2. 2003 Countywide Risk Assessment Survey Findings From a Large-scale Multi-site Survey in Los Angeles County Pamela Ogata, Research & Evaluation Mike Janson, Research & Evaluation Office of AIDS Programs and Policy Presented at the Los Angeles HIV Prevention Planning Committee Meeting, January 6, 2004

3. Los Angeles County 4,061 Square Miles 9.9 Million Residents (Estimated) Proportion of State Population: 27% (Estimated) Proportion of State AIDS Cases: 35% Living with HIV/AIDS: 52,000 (Estimated) 2 South South Bay West San Fernando Metro San Gabriel Antelope Valley East 2003 Estimated Population Statistics, U.S. Census Bureau HIV/AIDS Semi-Annual Surveillance Summary, Los Angeles County HIV Epidemiology Program

4. 3 Background One Important Data Source for Priority Setting Evaluation of the Linkages Among HIV Prevention Plan Resource Allocation CDC Application Local Needs Assessment

5. 4 Provider Trainings 22 Trainings (May 2003) 238 Staff from 50 Agencies Attended Training covered Sampling Methodology Survey Instruments and Procedures IRB and HIPAA protocols California Mandated Child and Elder Abuse Reporting On-Site Technical Assistance

6. Source: 2003 CRAS Data (weighted) 5 CRAS 2003 Participation Surveys Total Expected: 2,520 Total Received: 2,107 Survey Return Rate: 83.6% Total Completed: 1,847 Proportion of Surveys Complete: 87.7% Agencies 47 out of 50 Participated Programs 164 out of 175 Participated

7. Source: 2003 CRAS Data (weighted) 6 Instrument and Eligibility Four Sections Examine Behavior and Perceptions Eligibility Receiving HIV Prevention Services from OAPP- funded Contractor(s) in Los Angeles County 12 Years of Age or Older Not Previously Surveyed in 2003

8. 7 Data Collection and Analysis Surveys Administered May 5 -July 30, 2003 Agency Staff One-on-one Interviews Respondents Randomly Selected Using Systematic Sampling Received Compensation (Value $10) Data Entry OAPP Staff Password-protected Database Data Entry Error Rate was <2% No Critical Variables Involved

9. 8 Weighting Surveys Weighted to Represent Average Number of Prevention Service Clients by Agency Analyses Conducted on Weighted Sample Equivalent to 5,147

10. Source: 2003 CRAS Data (weighted) 9 Clients by Service Planning Area SPAs N=5147 Percent

11. Source: 2003 CRAS Data (weighted) 10 Numbers may not equal 100% due to rounding CRAS Respondents by Gender N=5147

12. Source: 2003 CRAS Data (weighted) 11 Clients by Age Percent

13. Source: 2003 CRAS Data (weighted) 12 CRAS Respondents by Race Ethnicity and Service Planning Area N=5147 Percent

14. Source: 2003 CRAS Data (weighted) 13 Selected CRAS Respondents by Education N=3,696 Completed HS or received a GED76.7% 1-2 years of college includes technical/ vocational school 40.8% 3 or more years of college21.6% Four-year college degree15.6% Graduate or professional school5.7% Of participants 25 years of age or older…

15. Source: 2003 CRAS Data (weighted) 14 CRAS Respondents by Living Situation House or Apartment70.2% Transitional Living (Halfway House, Treatment Center, Board and Care Facility, Hotel, Motel or Rooming House) 20.0% Homeless (Shelter, Mission, Vacant Building, Car or Other Vehicle, Outside, Street, Park, Bench, Under an Overpass) 8.6% With Friends or Relatives0.6% Numbers may not equal 100% due to rounding and missing data

16. Source: 2003 CRAS Data (weighted) 15 Proportion of CRAS Respondents Who Are Homeless by PPC Priority Percent

17. Source: 2001-03 CRAS Data (weighted) 16 Homeless CRAS Respondents Percent

18. Source: 2003 CRAS Data (weighted) 17 Of CRAS Respondents 22% Born Outside of the United States

19. Source: 2003 CRAS Data (weighted) 18 CRAS Respondents and Substance Use Any Substance86.9% Alcohol71.8% Tobacco56.3% Marijuana37.3% Any Drug56.8% (Excluding Marijuana, Alcohol, Tobacco) Crack Cocaine19.1% Crystal Methamphetamine15.6%

20. Source: 2003 CRAS Data (weighted) 19 CRAS Respondents and Substance Use (Cont’d) Heroin14.3% Cocaine (not crack)11.4% Other Opiate10.9% Speedball7.2% Inhalant6.8% Other Amphetamine6.5% Club Drugs6.9% Other Drugs6.8%

21. Source: 2003 CRAS Data (weighted) 20 CRAS Respondent Drug Use by BRG Percent N=3,684

22. Source: 2003 CRAS Data (weighted) 21 CRAS Respondent Injection Drug Use N=5,147 Injected Drugs (last 6 mos.)19.1% N=990 Shared Needle(s)56.2% Cleaned Needle(s) with Bleach37.8% Of those who injected drugs…

23. Source: 2003 CRAS Data (weighted) 22 Sexual Risk Behaviors HIV-Negative CRAS Respondents MainCasualPartner N=1,825N=1,716 Had a Main Partner65.3% Had a Casual Partner(s)61.4% Median Number Casual Partners5 Partner(s) HIV-Positive4.2%6.0% Did Not Know Partner(s) Serostatus 9.5%39.3% Partner(s) Injects Drugs16.1%17.1% Sex While High58.1%65.4% Inconsistent Condom Use74.1%59.2%

24. Source: 2003 CRAS Data (weighted) 23 Sexual Risk Behaviors HIV-Positive CRAS Respondents MainCasualPartner N=1,825N=1,716 Had a Main Partner61.5% Had a Casual Partner(s)64.6% Median Number Casual Partners6 Partner(s) HIV-Positive53.8%35.3% Did Not Know Partner(s) Serostatus 8.0%51.1% Partner(s) Injects Drugs22.0%26.2% Sex While High44.2%59.8% Inconsistent Condom Use48.1%57.2%

25. Source: 2003 CRAS Data (weighted) 24 Male CRAS Respondents, Sexual Orientation and Sexual Behavior Self-Reported Sexual Orientation 31.7% Heterosexual 52.6% Gay 15.7% Bisexual Sexual Behavior Proportion of Heterosexual Men who Reported Sex with a Man13.4% Proportion of Gay Men Reporting Sex With a Woman <1%

26. Source: 2003 CRAS Data (weighted) 25 CRAS Respondents by Behavioral Risk Group (BRG) N=5,147

27. Source: 2003 CRAS Data (weighted) 26 Clients by Behavioral Risk Group (BRG) Percent

28. Source: 2003 CRAS Data (weighted) 27 CRAS Respondents by Behavioral Risk Group (BRG) and SPA Percent

29. Source: 2003 CRAS Data (weighted) 28 Reported Inconsistent Condom, Barrier Use by PPC Priorities Percent

30. Source: 2003 CRAS Data (weighted) 29 CRAS Respondents and HIV Counseling & Testing HE/RR, HCT ClientsN=4,903 Ever Received HCT87.2% Received HCT Results82.1% HCT Last Six Months51.2%

31. Source: 2003 CRAS Data (weighted) 30 CRAS Respondents and HIV Counseling & Testing (Cont’d) Received HCT Results N=4,021 HIV-Positive10.1% Positive Result, Last Six Months4.5% HIV-Negative82.6% Unknown5.8%

32. Source: 2001-03 CRAS Data (weighted) 31 CRAS Respondents by HIV Counseling & Testing 2001-2003 (HE/RR, HCT clients) Percent

33. Source: 2003 CRAS Data (weighted) 32 Limitations Limited Time Period May Not Capture All Drug Users May Contribute to the Unknown BRG Category

34. 33 Conclusions CRAS Provides timely and geographically relevant data. Shows a need for more focused outreach in communities of color Suggests a need to refine the targeting of prevention services

35. Source: 2003 CRAS Data (weighted) 34 Data Requests Please send an e-mail or FAX data request to: Pamela Ogatapogata@dhs.co.la.ca.uspogata@dhs.co.la.ca.us or Mike Jansonmjanson@dhs.co.la.ca.usmjanson@dhs.co.la.ca.us Fax: 213/381-8023

36. This presentation is available at www.LAPublicHealth.org/AIDS