New Jersey HIV/AIDS Epidemiologic Overview, 2018...Introduction This presentation will: • Discuss...

New Jersey HIV/AIDS Epidemiologic Overview, 2018

(Data based upon the HIV/AIDS Reporting System‘eHARS,’ unless otherwise noted.)

New Jersey Department of HealthDivision of HIV, STD, TB Services

IntroductionThis presentation will:

• Discuss HIV Incidence in light of two initiatives: the National strategy, which calls for reducing the rate of new HIV infections by 75% in 5 years and at least 90% by 2030; and New Jersey initiative to end the epidemic by 2025 (EtE).

• CDC estimates that more than 80% of new infections in the US were transmitted by individuals who either did not know they were infected with HIV or diagnosed but were not receiving care. Nationally, it is estimated that undiagnosed HIV infections amount to 14.2% (2016), while it is 10% in New Jersey.

• Examine HIV Prevalence= persons living with HIV in New Jersey in 2018.• Present HIV data of diagnoses between 2012 through 2016, and prevalence

as of December 31, 2018. (All surveillance data is based upon cases entered in the HIV registry by December 31, 2018).

• HIV data will be examined by demographics: gender, age, race, and exposure category, as well as racial and ethnic disparity.

• Review geographic dispersion of HIV in NJ; and• Track NJ Care Continuum (clinical data versus surveillance data).

PresenterPresentation Notes Idaho, New Jersey, Pennsylvania and Vermont in the lightest Shade have the largest percentage (>=90.0) of persons living with diagnosed HIV. CDC estimates that in 2016 about 1.2 million people were living with HIV/AIDS in the United States, but roughly 14.2% HIV infected Americans remain undiagnosed or unreported. NJ true prevalence is estimated to be about 10% greater than the cases diagnosed and reported to the NJ Department of Health.

• New Jersey ranked 11th in the rate of adults and adolescents diagnosed with HIV/AIDS at the end of 2016. In 2014, NJ ranked 9TH in the United States in the rates of diagnosed HIV infections.

• Cumulatively, 82,643 adult\adolescent cases of HIV/AIDS have been reported in New Jersey. There are 1,200 new patients diagnosed with HIV in 2016.

• Between 2012 and 2016, the number of new adult/adolescent HIV/AIDS diagnoses decreased by about 8% in New Jersey.

• Number of HIV/AIDS diagnoses in 2016 for the three most-Affected Subpopulation:

1) Hispanic/Latino MSM (MSM/IDU included) : 193.

2) Black MSM (MSM/IDU included) : 173.

3) Black Heterosexual Women: 114.

The next slide shows the HIV/AIDS incidence rate nationally.

HIV infection in New Jersey

Incidence Rates of HIV Infection Among Adults and Adolescents, 2016 – Rates per 100,000: United Sates=14.7 NJ = 15.2

PresenterPresentation Notes This map shows rates of adult/adolescent diagnoses of HIV infection in the United States for 2016. Adults and adolescents include those ages 13 and older. The HIV/AIDS diagnosis rate among adults and adolescents in the US was 14.7 per 100,000 population in 2016. The areas shaded in the darkest blue have the highest rates followed by the lighter blue and lightest blue areas. New Jersey and CA (15.2) ranked after LA, GA, FL, MD, MS, TX, NY, SC, NV and NC, in the rate of adult and adolescent HIV/AIDS diagnoses in 2016 with a diagnosis rate of 15.2 per 100,000 population.

Note: Data for the year 2016 are preliminary and based on 6 months reporting delay, HIV infection rates per 100,000: 16.8 in South, 11.2 in Northeast, 10.2 in West and 7.5 in Midwest.

• New Jersey ranked 11th in the rate of adults and adolescents 2016 diagnosed with HIV/AIDS, but New Jersey ranked 7TH among the states in the rates of diagnosed HIV infection classified as Stage 3 (AIDS).

• The percentage of simultaneously concurrent HIV and AIDS diagnoses (cases that have already progressed to AIDS at the time of the firstdiagnosis with the HIV) has remained 25% to 21% (2012-2016). Only 21% of new cases were concurrent HIV and AIDS diagnosed in 2016 (Large percentage mean that patients were tested late): - by Sex at Birth: AIDS concurrent percentage is 18.8% among females,

21.5% among males. - by Race/Ethnicity: AIDS concurrent percentage is 18% among White,

19% among Black, 24% among Hispanic. - by Age Group: The largest AIDS concurrent is 36% among persons

aged 65 years or older followed by persons aged 35-44 (27.4%), and by 55-64 (26.7%) and by those aged 45-54 (23.8)%. And those age 25-34 (18.6%) and those aged less than 25 years (9%).

- by Risk Category: AIDS concurrent percentage is only 17% among MSM (only 13.4% among Black MSM, 18.8% White MSM and 19% among Hispanic MSM).

HIV infection stages in New Jersey

PresenterPresentation Notes The rate (per 100,000 population) of stage 3 (AIDS) classification in 2016 for persons (all ages) with diagnosed HIV infection are shown for each state. Top 3 states with highest rate of stage 3 (AIDS) are Louisiana (12.0), Florida (11.4) and Georgia (11.2). New Jersey (5.8) ranked 7Th among the U.S. highest rate of ever stage 3 (AIDS)

Number HIV/AIDS Diagnoses by Stage Of disease New Jersey, 2012 - 2016

PresenterPresentation Notes The number of NJ HIV and AIDS diagnoses by stage of disease presented in this slide – HIV only at the time of first diagnosis with the HIV virus and diagnosed HIV and AIDS at the same time. The percentage of concurrent HIV and AIDS diagnoses (late diagnoses that have already progressed to AIDS at the time of the first diagnosis with the HIV virus ) has remained consistent over the last decade. In 2016, 20.8% of new cases were concurrent HIV and AIDS diagnoses, which is down from 25.3% in 2012. It means people get HIV diagnoses little earlier than five years ago.

This slide shows the number of HIV and AIDS cases diagnosed from 2012 to 2016 in New Jersey. Overall, HIV infections decreased from 1306 in 2012 to 1200 in 2016, a decrease only about 8%.

Chart1

20122012

20132013

20142014

20152015

20162016

Concurrent HIV and AIDS Diagnoses

HIV not simultaneosly Diagnosed w/AIDS

330

976

293

919

279

937

296

905

250

950

Sheet1

20122013201420152016

Concurrent HIV and AIDS Diagnoses330293279296250

HIV not simultaneosly Diagnosed w/AIDS976919937905950

• As of December 31, 2018, 37,801 individuals living with HIV were known to be alive and residing in New Jersey. Prevalent cases include 18,410 (48.7%) persons living with HIV only and 19,391 (51.3%) persons living with AIDS.

• Number of deaths among HIV patients declined by 41.6% from 1,013 in 2007 to 592 in 2017, and the percent died due to HIV as the underlying cause of death declined from 57% in 2007 to 28% in 2017 (more than half). Advances in treatment delayed disease progression and reduced death due HIV/AIDS.

• In 2016 there were 1,200 new HIV/AIDS diagnoses, but only 629 deaths.

• It is important to ensure that 100% of persons living with HIV know their status to help prevent the spread of the disease. Patients who know their status are more likely to take further steps to protect their partners.

• New Jersey ranked 6th among the 50 states in the number of persons living with HIV/AIDS in 2016.

• The following slide shows HIV/AIDS prevalence among persons aged 13 years or older by area of residence in 2016, nationally.

HIV/AIDS prevalence in New Jersey

PresenterPresentation Notes This map presents of HIV prevalence for persons aged >= 13 years in the United States for 2016. HIV prevalence was highest in California, Florida, Georgia, Illinois, New York, New Jersey and Taxes. Five states accounted for 51% of persons living with HIV infections: California, Florida, Georgia, New York and Taxes. New Jersey ranked 6th among the 50 states in the number of adults and adolescents living with HIV/AIDS in 2016. All data presented in this slide set are from CDC HIV supplemental Surveillance Report “Estimated HIV incidence and Prevalence in the United States 2010-2016”.

• New Jersey ranked 8th in the rate of female adults and adolescent with diagnosed HIV infection in 2016 with 6.9 per 100,000 females and ranked 10th in the rates of stage 3 (AIDS).

• New Jersey has historically had one of the highest proportions of HIV infections occurring in females, 24.4% of adolescent and adult HIV/AIDS diagnoses in 2016 were females in NJ, compared to only 19% in the United States.

• The number of new HIV/AIDS diagnoses annually from 2012 to 2016 among females in New Jersey decreased by 14%; only 6% among males.

• Although new cases among females are declining, females account for 32.1% of all prevalent cases in NJ in 2018 (black women account for 39.2% among blacks living with HIV/AIDS in 2018), compared to 21% of prevalent cases is females nationally in 2016.

HIV/AIDS and Sex at Birth

Number HIV/AIDS Diagnoses by Sex at birth New Jersey, 2012 - 2016

PresenterPresentation Notes This slide shows the number of HIV and AIDS cases diagnosed from 2012 to 2016 in New Jersey by sex. Overall, annual HIV infections decreased about 8% from 1306 in 2012 to 1200 in 2016; a decrease of 8%.

The number of new HIV/AIDS cases annually diagnosed among females in New Jersey decreased 14% in 5 years (from 2012 to 2016), but new cases among men decreased about 6% during these 5 years. In NJ, 26.2% of 2012 new HIV/AIDS cases were females, but only 24.4% of 2016 new cases were females.

Chart1

20122012

20132013

20142014

20152015

20162016

Female

Male

342

964

319

893

318

898

288

913

293

907

Sheet1

20122013201420152016

Female342319318288293

Male964893898913907

• ‘Transgender’ indicates a difference between (1) Sex at birth and (2) Current gender identity.

• One hundred twenty two transgender persons were cumulatively diagnosed with HIV among New Jersey residents as of December 31, 2018.

• Seven were diagnosed with HIV prior to 1990, twenty-seven between 1990 and 1999, twenty-eight between 2000 to 2009 and sixty since 2010 (nearly half).

• Six were incarcerated at time of diagnosis; four ever had an episode of homelessness though these categories are not mutually exclusive.

• Eighty percent were known to be alive through December 31, 2018. 3 of the 6 cases with an indication of incarceration were alive as of the end of 2017.

HIV/AIDS Among Transgender Individuals

Transgender Cases --New Jersey, December 31, 2018

Gender N %M to Female 122 99%F to Male 1 1%

Race/Ethnicity N %White 5 4%Black 67 55%Hispanic 48 39%Other/Unknown 3 2%Age at Diagnosis N %0-12 1 1%

13-24 45 32%25-34 51 45%35-44 21 16%45+ 5 7%Transmission N %Sex 108 88%IDU-Related 12 10%Unknown 3 2%

Gender N %M to Female 96 98%F to Male 2 2%

Race/Ethnicity N %White 6 6%Black 52 53%Hispanic 37 38%Other/Unknown 3 3%Age at 12/31/2018 N %

13-24 10 10%25-34 35 36%35-44 26 26%45+ 27 28%Transmission N %Sex 88 90%IDU-Related 8 8%Unknown 2 2%

Prevalent Cases (N=98)Cumulative Cases (N=123)

PresenterPresentation Notes Of the cumulative transgender cases diagnosed in NJ, one hundred twenty-two (99%) were female (birth sex male); one (1%) were male (birth sex female). Five (4%) were white, sixty-seven (55%) were black, and forty-eight (39%) were Hispanic. Forty-five (32%) were between ages 13 and 24, 51 (45%) were 25 to 34 years, 21 (16%) were 35 to 44, five (7%) were age 45 or older. 108 (88%) were attributed to sexual transmissions. Twelve (10) were IDU. Three had an unknown (2%) mode of HIV exposure.

Ninety-eight cases were known to be alive and currently living in NJ through December 31, 2018.

•About 60% of prevalent cases in New Jersey were age 50 and older in 2018. According to CDC, those over age 50 living with HIV are rapidly increasing. The advances in treatment is a major driver of this increase, but at the same time, 22% of 2016 new cases of HIV are among 50 years or older in New Jersey.

Diagnoses among those 55 and older comprised 10% of adult\adolescent diagnosed in 2012 and 12.9% in 2016. In contrast those aged 13-24 constituted 19% of diagnoses in 2012 and 16.5% in 2016. The percent of those aged 25-34 also increased between 2012 and 2016 while the percent of those aged 35-44 decreased between 2012 and 2016.

• The following 2 graphs represent diagnoses by age group for men and women. For men, the median age of HIV/AIDS diagnoses in 2016 was 34 (in 2013 was 36). For women, the median age of diagnoses in 2016 was 40.

HIV/AIDS and Age

Number and Percent for Adultl\Adolescent diagnosed with HIV/AIDS in 2016 by Sex and Age Group

NJ Women (aged 13+) 2016diagnosed HIV/AIDS N=290

NJ Men (aged 13+) 2016 diagnosed HIV/AIDS N=905

52.7%37.2%

PresenterPresentation Notes Right side of this slide present adult/adolescent males new 2016 diagnoses, over a half (53% ) in 2016 occurred under age 35 (compared only 50% under age 35 in 2014). Left side of the slide shows that about 37% of 2016 new diagnoses among women were under age 35 (compared 38% in 2014).

Males aged 13 to 24 year old comprised 18.6% of HIV infection among men in 2016. On the left side, the number of diagnoses of females aged 13 to 24 comprised only 10% among women diagnoses in 2016.

Chart1

13-24

25-34

35-44

45-54

55+

East

13-24168 18.6%

25-3430934.1%

35-4416818.6%

45-5415817.4%

55+10211.3%

168

309

168

158

102

Sheet1

13-2425-3435-4445-5455+

East168309168158102

Chart1

13-24

25-34

35-44

45-54

55+

East

13-2429 10.0%

25-3479 27.2%

35-4466 22.8%

45-5463 21.7%

55+5318.3%

29

79

66

63

53

Sheet1

13-2425-3435-4445-5455+

East2979666353

• A disparity persists with regards to the disproportionately high percentage of cases occurring among minorities. Diagnoses among Blacks accounted for 42.3% of new HIV/AIDS diagnoses in 2016 and diagnoses among Hispanics accounted for 34.6% of new diagnoses.

• Women of color represent the majority of new diagnoses among females in NJ with 84% of new diagnoses in 2016. Among men, 78% in 2016 new diagnoses were persons of color.

• The disparity of new cases in minorities is particularly pronounced for persons ages 13-24. Minorities accounted for 86% of all diagnoses occurring among persons within this age group in 2016 compared with 78% for other age groups.

HIV/AIDS and Race/Ethnicity

# and % of HIV/AIDS Diagnosed in 2016 by Race/Ethnicity and Sex – New Jersey

NJ Females diagnosed HIV/AIDS

New Jersey, 2016, N=293

NJ males diagnosed HIV/AIDS

New Jersey, 2016, N=907

NJ eHARS as of 12/31/ 2018.

PresenterPresentation Notes The left slide shows males diagnosed HIV/AIDS by race/ethnicity in 2016 compared with right slide for females HIV/AIDS cases in 2016. Whereas Blacks comprised 38.9% of NJ males diagnosed HIV/AIDS in 2016, but Blacks comprised 53.6% of NJ females diagnosed HIV/AIDS in 2016. On the other hand, Hispanic comprised 36.4% among males and 28.7% among females diagnosed HIV/AIDS in 2016. White comprised 21.5% among males and 16.4% among females diagnosed HIV/AIDS in 2016.

# and % of White females diagnosed HIV/AIDS are very small. Overall, 75.3% of males cases in 2016 are minorities. compared to 82.3% of females cases in 2016.

Chart1

HispanicHispanicHispanic

BlackBlackBlack

WhiteWhiteWhite

Other/Asian/PacOther/Asian/PacOther/Asian/Pac

0

Hispanic 33036.4%

Black353 38.9%

White 19521.5%

Other/Unknown29 3.2%

330

353

195

29

Sheet1

HispanicBlackWhiteOther/Asian/Pac

33035319529

Chart1


BlackBlackBlack

WhiteWhiteWhite

Other/UnkownOther/UnkownOther/Unkown

0

Hispanic 8428.7%

Black 157 53.6%

White4816.4%

Other/Unknown4 1.4%

84

157

48

4

Sheet1

cHispanicBlackWhiteOther/Unkown

84157484

White

Number Adult/Adolescent HIV/AIDS Diagnoses by Race/Ethnicity and Age Group -- New Jersey, 2016

HispanicBlack

PresenterPresentation Notes The largest percentages of diagnoses among all these 3 races were occurring between ages 25 to 34. The percentage of people with other ages of 2016 HIV/AIDS diagnosis differs by race/ethnicity. The smallest percentage of diagnoses occurred among White was in ages 13 to 24. In terms of the proportion of aged 55 or older diagnosed HIV/AIDS in 2016 among each race, White is biggest. For White, the median age of HIV/AIDS diagnoses in 2016 was 39. For African Americans and Hispanic, the median age of HIV/AIDS diagnoses was 34. The second largest percentages of 2015 diagnoses among Hispanic was those ages 35-44. Hispanic third largest of 2015 diagnoses was those ages 13-24. Hispanic with the smallest percentage of 2015 diagnoses occurred among those age 55+.

Chart1

68919390164

50+

35-44

45-54

13-24

25-34

55+ 6813.4%

45-549318.4%

35-449117.9%

13-249017.8%

25-34164 32.4%

Sheet1

50+68

35-4491

45-5493

13-2490

25-34164

Chart1

43687287144

55+

45-54

13-24

35-44

25-34

55+43 10.4%

45-546816.4%

13-247217.4%

35-448721.0%

25-3414434.8%

Sheet1

55+43

45-5468

13-2472

35-4487

25-34144

Sheet2

Chart1

2842485470

13-24

55+

35-44

45-54

25-34

13-24 2811.65%

55+42 17.4%

35-444819.8%

45-545422.4%

25-3470 28.9%

Sheet1

13-2428

55+42

35-4448

45-5454

25-3470

Sheet5

Sheet3

Sheet4

Sheet2

# of persons Living with HIV/AIDS 2018 by Sex at Birth and Race in New Jersey

39.2% 27.7% 21.5%

PresenterPresentation Notes This slide shows the number of persons Living with HIV/AIDS through 2018 in New Jersey by sex and Race/Ethnicity. Black non-Hispanic females represented 39.2% of cases living with HIV/AIDS among all Blacks; Hispanic females represented 27.7% of all Hispanic living with HIV/AIDS, and White females represent only 21.5% of cases living with HIV/AIDS among Whites in 2018. people. NJ females in color are very vulnerable with HIV/AIDS, this may be related to that the mode of exposure varies across racial and ethnic groups. New Jersey has historically had one of the highest proportions of HIV infections occurring in females, although female cases are declining. Overall, about one third (32.1%) of prevalent cases in New Jersey were females compared with one fifth of prevalent cases nationally among females in 2018.

Chart1

BlackBlack

HispanicHispanic

WhiteWhite

Women

Men

7296

2984

1675

11305

7780

6121

7296

11305

2984

7780

1675

6121

Sheet1

BlackHispanicWhite

Women729629841675

Men1130577806121

Population (2017) and PLWHA (2018) by Race/Ethnicity –New Jersey

Persons Living with HIV/AIDS

New Jersey, 2018, N=37,801

New Jersey Population 2017, N=9,005,644

July 2018 Bridged-Race estimates for 2017 population NJ eHARS as of 12/31/ 2018.

PresenterPresentation Notes This slide shows the population of New Jersey by race/ethnicity in 2017 compared with prevalent HIV/AIDS cases in 2018. Blacks comprised 13.4% of the population of NJ in 2017, Blacks comprised 49.2% of persons living with HIV/AIDS in 2018. Hispanic persons comprised 20.4% of the population in 2017 but 28.5% of prevalent cases in 2018. On the other hand, Whites comprised 55.8% of the population in 2017, yet represented 20.6% of persons living with HIV/AIDS in 2018. The Statewide HIV/AIDS prevalence rate in New Jersey was 420 per 100,000 persons in 2018. The prevalence rate for Black was 1,544 per 100,000 people, rate 585 per 100,000 was for Hispanics and 155 per 100,000 was for Whites, and 68 was for Other (include Asians and Pacific Islanders) living with HIV/AIDS in 2018. The HIV/AIDS rate among all Blacks was 9.95 times higher than it was for Whites. The HIV/AIDS rate among Hispanics was 3.77 times higher than it was for Whites.

Chart1


BlackBlackBlack

WhiteWhiteWhite


0

Hispanic 1,840,43320.4%

Black1,204,854 13.4%

White 5,024,56555.8%

Other935,79210.4%

1840433

1204854

5024565

935792

Sheet1

HispanicBlackWhiteOther/Asian/Pac

1,840,4331,204,8545,024,565935,792

Chart1


BlackBlackBlack

WhiteWhiteWhite


0

Hispanic 10,76428.5%

Black 18,601 49.2%

White7,79620.6%

Other/Unknown6401.7%

10764

18601

7796

640

Sheet1


10,76418,6017,796640

Rate per 100,000 NJ Persons 2018 Living with HIV/AIDS by Sex and Race/Ethnicity -- Bridged-race

estimates for 2017 NJ population

PresenterPresentation Notes This slide present that the disparity of rates of HIV by race/ethnicity is greater for women compared with men. The rate of 2018 HIV prevalence was 17.6 times higher for African American women than it was for White women. The rate of HIV prevalence was 5 times higher for Hispanic women in 2018 than it was for White women.

The rate among Black males was 1.7 times higher than Black females. The rate among Hispanic males was 2.6 times higher than Hispanic females. Rate among White males was 3.8 times higher than White females.

Chart1

MalesMalesMalesMales

FemalesFemalesFemalesFemales

Black

Hispanic

White

Asian/Pac Isl

1,986

1,148

844

325

250

65

106

33

1991

837

247

104

1152

331

66

34

Sheet1

MalesFemales

Black1,9911,152

Hispanic837331

White24766

Asian/Pac Isl10434

• The number and percentage of new HIV/AIDS diagnoses due to IDU transmission in NJ diminished in recent years. In 2016, only 2% of men diagnosed with HIV/AIDS were IDU, this figure was 3% for women. Currently, 2018,16% of PLWHA is attributed to IDU exposure (19% of females and 15% of males living with HIV/AIDS are IDUs).

• The heterosexual exposure remained largely unchanged among men (23%) and women (70%) of new HIV infections between 2012 to 2016.

• Black men comprised 49% of NJ heterosexual men diagnosed HIV/AIDS in 2016. Black women comprised 53% of NJ heterosexual women diagnosed HIV/AIDS in 2016.

• MSM is the highest HIV/AIDS exposure category for both U.S. and NJ population. Fifty-three percent of NJ men diagnoses in 2016 are MSM. Forty-nine percent of Black and white men diagnosed are MSM, but 58% of Hispanic men were diagnosed in 2016 are MSM.The median age of MSM HIV/AIDS diagnoses in 2016 is 29.

HIV/AIDS and Mode of transmission

2016 New HIV/AIDS cases diagnosed by Gender and Exposure Category –New Jersey

NJ eHARS data as of 12/31/2018

women Diagnosed HIV/AIDS2016, N=290

Men diagnosed with HIV/AIDS2016, N=905

PresenterPresentation Notes This slide shows prevalence HIV and AIDS cases in NJ by birth sex and exposure category. As of the end of 2016, 53.7% of men diagnosed HIV/AIDS to attribute to MSM (1.1% MSM&IDU included), 2% male cases attributed to IDU and 23.3% to heterosexual contact. Among women diagnosed HIV/AIDS in 2016, 3.1% cases attributed to IDU and 74.8% female cases were heterosexual contact.

Chart1

MSMMSMMSM

Heterol sexualHeterol sexualHeterol sexual

IDUIDUIDU


0

MSM 48653.7%

Heterosaxual211 23.3%

IDU 182%


476

211

18

190

Sheet1

MSMHeterol sexualIDUOther/Asian/Pac

47621118190

Chart1

HeteroSexHeteroSexHeteroSex

IDUIDUIDU


0

Heterosexual 217 74.8%

IDU93.1%


217

9

64

Sheet1

HeteroSexIDUOther/Unkown

217964

PLWHA by Exposure Category –New JerseyeHARS data as of 12/31/2018

Females Living with HIV/AIDS2018, N=12,114

Males Living with HIV/AIDS2018, N=25,687

PresenterPresentation Notes This slide shows prevalence HIV and AIDS cases in NJ by birth sex and exposure category. As of the end of 2018, 46% of prevalent male HIV/AIDS cases was attribute to MSM (3% MSM&IDU included), 15% males attributed to IDU and 25% to heterosexual contact. Among females living with HIV/AIDS, 19% cases attributed to IDU and 67% cases to heterosexual contact.

A greater percentage of prevalent cases among females is 32% of all persons living with HIV/AIDS in 2018. In comparing with national, only about a quarter of prevalence cases are females.

Chart1

MSMMSMMSM

Heterol sexualHeterol sexualHeterol sexual

IDUIDUIDU


0

MSM 12,00246%

Heterosaxual6,441 25%

IDU 3,75715%

Other/unknown3,48714%

12002

6441

3757

3482

Sheet1

MSMHeterol sexualIDUOther/Asian/Pac

12,0026,4413,7573,482

Chart1

HeteroSexHeteroSexHeteroSex

IDUIDUIDU


0

Heterosexual 8,214 67%

IDU2,32419%

Other/Unknown1,57613%

8214

2324

1576

Sheet1

HeteroSexIDUOther/Unkown

8,2142,3241,576

MSM only diagnosed HIV/AIDS by Race/Ethnicity—New Jersey, 2012-2016

PresenterPresentation Notes This slide shows the number of MSM (MSM/IDU included), diagnosed HIV/AIDS from 2012 to 2016 by race/ethnicity in New Jersey. The decline in new diagnoses HIV/AIDS among White MSM between 2012 and 2016 was 16%, , the decline in numbers of new HIV/AIDS among Black MSM were 4% during this 5 years. The number of Hispanics MSM diagnosed HIV/AIDS shows upwards in these 5 years (4.3% increase among NJ Latino MSMs from 2012 to 2016). 193 is the largest number of HIV/AIDS diagnoses in NJ for 2016 most-Affected Subpopulation which is Hispanic/Latino MSM. 173 is the second top number of HIV/AIDS diagnoses in NJ for 2016 most-Affected Subpopulation which is Black MSM. Male diagnoses among Color Americans (not White) comprised 76% of all male diagnoses in 2015, but MSM diagnosed HIV/AIDS among Color Americans comprised 80% of all MSM diagnosed HIV/AIDS in 2015.

Chart1

201220122012

201320132013

201420142014

201520152015

201620162016

White

Hispanic

African American

121

185

180

121

156

145

95

215

179

93

211

202

102

193

173

Sheet1

20122013201420152016

White1211219593102

Hispanic185156215211193

African American180145179202173

Number of MSM (MSM/IDU included) Diagnoses HIV/AIDS by Age Group in NJ, 2012 - 2016

PresenterPresentation Notes This slide presents the number and percent of MSM (MSM/IDU included) diagnoses in 5 years by 5 age groups in New Jersey. Between 2012-2016, Proportionally, cases for younger MSM constitute a large share of diagnoses. MSM aged 13-24 and 35-34 make up the bulk of new diagnoses which the number and percentage are increasing during this 5 years. New Cases among MSM under 35 years of age accounted for 62.8% of 2011 new diagnoses but 67.9% of 2015 diagnoses. The number of diagnoses among those aged 45 and above (2 age groups) decreased. The new cases among MSM category increased 15% from 2011 to 2015. The number of diagnoses decreased a lot for those 13-24 (19% down) and for age 25-34 has increased a little; Age 13-34 comprised 46%-49% of all age patients in 5 years. The number remained stable among age 35-44 and those 55 or older during these 5 years. Persons aged 25-34 make up the bulk of new diagnoses since 2012, especial during 2016.

.

Chart1

20122012201220122012

20132013201320132013

20142014201420142014

20152015201520152015

20162016201620162016

13-24

25-34

35-44

45-54

55+

156

171

86

73

18

120

150

75

62

23

147

183

83

62

21

151

208

91

55

23

128

200

78

51

29

Sheet1

20122013201420152016

13-24156120147151128

25-34171150183208200

35-448675839178

45-547362625551

55+1823212329

# and % of HIV/AIDS Diagnosed in 2016 by Race/Ethnicity and Sex–for Heterosexual people

Heterosexual NJ women diagnosed HIV/AIDS 2016, N=217

Heterosexual NJ men diagnosed HIV/AIDS 2016, N=211

NJ eHARS as of 12/31/ 2018.

PresenterPresentation Notes This slide is for NJ Heterosexual people diagnosed HIV/AIDS in 2016. The left side shows that the Heterosexual males diagnosed HIV/AIDS by race/ethnicity in 2016 compared with right side for Heterosexual females HIV/AIDS in 2016. Blacks comprised 49.3% (down from last year) of NJ heterosexual men diagnosed HIV/AIDS in 2016, and Blacks comprised 52.5% of NJ heterosexual females diagnosed HIV/AIDS in 2016 (Black women comprised 52% among Black heterosexual people). Hispanic comprised 35.1% among heterosexual men and 32.7 % among heterosexual women diagnosed HIV/AIDS in 2016. White comprised 14.7% among heterosexual men and 13.4% among heterosexual women diagnosed HIV/AIDS in 2016 (White women comprised 48% among white heterosexual people). Overall, 86% of heterosexual HIV infection cases in 2016 are in color.

Chart1


BlackBlackBlack

WhiteWhiteWhite


0

Hispanic 71 32.7%

Black: 114 52.5%

White:2913.4%

Other/Unknown:31.4%

71

114

29

3

Sheet1


71114293

Chart1


BlackBlackBlack

WhiteWhiteWhite


0

Hispanic 7135.1%

Black: 104 49.30%

White:3114.7%

Other/Unknown:21%

74

104

31

4

Sheet1


74104314

Counties: N (Rates)1 Essex 9716 (1221)2 Hudson 5007 ( 748)3 Union 2866 (518)4 Atlantic 1414 (514)5 Passaic 2505 (492)6 Mercer 1506 (405)7 Cumberland 599 (381)8 Camden 1869 (366) 9 Monmouth 1913 (304)10 Middlesex 2142 (257)11 Salem 160 (247)12 Cape May 212 (222)13 Burlington 862 (192)14 Bergen 1781 (191)15 Somerset 612 (184)16 Morris 867 (174)17 Warren 179 (167)18 Gloucester 443 (152)19 Ocean 779 (133)20 Hunterdon 159 (126)21 Sussex 173 (119)

Persons Living with HIV/AIDS in 2018 by County

0.0 - 199

220 - 420

491 - 599

600 +

Prevalence Rate: Persons Living withHIV/AIDS as of 12/31/2018 per 100,000 2017 population (Bridged Race Estimates at June 2018)Statewide rate= 419 per 100,000

Data as of 12/31/2018

2

9

15

5

1

4

3

6

7

8

11

10

12

1416

13

18

20

17

21

19

PresenterPresentation Notes The overall 2018 HIV/AIDS statewide prevalence rate was 419 per 100,000 population. Overall prevalence was highest in Essex and Hudson counties followed by Union, Atlantic and Passaic. Roughly the orange and red areas have a prevalence at or higher than the Statewide rate and the yellow and green areas have prevalence lower than the Statewide rate. Ten, or nearly half of New Jersey’s 21 counties, accounted for more than four-fifths (82%) of NJ persons living with HIV/AIDS in 2018.

• As of 2017, ten percent of New Jersey’s population live in poverty (lower than the national rate (14.6%).

• Incomes below the poverty level for 20 counties in 2017 improved than in 2016. Only one county (Cumberland) where poverty level has not changed.

• Counties with the lowest percentage of residents living below the poverty level (richest counties) are Hunterdon, Morris and Somerset. The richer counties tend to have lower HIV/AIDS prevalence.

• Conversely, counties with the highest percentage of residents living below the poverty level (poorest counties) tend to have higher HIV incidence and prevalence rates

Socio-economic Status in New Jersey

PresenterPresentation Notes The top two counties with highest HIV/AIDS 2017 prevalence rate are Essex County and Hudson County. These two counties are close to New York City. Cumberland County has the highest poverty among 21 counties in 2016 and 2017. The new HIV/AIDS rate has increased from 7.0 in 2014 to 10.3 in 2015 per 100,000 persons in Cumberland.

Counties: Poverty Rates1 Cumberland 18.4%2 Passaic 16.5%3 Essex 15.8%4 Atlantic 14.1%5 Hudson 14.2%6 Salem 13.3%7 Camden 11.7%8 Mercer 11.4%9 Cape May 10.4%

10 Ocean 10.2%11 Union 9.3%12 Middlesex 8.5%13 Warren 7.4%14 Monmouth 7.3%15 Gloucester 6.7%16 Bergen 6.6%17 Burlington 6.5%18 Sussex 5.3%19 Somerset 5.3%20 Morris 4.9%21 Hunterdon 3.9%

Living with HIV/AIDS, 2018 Poverty Rates in 2017 by County

3.9 – 6.5 (17-21)6.6 – 10.0 (11-16)10.2 – 12.0 (7-10)13.0 + (1-6)

Statewide rate = 10.0%

Data as of 12/31/2018

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14

19

2

3

4

11

8

1

7

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12

9

20

17

15

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13

18

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Counties: N (Rates)1 Essex 9716 (1221)2 Hudson 5007 ( 748)3 Union 2866 (518)4 Atlantic 1414 (514)5 Passaic 2505 (492)6 Mercer 1506 (405)7 Cumberland 599 (381)8 Camden 1869 (366) 9 Monmouth 1913 (304)10 Middlesex 2142 (257)11 Salem 160 (247)12 Cape May 212 (222)13 Burlington 862 (192)14 Bergen 1781 (191)15 Somerset 612 (184)16 Morris 867 (174)17 Warren 179 (167)18 Gloucester 443 (152)19 Ocean 779 (133) 20 Hunterdon 159 (126)21 Sussex 173 (119)

PresenterPresentation NotesThe overall poverty rate in New Jersey was 10% in 2017. The columns on the right of the map indicate counties’ rankings by percentage of residents living in poverty. The percentage of residents living in poverty by county ranges from as low as 3.9% in Hunterdon to as high as 18.4% in Cumberland. Ten counties have a higher percentage of residents above the Statewide poverty level and ten counties have poverty below the Statewide level. The red columns on the left show the number and rate of persons living with HIV/AIDS through 2018. Those 10 counties with higher percentage poverty level are also ranked higher in HIV/AIDS prevalence rate in 2018. Seven of on 8 top poverty rate are also on the top 8 counties on the left list with highest HIV/AIDS prevalence rate.

PresenterPresentation NotesOf the 29,955 adjusted denominator, 11,765 don’t have any reported VL. 15,966 have suppressed VL and 2,224 have VL > 200 copies/ML.If we limited the calculation only to those with reported VL the percent of VLS would increase to 88% instead of 53%.

Chart1

Adjusted Denominator

Retained in any care in 2018 (>=CD4/VL/ART)

Continuously Retainedin care in 2018 (>=2 CD4/vl / 3 mons. Apart)

Suppressed Vl = 1 CD4/Vl or ART in 2011 (NJ unmetneed)

>=1 CD4/VL in 2011

>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)

ART in 2011(mostly public sources)

Denominator: N=33870

Percentages

Continuum of HIV Care in NJ 2011

0.51

0.46

0.3

0.26

0.31

by sex

>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)

ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)

Suppressed Vl (= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)

ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)


ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)


ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)

Suppressed Vl (

Chart1

Retained in any care

Continuously Retained in care

Suppressed VL

Denominator: N=29,955

Percentages

HIV Continuum of Care in NJ 2018: Percentages

46%

53%

0.71

0.46

0.53

various measures of care

Denominator:Diagnosed Prevalenve

Retained in any care

>=1 CD4/VL in 2011

>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)

Suppressed Vl (= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)>= 2 CD4/VL at least 3 mons. apart in 2011(retained in Care)

ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)


ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)


ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)


ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)ART in 2011(mostly public sources)

Suppressed Vl (

Key Points• New HIV infections are down overall; between 2012 and 2016

there was about 8% decline in new infections: among non-Hispanic Blacks by 17%, only 2% among non-Hispanic Whites, but increased among Hispanics by 5%. The goal is to reduce the rate of new HIV infection by 75% toward to end the HIV epidemic by 2025.

• The only demographic group experiencing a growth in new infections is MSM, particularly for Hispanic men. MSM become the highest HIV/AIDS risk for both U.S. and NJ. 53.7% or more of new HIV/AIDS cases among men is MSM, For MSM in NJ, the median age of HIV/AIDS diagnoses in 2016 is 29. The disparity of new cases in minorities is particularly pronounced for young MSM.

Racial ethnic disparities still exist. Seventy nine percent (79%) of persons 2018 living with HIV were minorities.

Seventy percent were retained in any HIV care in 2018, 48% were in continuous HIV care and 53% were virally suppressed.

Slide Number 1IntroductionSlide Number 3Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11Slide Number 12Slide Number 13Slide Number 14Slide Number 15Number and Percent for Adultl\Adolescent diagnosed with HIV/AIDS in 2016 by Sex and Age GroupSlide Number 17# and % of HIV/AIDS Diagnosed in 2016 �by Race/Ethnicity and Sex – New JerseySlide Number 19Slide Number 20Population (2017) and PLWHA (2018) �by Race/Ethnicity –New JerseyRate per 100,000 NJ Persons 2018 Living with HIV/AIDS by Sex and Race/Ethnicity -- Bridged-race estimates for 2017 NJ populationSlide Number 232016 New HIV/AIDS cases diagnosed �by Gender and Exposure Category –New Jersey�NJ eHARS data as of 12/31/2018�PLWHA by Exposure Category –New Jersey�eHARS data as of 12/31/2018Slide Number 26Slide Number 27# and % of HIV/AIDS Diagnosed in 2016 by �Race/Ethnicity and Sex–for Heterosexual people Slide Number 29Slide Number 30Slide Number 31Slide Number 32Slide Number 33Key Points

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