HIV/AIDS among Women in Texas Enhanced Perinatal Surveillance May 30, 2007 Nita Ngo, MPH

Background  HIV/AIDS Surveillance in Texas  Data collected through HIV/AIDS Reporting System, hereafter referred to as HARS 1983: AIDS became reportable 1994: Pediatric HIV cases became reportable 1999: All confidential HIV infections reportable by name  As of February 2007, all but 3 states (i.e., Utah, Vermont, and Hawai’i) were reporting HIV by name

HIV/AIDS among females United States, An estimated 9,893 women were diagnosed with HIV/AIDS (12.4 per 100,000) High-risk heterosexual contact accounted for 80% of the newly diagnosed infections African-American women are disproportionately affected by HIV/AIDS –Represented 66% of newly diagnosed cases –Rates exceed those for all women and men, except African-American men 1 CDC. HIV/AIDS Surveillance Report, Vol. 16. Atlanta: US Department of Health and Human Services.

Number of Women Estimated to be Living with AIDS: Top 10 States, 2005* *Women and HIV/AIDS in the United States. Kaiser Family Foundation, 2006.

HIV/AIDS in Texas  56,153 persons were known to be living with HIV/AIDS and the overall rate was 244 cases per 100,000 people in 2005  Males accounted for most of the living cases (78%) and new diagnoses (78%) of HIV/AIDS in 2005  African-Americans have been disproportionately impacted by HIV, with a rate of 809 persons living with HIV/AIDS per 100,000 in 2005  Mode of exposure varied among races/ethnicities Male-to-male sex more frequently reported among Whites and Hispanics

HIV/AIDS among females in Texas  Proportion of newly diagnosed AIDS cases among females has increased  HIV/AIDS has affected African-American women disproportionately Represent 12% of female population Make up 59% of living cases among women  The number of women living with HIV/AIDS has nearly doubled since 1999

Number and Proportion of AIDS cases among females in Texas,

AIDS cases among females by race/ethnicity in Texas, African-American White Hispanic Other/Unknown

Number of females living with HIV/AIDS in Texas,

Race/Ethnicity of females diagnosed with HIV/AIDS in Texas, 2005 Note: Data include persons with a diagnosis of HIV infection, regardless of AIDS status at diagnosis.

HIV/AIDS cases among females by Age in Texas, 2005

HIV/AIDS cases among females by Race and Age in Texas, 2005 Race/Ethnicity African-American1%5%14%33%27%19% Hispanic1%7%14%34%23%22% White0%4%6%29%30%32% Other/Unknown0% 14%38%19%29% Age at Diagnosis Note: Data include person with a diagnosis of HIV infection, regardless of AIDS status at diagnosis.

HIV/AIDS cases among females by Transmission Category in Texas, 2005 *Heterosexual contact with person known to have or to be at high risk for HIV infection †Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or identified

HIV/AIDS cases among females by Transmission Category and Race in Texas, 2005 *Heterosexual contact with person known to have or to be at high risk for HIV infection †Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or identified 5% 10% 72% 14%72% 8% 11% 9% 25% 7% 11% 56% 57% 9% 24%

HIV/AIDS cases among females by Transmission Category and Age Texas, 2005 Transmission Category Injection drug use0%1%5%25%38%30% High-risk heterosexual contact* 0%5%15%37%28%19% Unspecified heterosexual contact 0%7%14%37%20%22% Other/not identified † 6%4%10%30%22%28% Age at Diagnosis Note: Data include person with a diagnosis of HIV infection, regardless of AIDS status at diagnosis. * Heterosexual contact with person known to have or to be at high risk for HIV infection † Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or identified

Annual Age-Adjusted* Rate of Death Among Persons with HIV/AIDS in Texas Female Male *Standard age distribution of 2000 US population

Females diagnosed with HIV/AIDS by Public Health Region in Texas, 2005

Sexually Transmitted Diseases Increase the risk for HIV infection and transmission Indicator of sexual risk behavior Primarily affects those in the and age groups High rates among African-Americans Disproportionately higher rates of chlamydia among women

STDs in Texas,

Proportion of females co-infected with HIV/AIDS and STDs in Texas,

STDs among females diagnosed with HIV/AIDS in Texas,

Summary Women are increasingly contributing to a greater proportion of newly diagnosed AIDS cases In 2005, 12,202 females were living with HIV/AIDS High-risk heterosexual contact accounted for most newly diagnosed HIV/AIDS infections African-American women have been disproportionately impacted by HIV/AIDS

Contact Information Texas Department of State Health Services HIV/STD Program Nita Ngo