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New diagnoses, prevalent cases, and deaths through December 31, 2012
April 2013
Introduction
This annual review relies on HIV and AIDS diagnoses reported to the Wisconsin Department of Health Services HIV/AIDS Surveillance System through 2012. The annual review is intended to assist planners of HIV prevention and care services to better serve those at risk of and living with HIV, to ensure effective use of existing resources, and to seek additional resources where most needed. The tables and technical notes at the end of the PDF version of the annual review provide additional information. http://www.dhs.wisconsin.gov/aids-hiv/Stats/index.htm
Wisconsin Department of Health Services
Methods
Methodological changes that affect 2012 HIV/AIDS Surveillance Summary include: Analyzing data by year of diagnosis rather than year of report. Including a review of the National Death Index, in addition to Wisconsin Death Index.
New diagnoses Prevalent cases reported, (n=6,549) Out of state cases Cases already living in Wisconsin
Cases ever reported in Wisconsin but currently residing in another state (n 1,000) Deaths through 2010 (n = 4,466; newly occurring or retrospectively identified)
Wisconsin Department of Health Services
UNITED STATES Figure 2. HIV diagnosis rates per 100,000 population by state, 2011
35 30
25
20
IL U.S.
15
10
MI
IN
MN
WI
IA
0
MD LA FL GA NY MS TX MA SC NJ AL NC IL CA US NV TN DE VA PA RI CT AZ OH MO OK AR MI CO WA IN KY NM OR MN HI WV KS WI ME IA NE NH AK UT SD WY ID MT ND VT
500
HIV diagnoses
400
300
200
100
CASES BY SEX Figure 4. HIV diagnoses per 100,000 population by sex, Wisconsin, 2003-2012
9.0
8.0
Male
7.0
6.0
5.0
4.0
3.0
Female
2.0 1.0
0.0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
SEX AND AGE Figure 5. HIV diagnosis rates per 100,000 population by sex and age group, Wisconsin, 2003-2012
18.0
16.0
14.0
12.0
Males 15-29
10.0
8.0
Males 30+
6.0
4.0
Females 15-29
2.0
Females 30+
0.0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
RACE/ETHNICITY Figure 6. Percent of HIV diagnoses in Whites and racial/ethnic minorities, Wisconsin, 1983-2012
100% 90% 80%
Multi-racial Asian
HIV diagnoses
70% 60%
Racial/ethnic minority
Hispanic
50%
40% 30% 20% 10% 0% 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Black
White
White
SEX AND RACE/ETHNICITY: RATES Figure 7. HIV diagnosis rates per 100,000 population by sex and race/ethnicity, Wisconsin, 2008-2012
50.0
Black
45.6
45.0
Hispanic
Asian/Pacific Islander
White American Indian
16.8
16.6
6.6
5.0 0.0 Male Female
3.6
2.5
3.7
46
45 40 35
38
32
HIV diagnoses
31
30
25
25 20 15 10 5
18 16 14
12
8
0
0
1 5-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+
<5
DIAGNOSIS BY AGE GROUP Figure 9. HIV diagnosis by age group and demographic characteristics, Wisconsin, 2012
100% 90% 80% 70% 60% 50%
10%
9%
40%
30% 20%
42%
27% 24%
10% 0%
* Data have been statistically adjusted to account for unknown risk. See technical notes. ** MSM includes those who have also injected drugs. Wisconsin Department of Health Services
RISK EXPOSURE Figure 10. HIV diagnoses by estimated risk exposure group*, Wisconsin, 2012
(n=241)
Other , 0.4%
Heterosexual , 21%
IDU , 7%
MSM , 68%
* Data have been statistically adjusted to account for unknown risk. See technical notes.
RISK EXPOSURE Figure 11. HIV diagnoses by estimated risk exposure group*, Wisconsin, 2003-2012
180 160 140 120
MSM
100 80 60 40 20
Heterosexual
IDU
0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
* Data have been statistically adjusted to account for unknown risk. See technical notes.
RISK AND RACE/ETHNICITY Figure 12. HIV diagnoses by estimated risk exposure group* and race/ethnicity Wisconsin, 2012
90 80
77
70
62
60
50
40
31
30
26
20
14
10
2
0
MSM (n170)
5
1
Heterosexual (n52)
7 4 1 1
Perinatal (n=1)
IDU (n18)
* Data have been statistically adjusted to account for unknown risk. See technical notes.
YOUNG MSM: RACE/ETHNICITY Figure 13. HIV diagnoses in MSM* ages 15-29, by race/ethnicity, Wisconsin, 2003-2012
60
50
Black
40
30
20
White
10
Hispanic
0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
* Data have been statistically adjusted to account for unknown risk. See technical notes. ** Includes Asians, American Indians, and multi-racial individuals. Wisconsin Department of Health Services
AGE AT DIAGNOSIS BY RISK Figure 14: Median age at HIV diagnosis by risk exposure*, and among MSM, by race/ethnicity, Wisconsin, 2012
Median age at HIV diagnosis
Total (n=241) 33
IDU (n=9)
42
Heterosexual (n=20)
41
30
23
MSM
31
43
45 50
AGE AT DIAGNOSIS Figure 15. Median age at HIV diagnosis for Black MSM*, 2003-2012, Wisconsin
Circle size and number in circle represent the number of HIV diagnoses among Black MSM that year
30
28 27 26
42 22
25 24 23
31
43 52 54 46 42 62
2010
2011
2012
TRANSGENDER INDIVIDUALS Figure 16. HIV diagnoses among transgender individuals by race/ethnicity, Wisconsin, 2003-2012
12
10
1
8
HIV diagnoses
3 9
4
1
2
4
2 1
2012 DIAGNOSES BY COUNTY Figure 17. HIV diagnoses by county, Wisconsin, 2012
Burnett
Bayfield Douglas
Ashland
Iron
Vilas Washburn
Sawyer
Florence Oneida
Price
Forest
Polk Barron
Oconto Door
Pierce Pepin
Eau Claire
Waushara
Winnebago
Calumet
Manitowoc
La Crosse
Monroe
Juneau
Washington Ozaukee
Jefferson
Waukesha Milwaukee
11 - 25 128
DIAGNOSIS BY GEOGRAPHY Figure 18. HIV diagnosis by geography and demographic characteristics, Wisconsin, 2012
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% White Black Hispanic 15-29 30-49 50+
Milwaukee County
76%
24%
Black MSM under age 30 58% of 2012 diagnoses (8% of male population, ages 15-29) Diagnoses tripled 2003-2010, declined modestly 2010 2012 Median age at diagnosis, 23
Wisconsin Department of Health Services
PREVALENT CASES
Prevalence is the number of people living with HIV infection at a given point in time
AWARE OF HIV INFECTION: UNITED STATES Figure 19. Percent aware of their HIV infection, by demographic group, United States, 2009
Total BY AGE Aged 13-24 years Aged 25-34 years Aged 35-44 years Aged 45-54 years Aged 55-64 years Aged 65 years and over BY SEX Male Female BY RACE/ETHNICITY White only Black or AA only American Indian or AN only Asian only Native Hawaiian or PI only 2 or more races Hispanic or Latino
NUMBER UNAWARE OF HIV INFECTION Figure 20. Estimated number unaware of their HIV infection, by demographic group, Wisconsin, 2012
BY AGE Aged 13-24 years Aged 25-34 years Aged 35-44 years Aged 45-54 years Aged 55+ years BY SEX Male Female BY RACE/ETHNICITY White Black American Indian Asian Multi-racial Hispanic or Latino
-
438 345 276 303 171 1,228 237 537 599 13 26 18 192
200 400 600 800 1,000 1,200 1,400
PREVALENCE: STATE OF DIAGNOSIS Figure 21. Prevalent cases of HIV infection by state of initial HIV diagnosis, Wisconsin, as of December 31, 2012 n = 6,549
PREVALENCE: AGE Figure 22. Prevalent cases of HIV infection by current age as of 12/31/2012 and cases reported during 2012 by age at diagnosis, Wisconsin
Current age of prevalent cases (n=6,549)
20%
Percent
15%
10%
5%
0% <5 5-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+
ESTIMATED PREVALENCE* BY DEMOGRAPHIC GROUP Figure 23. Impact of HIV on selected demographic groups, ages 15-59 years, Wisconsin, as of December 31, 2012
30%
27%
25% 20%
15%
10%
5% 0% MSM
Demographic Group
* The estimated prevalence is adjusted to account for the CDCs estimate that 18% of HIV-infected persons are unaware of their infection and therefore not reported. The percent of males that are MSM was calculated using published estimates (Lieb, 2011).
Wisconsin Department of Health Services
PREVALENCE: GEOGRAPHY
Figure 24. Reported cases of HIV infection presumed to be alive by county, Wisconsin, as of December 31, 2012
Burnett
Bayfield Douglas
Ashland
Iron
Vilas Washburn
Sawyer
Florence Oneida
Price
Forest
Polk Barron
Oconto Door
Pierce Pepin
Eau Claire
Waushara
Winnebago
Calumet
Manitowoc
La Crosse
Monroe
Juneau
Washington Ozaukee
41 - 100
Iowa
Dane
Jefferson
Waukesha Milwaukee
*Excludes 228 cases with the Wisconsin Department of Corrections as the last known address and 285 cases where county of residence is unknown.
DEATHS
Deaths are the number of people with HIV infection who died in a given year, irrespective of cause of death
DEATHS Figure 25. Deaths due to any cause among persons reported with HIV infection by year of death, Wisconsin, 1990-2010
400
350
Number of deaths
300
250
200
150
100
50
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
DEATHS: AGE Figure 26. Deaths due to any cause among persons reported with HIV infection, by median age at death, Wisconsin, 2001-2010 n=1,251
60
50
50
50
43
40
45 42 42 39.5 40
47
47
30
20
10
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Estimated HIV positive by risk and race General population: 2 in 1,000 Blacks: Non-MSM males, 1.2%; females, 0.7% MSM: Black, 27%; Hispanic, 7%; White, 3% Geography: Milwaukee County: 48%; Dane County, 12%; all other 4% or less
DEATHS
89 in HIV-infected individuals in 2010
Wisconsin Department of Health Services