1. Impact of HIV Disease by Country of Birth in Florida, Reported Through 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division of Disease Control and Health Protection Annual data trends as of 12/31/2012 Living (Prevalence) data as of 06/30/2013 Created: 08/12/13 Revision: 09/20/13 To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.

2. HIV and AIDS Case Data  Adult cases represent ages 13 and older, pediatric cases are those under the age of 13. For data by year, the age is by age of diagnosis. For living data, the age is by current age at the end of the most recent calendar year, regardless of age at diagnosis.  Unless otherwise noted, whites are non-Hispanic and blacks are non-Hispanic.  Total statewide data will include Department of Correction Cases (DOC) unless otherwise noted. County data will exclude DOC cases.  HIV prevalence data are generated later in the year, usually in May, when most of the “expected” death data are complete.  Unless otherwise note, cases with an unknown or blank country of birth were eliminated from these analyses.

3. ESCAMBIA SANTA ROSA OKALOOSA WALTON HOLMES WS BAY JACKSON CN GF LIBERTY FK GD LEON WK JF TAYLOR MD SW LF DIXIE LEVY CB NASSAU MARION PASCO PTPT CLAY BK DUVA L ST J VL ORANGE BREVARD OSCEOLA POLKHB PN DESOTO LEE HENDRY COLLIER MARTIN ST LUCIE OB HG 10 9 15 7 12 4 3 2 1 13 6 8 14 Florida Areas SS Area 5 Pasco Pinellas FG MONROE DADE PALM BEACH GLADESCHARLOTT E IR HR SM HN CT STST LAKE GC AL BFUN HM 5 11 Area 4 Baker Clay Duval Nassau St Johns Area 3 Alachua Bradford Columbia Dixie Gilchrest Hamilton Lafayette Levy Putnam Suwannee Union Area 10 Broward Area 8A CharlotteDeSoto Glades Sarasota Hendry Collier Lee Area 6 Hernando Hillsborough Manatee Area 2a Bay Calhoun Gulf Holmes Jackson Washington Area 11a Dade Area 1 Escambia Okaloosa Santa Rosa Walton Area 9 Palm Beach Area 7 Brevard Orange Osceola Seminole Area 14 Hardee Highlands Polk Area 15 Indian River Martin Okeechobee St Lucie Area 12 Flagler Volusia Area 13 Citrus Lake Marion Sumter BROWARD MA Area 11b Monroe Area 2b Franklin Gadsden Jackson Jefferson Leon Liberty Madison Taylor Wakulla

4. Definitions of Mode of Exposure Categories  MSM = Men who have sex with men  IDU = Injection Drug Use  MSM/IDU = Men who have sex with men & Injection Drug Use  Heterosexual = Heterosexual contact with person with HIV/AIDS or known HIV risk  OTHER = includes hemophilia, transfusion, perinatal and other pediatric risks and other confirmed risks.  NIR = Cases reported with No Identified Risk  Redistribution of NIRs = This illustrates the effect of statistically assigning (redistributing) the NIRs to recognized exposure (risk) categories by applying the proportions of historically reclassified NIRs to the unresolved NIRs.

5. Florida’s Population* by Country of Birth (2010 U.S. Census) * U.S. Census Bureau, 2008-2010 American Community Survey 3-year Estimate http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

6. Male AIDS Cases by Race/Ethnicity and Country of Birth* and Year of Diagnosis, 2003-2012, Florida *FB=Foreign Born, USB=US Born Note: Among U.S.-born males, each year the majority of AIDS cases were U.S.-born blacks, followed by U.S.-born whites. Among Foreign-born males, each year the majority of AIDS cases with a known country of birth were foreign-born Hispanics, followed by foreign-born blacks.

7. Female AIDS Cases by Race/Ethnicity and Country of Birth* and Year of Diagnosis, 2003-2012, Florida *FB=Foreign Born, USB=US Born Note: Among U.S.-born females, each year the majority of AIDS cases were among U.S.-born black females. Likewise, among foreign-born females, each year the majority of AIDS cases were among foreign-born black females.

8. Male HIV Infection Cases by Race/Ethnicity and Country of Birth* and Year of Diagnosis, 2003-2012, Florida *FB=Foreign Born, USB=US Born Note: Among U.S.-born males, each year the majority of HIV cases were U.S.-born blacks, followed by U.S.-born whites. Among Foreign-born males, each year the majority of HIV cases with a known country of birth were foreign-born Hispanics.

9. Female HIV Infection Cases by Race/Ethnicity and Country of Birth* and Year of Diagnosis, 2003-2012, Florida *FB=Foreign Born, USB=US Born Note: Among U.S.-born females, each year the majority of HIV cases were among U.S.-born black females. Likewise, among foreign-born females, each year the majority of AIDS cases were among foreign-born black females.

10. Adult HIV/AIDS Cases, Known Dead, Regardless of Cause, by Race/Ethnicity and Country of Birth* and Year of Death, 2003-2012, Florida *FB=Foreign Born, USB=US Born Note: Among U.S.-Born HIV/AIDS cases, each year the majority of cases deaths were U.S.- born blacks. Meanwhile among foreign-born HIV/AIDS cases, each year the majority of case deaths were foreign-born Hispanics.

11. Impact of HIV Disease Among Blacks, by Country of Birth in Florida, Reported through 2012

12. Black Foreign-Born Adults Living with HIV Disease by Country of Birth and Year of Report, 2003-2012, Florida Note: Each year, the majority of black foreign born adults living with HIV disease were Haitian born. Enhanced reporting laws were implemented in Nov. 2006, leading to an artificial spike in HIV cases between 2007 and 2008, then a subsequent artificial dip between 2008 and 2009.

13. Black Foreign-Born, Adult HIV/AIDS Cases, Known Dead, Regardless of Cause, by Country of Birth and Year of Death, 2003-2012, Florida Note: Each year, the majority of black foreign born HIV/AIDS case deaths were Haitian born. Enhanced reporting laws were implemented in Nov. 2006, leading to an artificial spike in HIV cases between 2007 and 2008.

14. Males N=27,467 Females N=20,103 Black Adults Living with HIV Disease, by Country of Birth and Sex, Reported through 2012, Florida Foreign-BornUS BornUnknown* Note: The majority (78% males and 76% females) of blacks living with HIV disease in Florida were born in the United States.

15. Black Adults Living with HIV Disease, by Selected Country of Birth, Reported through 2012, Florida Over 100 Cases51-100 Cases 1-50 Cases0 Cases Living HIV/AIDS Cases Haiti N=7,247 Jamaica N=964

16. Non-U.S. Born Blacks Living with HIV Disease, by Country of Birth and Reporting Area, Reported through 2012, Florida N=9,518

17. Black Adults Living with HIV Disease, by Country of Birth*, Reported through 2012, For Florida and Selected South Florida Counties** *Data sorted by foreign country of birth by number of cases, and excludes cases whose country of birth is unknown. **County data exclude Department of Correction cases.

18. Black Adults Living with HIV Disease, by Country of Birth, Reported through 2012, Florida and South Florida Counties Florida (N=46,116) Miami-Dade (N=11,361) Broward (N=7,752) Palm Beach (N=4,718)

19. Black Adults Living with HIV Disease, by Country of Birth and Sex, Reported through 2012, Florida and South Florida *South Florida = Dade, Broward, and Palm Beach Counties (excl DOC) Males (N=26,558) Females (N=19,558) Florida Males (N=12,874) Females (N=10,957) South Florida

20. Black Adults Living with HIV Disease, by Country of Birth and Sex, Reported through 2012, Florida and Central Florida *Central Florida = Orange, Osceola and Seminole Counties (excl DOC) Florida Males (N=2,061) Females (N=1,351) Central Florida Males N=26,558) Females (N=19,558)

21. Black Adults Living with HIV Disease, by Country of Birth and Sex, Reported through 2012, Florida and Southwest Florida *Southwest Florida = Hernando, Hillsborough, Pasco and Pinellas Counties (excl DOC) Florida Males (N=2,129) Females (N=1,473) Southwest Florida Males (N=26,558) Females (N=19,558)

22. Black Adult Males Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Florida Haiti N=3,981 Jamaica N=584 U.S. Born N=21,230 Note: NIRs redistributed. Heterosexual contact is a much more common risk factor among male cases born in Haiti and Jamaica, compared to US-born cases.

23. Black Adults Females Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Florida Haiti N=3,266 Jamaica N=380 U.S. Born N=15,273 Note: NIRs redistributed. Female US-born cases were more likely to be injection drug users than their Haitian-born or Jamaican-born counterparts.

24. Black Adult Males Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, South Florida* Haiti N=3,111 Jamaica N=440 U.S. Born N=8,857 Note: NIRs redistributed. *South Florida = Dade, Broward, and Palm Beach Counties (excl DOC) Note: NIRs redistributed. Heterosexual contact is a much more common risk factor among male cases born in Haiti and Jamaica, compared to US-born cases.

25. Black Adult Females Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, South Florida* *South Florida = Dade, Broward, and Palm Beach Counties (excl DOC) Haiti N=2,604 Jamaica N=309 U.S. Born N=7,659 Note: NIRs redistributed. Note: NIRs redistributed. Female US-born cases were more likely to be injection drug users than their Haitian-born or Jamaican-born counterparts.

26. Black Adult Males Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Central Florida* *Central Florida = Orange, Osceola and Seminole Counties (excl DOC) Haiti N=299 Jamaica N=37 U.S. Born N=1,635 Note: NIRs redistributed. Note: NIRs redistributed. Heterosexual contact is a much more common risk factor among male cases born in Haiti and Jamaica, compared to US-born cases.

27. Black Adult Females Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Central Florida* *Central Florida = Orange, Osceola and Seminole Counties (excl DOC) Haiti N=271 Jamaica N=20 U.S. Born N=969 Note: NIRs redistributed. Note: NIRs redistributed. Female US-born cases were more likely to be injection drug users than their Haitian-born or Jamaican-born counterparts.

28. Black Adult Males Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Southwest Florida* *Southwest Florida = Hernando, Hillsborough, Pasco and Pinellas Counties (excl DOC) Haiti N=55 Jamaica N=24 U.S. Born N=1,993 Note: NIRs redistributed. Heterosexual contact is a much more common risk factor among male cases born in Haiti and Jamaica, compared to US-born cases.

29. Black Adult Females Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Southwest Florida* *Southwest Florida = Hernando, Hillsborough, Pasco, and Pinellas Counties (excl DOC) Haiti N=35 Jamaica N=15 U.S. Born N=1,374 Note: NIRs redistributed. Female US-born cases were more likely to be injection drug users than their Haitian-born or Jamaican-born counterparts.

30. Black Adults Living with HIV Disease by Country of Birth, Mode of Exposure* and Sex, Reported through 2012, Florida

31. Impact of HIV Disease Among Hispanics, by Country of Birth in Florida, Reported Through 2012

32. Hispanic Foreign-Born HIV/AIDS Cases, by Country of Birth and Year of Report, 2003-2012, Florida Note: Each year, the majority of Hispanic foreign-born HIV/AIDS cases with a known country of birth were Cuban-born followed by Puerto Rican-born.

33. Hispanic Foreign-Born, Adult HIV/AIDS Cases, Known Dead, Regardless of Cause, by Country of Birth and Year of Death, 2003-2012, Florida Note: Each year, the majority of Hispanic foreign born HIV/AIDS case deaths with a known country of birth were Cuban born, followed by Puerto Rican born.

34. Males N=16,036 Females N=3,915 Foreign-BornUS BornUnknown* Note: The majority (59% for males and 52% for females) of Hispanics living with HIV disease in Florida were foreign-born. Hispanic Adults Living with HIV Disease, by Country of Birth and Sex, Reported through 2012, Florida

35. Cuba N=3,068 Over 100 Cases51-100 Cases 1-50 Cases0 Cases Living HIV/AIDS Cases Puerto Rico N=1,983 Hispanic Adults Living with HIV Disease, by Selected Country of Birth, Reported through 2012, Florida

36. Non-U.S. Born Hispanics Living with HIV Disease, by Country of Birth, by Reporting Area, Reported through 2012, Florida N=11,468

37. *Data sorted by foreign country of birth by number of cases, and excludes cases whose country of birth is unknown. **County data exclude Department of Correction cases. Hispanic Adults Living with HIV Disease, by Country of Birth*, Reported through 2012, for Florida and Selected South Florida Counties**

38. Living Hispanic Adults Living with HIV Disease by Country of Birth, Reported through 2012, Florida and South Florida Counties Florida (N=17,588) Miami-Dade (N=8,841) Broward (N=1,997) Palm Beach (N=871)

39. Hispanic Adults Living with HIV Disease by Country of Birth and Sex, Reported through 2012, Florida and South Florida Males (N=14,063) Females (N=3,525) Florida Males (N=9,721) Females (N=1,988) South Florida *South Florida = Dade, Broward, and Palm Beach Counties (excl DOC)

40. Hispanic Adults Living with HIV Disease by Country of Birth and Sex, Reported through 2012, Florida and Central Florida Florida Males (N=1,408) Females (N=513) Central Florida *Central Florida = Orange, Osceola and Seminole Counties (excl DOC) Males (N=14,063) Females (N=3,525)

41. Hispanic Adults Living with HIV Disease by Country of Birth and Sex, Reported through 2012, Florida and Southwest Florida Florida Males (N=940) Females (N=388) Southwest Florida *Southwest Florida = Hernando, Hillsborough, Pasco and Pinellas Counties (excl DOC) Males (N=14,063) Females (N=3,525)

42. Hispanic Adult Males Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Florida Cuba N=2,766 Puerto Rico N=1,437 U.S. Born N=4,644 Note: NIRs redistributed. Injection drug use is a much more common risk factor among male cases born in Puerto Rico, while MSM cases were more predominate among Cuban-born and US-born cases.

43. Cuba N=302 Puerto Rico N=546 U.S. Born N=1,476 Hispanic Adult Females Living with HIV Disease, by Selected Country of Birth and Mode of Exposure, Reported through 2012, Florida Note: NIRs redistributed. Female Cuban-born cases were less likely to be injection drug users than their U.S.-born or Puerto Rico-born counterparts.

44. Hispanic Adult Males Living with HIV Disease by Selected Country of Birth and Mode of Exposure, Reported through 2012, South Florida* Cuba N=2,509 Puerto Rico N=687 U.S. Born N=2,550 *South Florida = Dade, Broward, and Palm Beach Counties (excl DOC) Note: NIRs redistributed. Injection drug use is a much more common risk factor among male cases born in Puerto Rico, while MSM cases were more predominate among Cuban-born and US-born cases.

45. Cuba N=274 Puerto Rico N=204 U.S. Born N=632 Hispanic Adult Females Living with HIV Disease by Selected Country of Birth and Mode of Exposure, Reported through 2012, South Florida* *South Florida = Dade, Broward, and Palm Beach Counties (excl DOC) Note: NIRs redistributed. Female Cuban-born cases were less likely to be injection drug users than their U.S.-born or Puerto Rico-born counterparts.

46. Hispanic Adult Males Living with HIV Disease by Selected Country of Birth and Mode of Exposure, Reported through 2012, Central Florida* Cuba N=38 Puerto Rico N=336 U.S. Born N=725 *Central Florida = Orange, Osceola and Seminole Counties (excl DOC) Note: NIRs redistributed. Injection drug use is a much more common risk factor among male cases born in Puerto Rico, while MSM cases were more predominate among Cuban-born and US-born cases.

47. Cuba N=4 Puerto Rico N=137 U.S. Born N=290 Hispanic Adult Females Living with HIV Disease by Selected Country of Birth and Mode of Exposure, Reported through 2012, Central Florida* *Central Florida = Orange, Osceola and Seminole Counties (excl DOC) Note: NIRs redistributed. Female Cuban-born cases were less likely to be injection drug users than their U.S.-born or Puerto Rico-born counterparts.

48. Hispanic Adult Males Living with HIV Disease by Selected Country of Birth and Mode of Exposure, Reported through 2012, Southwest Florida* Cuba N=60 Puerto Rico N=135 U.S. Born N=533 *Southwest Florida = Hernando, Hillsborough, Pasco and Pinellas Counties (excl DOC) Note: NIRs redistributed. Injection drug use is a much more common risk factor among male cases born in Puerto Rico, while MSM cases were more predominate among Cuban-born and US-born cases.

49. Cuba N=17 Puerto Rico N=94 U.S. Born N=213 Hispanic Adult Females Living with HIV Disease by Selected Country of Birth and Mode of Exposure, Reported through 2012, Southwest Florida* *Southwest Florida = Hernando, Hillsborough, Pasco and Pinellas Counties (excl DOC) Note: NIRs redistributed. Female Cuban-born cases were less likely to be injection drug users than their U.S.-born or Puerto Rico-born counterparts.

50. Hispanic Adults HIV/AIDS Cases by Country of Birth, Mode of Exposure* and Sex, Reported through 2012, Florida

51. For Florida HIV/AIDS Surveillance Data Contact: (850) 245-4444 Lorene Maddox, MPH Ext. 2613 Tracina Bush, BSW Ext. 2612 Madgene Moise, MPH Ext. 2373 Visit Florida’s internet site for: Monthly Surveillance Reports Slide Sets and Fact Sheets Annual Reports and Epi Profiles http://www.doh.state.fl.us/disease_ctrl/aids/trends/trends.html Visit CDC’s HIV/AIDS internet site for: Surveillance Reports, fact sheets and slide sets http://www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htm