HIV Epidemiological Profile for Chicago EMA Tell audience to hold questions until the end. Also mention that data was from June from TG’s directive Stephanie Masiello Schuette Director of HIV/STI Surveillance, Epidemiology, and Research Stephanie.Schuette@cityofchicago.org Chicago Department of Public Health – STI/HIV Services Bureau

Quick Terminology Review Rate = a measure of the frequency of an event occurring in a defined population in a defined time The number of litters per 100,000 dogs in one year Proportion = No time component The number of dogs < 2 years old in Chicago Total number of dogs in Chicago Ratio = Comparison The number of female dogs in Chicago: the number of male dogs in Chicago Chicago Department of Public Health – STI/HIV Services Bureau

Extent of a Disease in a Population Incidence = measure of change from non-disease to disease (numerator) in a population at risk (denominator) New cases Prevalence = static measure of proportion of a population that is diseased Existing cases Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau Provisional Data Enhanced HIV/AIDS Reporting System (eHARS) is constantly being updated The data you are seeing today were up to date as of 12/28/2015 Chicago Department of Public Health – STI/HIV Services Bureau

HIV Continuum of Care, Chicago EMA 2014 aNumber of persons ≥13 years of age at diagnosis and diagnosed with HIV infection between 1/1/2014 and 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. bPercent of persons ≥13 years of age linked to care (at least one CD4 or VL) within 3, 6, and 9 months of HIV diagnosis among those diagnosed with HIV infection from 1/1/2014 to 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. C Number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 or VL1 tables. D Percent of HIV-infected adults who have at least one or more care visit between January-December 2014; Percent of HIV-infected adults who have at least two or more care visit between January-December 2014, 3 months apart. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 table. e Percent of persons with HIV viral suppression among number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, VL1 table. Chicago Department of Public Health – STI/HIV Services Bureau

HIV Continuum of Care by Sex, Chicago EMA 2014 1,294 28,218 1,149 1,095 1,059 16,726 12,176 12,598 aNumber of persons ≥13 years of age at diagnosis and diagnosed with HIV infection between 1/1/2014 and 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. bPercent of persons ≥13 years of age linked to care (at least one CD4 or VL) within 3, 6, and 9 months of HIV diagnosis among those diagnosed with HIV infection from 1/1/2014 to 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. C Number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 or VL1 tables. D Percent of HIV-infected adults who have at least one or more care visit between January-December 2014; Percent of HIV-infected adults who have at least two or more care visit between January-December 2014, 3 months apart. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 table. e Percent of persons with HIV viral suppression among number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, VL1 table. Chicago Department of Public Health – STI/HIV Services Bureau

HIV Continuum of Care by Race/Ethnicity, Chicago EMA 2014 1,294 28,218 1,149 1,095 1,059 16,726 12,176 12,598 aNumber of persons ≥13 years of age at diagnosis and diagnosed with HIV infection between 1/1/2014 and 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. bPercent of persons ≥13 years of age linked to care (at least one CD4 or VL) within 3, 6, and 9 months of HIV diagnosis among those diagnosed with HIV infection from 1/1/2014 to 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. C Number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 or VL1 tables. D Percent of HIV-infected adults who have at least one or more care visit between January-December 2014; Percent of HIV-infected adults who have at least two or more care visit between January-December 2014, 3 months apart. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 table. e Percent of persons with HIV viral suppression among number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, VL1 table. Chicago Department of Public Health – STI/HIV Services Bureau

HIV Continuum of Care by Age, Chicago EMA 2014 1,294 28,218 1,149 1,095 1,059 16,726 12,176 12,598 aNumber of persons ≥13 years of age at diagnosis and diagnosed with HIV infection between 1/1/2014 and 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. bPercent of persons ≥13 years of age linked to care (at least one CD4 or VL) within 3, 6, and 9 months of HIV diagnosis among those diagnosed with HIV infection from 1/1/2014 to 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. C Number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 or VL1 tables. D Percent of HIV-infected adults who have at least one or more care visit between January-December 2014; Percent of HIV-infected adults who have at least two or more care visit between January-December 2014, 3 months apart. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 table. e Percent of persons with HIV viral suppression among number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, VL1 table. Chicago Department of Public Health – STI/HIV Services Bureau

HIV Continuum of Care by Transmission Group, Chicago EMA 2014 1,294 28,218 1,149 1,095 1,059 16,726 12,176 12,598 aNumber of persons ≥13 years of age at diagnosis and diagnosed with HIV infection between 1/1/2014 and 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. bPercent of persons ≥13 years of age linked to care (at least one CD4 or VL) within 3, 6, and 9 months of HIV diagnosis among those diagnosed with HIV infection from 1/1/2014 to 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Link1 table. C Number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 or VL1 tables. D Percent of HIV-infected adults who have at least one or more care visit between January-December 2014; Percent of HIV-infected adults who have at least two or more care visit between January-December 2014, 3 months apart. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, Care1 table. e Percent of persons with HIV viral suppression among number of persons ≥13 years of age on 12/31/2013 diagnosed with HIV infection through 12/31/2013 and living with HIV on 12/31/2014. Source: Chicago HIV/AIDS Reporting System (as of 12/28/2015). NHAS output, VL1 table. Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau

Demographics of New HIV Diagnoses in Chicago EMA, 2014 (n = 1,370) Chicago Department of Public Health – STI/HIV Services Bureau

Demographics of PLWH in Chicago EMA, 2013 (n = 29,973) Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau

Increase of 6% (2,143 individuals diagnosed) needed to reach 90% goal ***Crude Estimate*** Use CDC’s IL estimate that 84% of people with HIV infection are diagnosed: Estimate: 35,700 HIV infections in EMA 30,000 diagnosed 5,700 undiagnosed Increase of 6% (2,143 individuals diagnosed) needed to reach 90% goal

Chicago Department of Public Health – STI/HIV Services Bureau EMA New HIV Diagnoses 2010-2014 = 1,441 25% reduction = 360 new diagnoses EMA New HIV Diagnoses in 2014 = 1,370 25% reduction = 342 new diagnoses Estimated need = ~ 350 less new diagnoses between 2014 and 2020. Chicago Department of Public Health – STI/HIV Services Bureau

From NHBS MSM4 cycle: 52% of participants stated they did not use a condom 39% of participants stated use of alcohol and 3% of participants stated use of drugs during sex 18% of participants had not been tested for HIV in the past 2 years

Chicago Department of Public Health – STI/HIV Services Bureau Currently: 82% of those newly diagnosed are linked into care within 3 months 85% of those newly diagnosed are linked into care within 6 months Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau Currently, 43% of those diagnosed are retained in care If we look at current numbers, we would have needed 13,220 more individuals retained to reach the 90% goal Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau Currently, 45% of those diagnosed are virally suppressed If we look at current numbers, we would have needed 9,976 more individuals suppressed to reach the 80% goal Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau 1.4% of people living with HIV infection in 2013 died Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau MSM 2014 = 40x more diagnoses than IDU males 18x more diagnoses than Heterosexual males ≤ 29 yrs Black MSM 2014 = 3.5x more diagnoses than same age White MSM 3x more diagnoses than same age Hispanic MSM Black Females 2014 = 7x more diagnoses than White and 5x more diagnoses than Hispanic females, respectively Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau Currently, 38% of youth (13-24 yrs) and 40% IDU are virally suppressed If we look at current numbers, we would have needed 599 more young individuals and 1,394 IDU virally suppressed to reach the 80% goal Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau Final Thoughts There is a heavier burden of HIV in certain counties in the EMA. HIV Prevalence and Incidence differs by county. Not a one-size fits all model. Based on the data, the largest risk populations are Males, NH Blacks, MSM, and those 20-29 yrs old Goals set by indicators are challenging, but achievable Chicago Department of Public Health – STI/HIV Services Bureau

Chicago Department of Public Health – STI/HIV Services Bureau Questions? Thanks to: HIV/STI SER data team Irina Tabidze Margaret Eaglin Joy Kane Monique Millington Laxmi Modali Chicago Department of Public Health – STI/HIV Services Bureau