HIV/STD Syndemic An Overview of South Los Angeles Los Angeles County Department of Public Health Division of HIV and STD Programs Research and Evaluation

4,060 sq mi 155,959 sq mi 9,848,011 36,961,664 Los Angeles County California Estimated living HIV/AIDS Cases 59,500 134,401* Reported HIV/AIDS Cases 43,900 111,100 Los Angeles County California 4,060 sq mi 155,959 sq mi Los Angeles County California 9,848,011 36,961,664 (Optional slide): This slide shows Los Angeles County in comparison with the State of California. We are 2.6% of the state’s land area, 26.6% of the population, and 46.1% of the estimated living HIV/AIDS cases as of January 1, 2011. Data Source: Los Angeles County Department of Public Health, HIV Surveillance, 2012 California State Department of Public Health, State Surveillance Data, 2012 *134,401 calculated assuming 21% of HIV positive Californians are unaware of their status. Data Source: U.S. Census , 2010

Estimated HIV/AIDS Cases Population Estimated HIV/AIDS Cases 9,848,011 59,500 Los Angeles County is the most populous in the United States with 9.8 million residents. The County is diverse in both it’s people and geography. There is no one majority racial/ethnic group and the County’s geography consists of urban, suburban, and rural areas divided by several mountain ranges. Data Source: U.S. Department of Commerce, 2010; Los Angeles County Department of Public Health, HIV Surveillance, 2011

Los Angeles County Chicago Houston New York City San Francisco Philadelphia (Optional slide): With over 4,000 square miles, Los Angeles County is larger than San Francisco (City and County), The District of Columbia, Philadelphia, Houston, Chicago, and all 5 boroughs of New York City combined. District of Columbia Data Source: U.S. Census Bureau, Topologically Integrated Geographic Encoding and Referencing system, 2009. Maps Drawn at 1:750,000 scale.

2012 Estimated Number of Persons Living with HIV and AIDS in LAC 12,800 1,200 1,600 43,900 Estimate ~ 59,500 living with HIV (including AIDS) in LAC Source: LAC Division of HIV and STD Programs, reported as of 12/31/2011. (1) Estimate that 21.5% of HIV+ in LA County are unaware of their infection; modified from CDC estimate. (2) Of 4,853 notifications pending investigation, estimate half of 2,400 who have detectable VL or confirmatory test to be unduplicated cases. (3) Out of the 3,200 cases reported as code, half are thought to represent unduplicated cases. 5

Percent Persons Diagnosed with HIV by Gender and Year, LAC, 2006-11 87% Male Percent Female 12% Transgender 1% Year * Data provisional due to reporting delay. Source: HIV/AIDS Surveillance Summary, data as of December 2011. 26

Persons Living with HIV/AIDS in LAC per 100,000 population Persons Living with HIV/AIDS in LAC per 100,000 population* by Race/Ethnicity *Sometimes called “Prevalence Rate”; it is really a proportion. Source: HIV/AIDS Surveillance Summary, data as of December 2011.

RATES OF HIV DIAGNOSES AMONG MEN BY RACE/ETHNICITY*, LAC, 2006-2011 Source: HIV/AIDS Surveillance Summary, data as of December 2011.

RATES OF HIV DIAGNOSES AMONG WOMEN BY RACE/ETHNICITY*, LAC, 2006-2011 Source: HIV/AIDS Surveillance Summary, data as of December 2011.

Central Cluster, 2009 HIV and Syphilis Burden HIV Demographic Summary African-American 27.8% Men 81.5% Women 18.5% Latino 44.4% 90.7% 9.3% White 23.8% 97.4% 2.6% This is an optional map slide. This map was developed from the HIV Epidemiology Program’s Semi Annual Surveillance Report and shows AIDS cases identified in CY2007 by Health District. Disease Burden Summary n % HIV 861 46.3% Syphilis + HIV 642 58.5% Syphilis no HIV 712 44.6% Gonorrhea 3,330 42.1%

South Cluster, 2009 HIV and Syphilis Burden HIV Demographic Summary % African-American 24.5% Men 83.3% Women 16.7% Latino 44.2% 83.0% 17.0% White 26.7% 91.8% 8.2% This is an optional map slide. This map was developed from the HIV Epidemiology Program’s Semi Annual Surveillance Report and shows AIDS cases identified in CY2007 by Health District. Disease Burden Summary n % HIV 318 18.4% Syphilis + HIV 94 9.0% Syphilis no HIV 222 13.9% Gonorrhea 1,613 20.4%

Source: HIRS, Calendar Year 2007 Data Source: eHARS as of September 30, 2011

Source: HIRS, Calendar Year 2007 Data Source: eHARS as of September 30, 2011

New Syphilis Cases by Resident Zip Code, 2009 Source: HIRS, Calendar Year 2007 Data Source: STD Surveillance, 2011

New Syphilis Cases by Resident Zip Code, SPA 6, 2009 Source: HIRS, Calendar Year 2007 Data Source: STD Surveillance, 2011

Source: HIRS, Calendar Year 2007 Data Source: eHARS, ADAP, Medicare, and MediCal and Casewatch, Jul09-Jun10

Target Population, Overall vs SPA 6, CY 2010 Characteristic Overall SPA 6   N (%) n (%) Number of HIV Tests 40,938 3,837 New Positives1 435 1.1% 54 1.4% Men 27,509 67.2% 2,247 58.6% Gay men 12,218 29.8% 620 27.6% Non- gay identified men who have sex with men2 817 2.0% 51 2.3% Women 12,981 31.7% 1,540 40.1% Women who have sex partners of unknown HIV status 12,763 31.2% 1,515 98.4% Transgender Individuals 448 50 1.3% People who Share Needles/Works 3,682 9.0% 236 6.2% Data Source: HIV Testing System (HTS) as of 123111 1 New Positives refers to individuals who self-reported never having a prior positive HIV test result. 2 Includes males who did not self-identify as homosexual or bisexual and reported having sex with men.

Race/Ethnicity, Overall vs SPA 6, CY 2010 Data Source: HIV Information Resources System (HIRS) as of 12/31/11

Age, Overall vs SPA 6, CY2010 n = 3,837 Data Source: HIV Information Resources System (HIRS) as of 12/31/11

Getis-Ord Gi* calculated at 6,000 foot threshold using the fixed distance band spatial conceptualization Source: American Community Survey, 5-year estimates, U.S. Census

Thank You! Division of HIV and STD Programs 600 South Commonwealth Avenue, 10th Floor Los Angeles, California 90005-4001 Phone: (213) 351-8000