an AIDS diagnosis.

In 2017, 1,018 new HIV cases were diagnosed in Louisiana. Of these cases, 30% (n=302) occurred in Region 1 (New Orleans) and 21% (n=214) occurred in Region 2 (Baton Rouge).

As of December 31, 2018, a total of 1,137 persons were diagnosed with early syphilis* in Louisiana; 621 persons were diagnosed with P&S syphilis, and 516 persons were diagnosed with early non-P&S syphilis. Of the total early syphilis cases, 36% (n=411) occurred in Region 1 (New Orleans) and 16% (n=177) occurred in Region 2 (Baton Rouge).

The primary risk factor for new HIV diagnoses in Louisiana is men who have sex with men (MSM). In 2017, of the persons who reported a risk factor, 57% reported being MSM, and an additional 2% reported being MSM and an injection drug user (IDU). As of December 31, 2018, 45% of all people living with HIV infection in Louisiana were MSM.

The primary risk factor for early syphilis diagnoses in Louisiana is men who sex with men (MSM). As of December 31, 2018, of the persons who reported a risk factor, 54% reported being MSM, and 51% reported engaging in heterosexual activity. Persons could report multiple risk factors for syphilis diagnoses.

In Louisiana, 74% of new HIV cases, 72% of new AIDS cases, and 74% of the early syphilis diagnoses were among men.

African Americans in Louisiana are experiencing a severe health disparity in regards to HIV and STDs. In 2017, 69% of newly diagnosed HIV cases and 71% of newly diagnosed AIDS cases were among African Americans. As of December 31, 2018, 67% of early syphilis cases were among African Americans. African Americans make up only 32% of Louisiana’s overall population.

A large percentage of new HIV and syphilis diagnoses occurred among adolescents and young adults. In 2017, 25% of all new HIV diagnoses occurred among persons 13-24 years old and an additional 37% occurred among persons 25-34 years old. As of December 31, 2018, 28% of all early syphilis diagnoses occurred among persons 13-24 years old and an additional 43% occurred among persons 25-34 years old.

Fourth Quarter 2018

2 Please note: This report reflects only information reported to Louisiana’s HIV/AIDS and STD surveillance systems.

New Quarterly Report Format: The format of the Quarterly Report has been redesigned starting Third Quarter 2017. Besides for the removal of cumulative HIV/AIDS cases and cumulative HIV/AIDS deaths by state and region, the core content of the Quarterly Report remains the same with some new modifications described below. In efforts to more accurately present the data as it relates to gender identity, tables for persons living with HIV infection now include race/ethnicity and exposure category stratified by current gender identity (i.e. men, women, trans women, & trans men) rather than sex at birth. In addition, there are three new HIV/AIDS exposure categories: “Trans women- sex with men,” “Trans women- sex with men/injection drug user (IDU),” and “Female presumed heterosexual contact” (FPHC). In previous versions of the Quarterly Report, trans women who indicated engaging in sex with men would have their HIV exposure classified as “Men who has sex with men” (MSM) or “MSM/IDU.” The new exposure categories (“Trans women- sex with men” & “Trans women- sex with men/IDU”) acknowledge and highlight the differences in gender identity between gay and bisexual men versus trans women as well as strive to better describe the populations affected by HIV in Louisiana. In previous Quarterly Reports, a significant number of HIV-positive women who did not meet the stringent “high risk” criteria for “Heterosexual contact” were classified as “No identified risk.” In an effort to better capture and present heterosexual transmission of HIV among women, the STD/HIV Program has used an algorithm from the Centers for Disease Control that re-categorizes many women formerly classified as “No identified risk” as now meeting the exposure criteria for FPHC. The primary criteria for FPHC includes: sex at birth is female, answered ‘yes’ to sex with men, answered ‘no’ to injection drug use, and has no other documentation that would suggest an alternative mode of HIV acquisition. Changes to Syphilis Case Definition The Quarterly Report includes revisions to the surveillance case definition for syphilis as approved by the Council of State and Territorial Epidemiologists (CSTE) effective January 1, 2018. Of note, the nomenclature for “Early latent syphilis” has been changed to “Early non-primary non-secondary syphilis.” Throughout the Quarterly Report it has been abbreviated to “Early non-P&S syphilis.” Please refer to the following documentation for additional information on all other syphilis case definition revisions: https://www.cdc.gov/std/stats/DCL-syph-case-def-sept-4-2017.pdf. Time Periods for this Quarterly Report (Fourth Quarter 2018 Report): Persons Living with HIV Infection – As of December 31, 2018 New HIV Diagnoses – Calendar Year 2017 (Updated from 3rd Quarter Report) New AIDS Diagnoses – Calendar Year 2017 (Updated from 3rd Quarter Report) New P&S Syphilis Diagnoses – January 1 to December 31, 2018 (Calendar Year 2018) New Early Latent Syphilis Diagnoses – January 1 to December 31, 2018 (Calendar Year 2018) Future Quarterly Report: First Quarter 2019 Report: Release in May 2019 Persons Living with HIV Infection, As of March 31, 2019 HIV and AIDS Diagnoses, Calendar Year 2018 P&S Syphilis and Early Latent Syphilis Diagnoses, First Quarter 2019 (January-March 2019)

https://www.cdc.gov/std/stats/DCL-syph-case-def-sept-4-2017.pdf

Fourth Quarter 2018

3

Abbreviations

Asian/PI Asian/Pacific Islander

CDC Centers for Disease Control and Prevention

FPHC Female presumed heterosexual contact

FSF Female sex with female

HRH High risk heterosexual contact

IDU Injection drug user

MSM Men who have sex with men

MSM/IDU Men who have sex with men and injection drug user

NH Non-Hispanic

PLWH Persons living with HIV

P&S Primary and secondary syphilis


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HIV Prevention Starts with ME

This year marks the 14th observance of National Women and Girls HIV/AIDS Awareness Day (NWGHAAD). The nationwide observance sheds light on the impactof HIV/AIDS on women and girls. This year's theme is:

Nationally, 1 in 9women living

with HIV do notknow they

have it.

In 2015, there werean estimated

256,500Women

living with HIV inthe United States

Black women

and other women of color

are more affectedby the HIVepidemic thanWhite women.

Between 2012-2017,the annualnumber ofnew HIV

diagnosesamongwomen

declinedby 11%

DATA SOURCE: Centers for Disease Control and Prevention

It is especially importantfor women of child-bearingage and pregnant women

receive HIV testing

The majority of women acquire HIV through:

Heterosexual Sex

Injection Drug UseOr

If an HIV positive mother receivesappropriate antiretroviral

treatment during pregnancy, labor,& delivery, does not breastfeed, andcompletes a treatment course forthe newborn, there is a less than

1% chance the mother willtransmit HIV to her child.

in LouisianaHIV/AIDS Among Women and Girls

Black women areaffected by HIV morethan other women in

Louisiana.

1 in 4 new HIV diagnoses inLouisiana are women.

women living with HIV inLouisiana are virally suppressed.

2 in 3

...78% of new female HIV diagnoses are Black women

33% of Louisiana's female population are Black women...

Approximately 150-160 HIV positivewomen give birth in Louisiana

each year. Many of these womenhave no prenatal care.

It is Louisiana Law that allpregnant women be tested for HIVat their first prenatal care visit and

again in the third trimester.

Over Half

under age 35.

of women newlydiagnosed with HIV

in Louisiana are Viral suppression is when a person has

very low levels of HIV in their blood. People who are virally suppressed

cannot pass HIV on to sex partners.

What YOU can do to Preventthe Spread of HIV:

If you are living with HIV, take your medications asprescribed to stay healthy and greatly reduce the riskof passing HIV to a partner.

If you are HIV-negative, ask your doctor aboutpre-exposure prophylaxis (PrEP), a daily pill toprevent HIV.

Regardless of your status, use a condom every timeyou have sex. Condoms reduce the risk of getting HIVand other sexually transmitted infections.

Know your status. Get tested for HIV. To find a testinglocation near you and information on HIV & othersexually transmitted infections visit:

www.lahhub.org @lahealthhub

Fourth Quarter 2018 - Louisiana Department of Health...Fourth Quarter 2018 2 Please note: This...

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