1. HIV Prevention Data Amanda Dennison, MPH Ohio Department of Health
Interim STD, Hepatitis & HIV Prevention & Surveillance Section Manager
STD & Hepatitis Prevention Program Manager
Ohio Department of Health
04/13/17

2. Cleveland CTR Demographics by Race
26.6%
33.3%
67.1%
66.7%
*** All data in this presentation represent CTR data only***
Percentage of all testing by race correlates well with positivity by race overall.

3. Testing by Race and Risk Category
All Other
11.4%
MSM
9.3%
All Other
11.5%
MSM
26.6%
Heterosexual
60.6%
Heterosexual
79.2%
While the majority of testing in Cleveland is among African Americans, the risk groups tested within each race category look very different.
The percentage of testing among MSM within the Black/African American population is much lower than testing among MSM within the White population.

4. Cleveland CTR Demographics by Sex
7.4%
54.9%
Percentage of all testing by sex is out of proportion with positivity by sex overall.
Why are we testing so many women? Clinics? Perceived risk? Actual risk? Other reasons?
How can we target testing among women to still capture positive women while aligning the proportion tested with proportion positive?
92.6%
45.0%

5. Cleveland CTR Demographics by Age Group
7.4%
3.7%
13.1%
3.7%
6.3%
7.4%
12.6%
11.1%
10.0%
22.2%
21.3%
Percentage of all testing by age group correlates well with positivity by age group overall.
Almost half of positives identified in the age group.
Nearly 80% of all positives are under age 40. (***reminder here that this is CTR data only)
35.3%
44.4%

6. MSM Testing and New Positives by Age
Among MSM, year olds account for 40% of all new CTR diagnoses in Cleveland.
This same age group account for 50% of all testing among MSM in Cleveland.
Are we finding more positives among year old MSM because that is the group that we are testing the most?
Give them a minute to consider this.
We can’t answer that question by looking at CTR data alone.
We need to look at Surveillance data to better assess how risk is stratified in the larger population that we are sampling with CTR testing.
It is true that surveillance data likely has the limitation of incomplete reporting, however the mechanisms in place to capture data accurately for the majority of the population makes it a very good estimate.
We will be using surveillance data along with prevention data to implement strategies for increased targeted testing.

7. Cleveland Risk Category Percentages All CTR Testing and CTR Positives
Heterosexual
18.5%
All Other
11.9%
MSM
74.1%
Heterosexual
73.8%
All Other
7.5%
MSM
14.3%
Almost 75% of HIV CTR testing in Cleveland is among heterosexuals.
Data shows that nearly three quarters of newly diagnosed HIV positive individuals have MSM as their primary risk category.
Another way to say this is that nearly 75% of new CTR diagnoses arise from less than 15% of all CTR testing in Cleveland.
This translates to a positivity rate of 2.5% among MSM tested and to a positivity rate of 0.12% among Heterosexuals tested.
Targeted testing is one of the 8 goals in the Integrated Plan and will be a priority over the next 5 years.
We need representatives from each region on the targeted testing work group.

8. MSM Testing and New Positives by Race
Since most new HIV diagnoses are among MSM, we stratified the data within the MSM risk category to examine more closely which groups are testing and which groups are being diagnosed.
African American MSM account for 60% of new diagnoses among MSM.
African Americans account for almost half of all testing among MSM.
This is a good example of targeted testing within a risk category.
Combined with the data from the previous slide, we can say that approximately 45% of new CTR diagnoses in Cleveland come from 6.5% of all CTR testing in Cleveland. (i.e. AA MSM account for 6.5% of all CTR testing in Cleveland; AA MSM account for 45% of all new CTR diagnoses in Cleveland.)
Increased targeted testing in Black/African American MSM populations would result in higher regional HIV positivity rates.

9. CTR Testing by Risk Category
Risk Category - Cleveland Testing
Heterosexual
4,214
73.5%
IDU
125
2.2%
MSM
838
14.6%
MSM/IDU 14
0.2%
Other
160
2.8%
Unknown
386
6.7%
TOTAL
5737
100%
Risk Category - Ohio Testing
Heterosexual
22,717
70.3%
IDU
2,141
6.6%
MSM
4,540
14.0%
MSM/IDU
109
0.3%
Other
509
1.6%
Unknown
2,320
7.2%
TOTAL
32336
100%
Testing needs to be more targeted in every region.
Cleveland percentages for testing by risk category are similar to state level percentages.

10. Linkage to Care by Race Cleveland CTR90
This data shows that LTC among African American HIV positive clients is twice the rate of LTC among White HIV positive clients.
However, these rates are based on small numbers and so should be interpreted with caution.
85.2%
51.9%
48.2%
51.9%
48.2%

11. Linkage to Care by Risk Cleveland CTR90
Cleveland proportions for linkage to care are about half across all risk categories.
LTC (within 90 days) for the state is approximately 67% overall.
What are the barriers to LTC and how do we address them?
We need representatives from each region on the linkage to care goal work group for the integrated plan.
**interpret small numbers with caution
85.2%
51.9%
48.2%
51.9%
48.2%

12. Questions???

13. Contact Information
Angela Allen, PhD
Research Administrator
Ohio Department of Health
(614)