HIV, AIDS and HIGH RISK BEHAVIORS among BEHAVIORAL RISK GROUPS in LOS ANGELES COUNTY

1
HIV, AIDS and HIGH RISK BEHAVIORS among
BEHAVIORAL RISK GROUPS in LOS ANGELES COUNTY

• As presented by Dr. Douglas Frye
• to the PPC on January 6, 2004
• Revised to include Transgender BRG
• HIV Epidemiology Program
• Los Angeles County Department of Health Services
• Public Health

2
Outline

• Estimates of BRG populations
• HIV and AIDS Estimates for BRGs based on HARS
• New HIV Infections at State-funded Testing Sites
• Distribution of persons living with AIDS by BRG,
  Service Planning Area, and Race/Ethnicity
• High risk behaviors in BRGs
• Transgendered persons
• American Indians/Alaskan Natives

3
Estimates of BRG Populations in Los Angeles
County
4
Estimated Population Size of Behavioral Risk
Groups - LAC, as of 2000
5
HIV and AIDS Estimates for BRGs Based on
HARS(HIV/AIDS Reporting System)
6
Persons Living with AIDS by Behavioral Risk Group
- LAC HARS, as of 2/28/03
7
Estimated Number of Persons Living with HIV
(including AIDS) by BRG
28,400
BRG with AIDS
6,400
4,200
4,200
3,100
1,700
1,700
8
Proportion of Persons Living with HIV and AIDS by
BRG - LAC, 2003
3
4
3
6
8
55
8
12
9
Proportion of Estimated Annual HIV Incidence by
BRG - LAC, 2003
3.5
6
8.5
3
6
53.5
6
13.5
10
Estimated Annual HIV Incidence Proportion of All
BRGs - LAC, 2003
4
9
3
6
6
57
15
11
Number of Persons Living with AIDS in LAC by BRG
and Service Planning Area
HARS data as of 2002 does not include 801 cases
with unknown SPA.
12
Source Data Analysis Unit, HIV Epidemiology
Program
13
Persons Living with AIDS in LAC Percent BRG by
Service Planning Area
HARS data as of 2002 does not include 801 cases
with unknown SPA.
14
Estimated HIV Seroprevalence (including AIDS) by
BRG in LAC - as of 2/28/03
living with AIDS
18
17
13
8.7
6.5
3.9
2.1
Source HIV Epidemiology Program, LAC/DHS.
15
New HIV Infections at State-funded Testing Sites
16
Rate of New HIV Infections among Repeat Testers
at State-funded Test Sites by BRG - LAC, 1997 -
2001
N 48
N 10
N 20
N 81
N 113
N 653
N 36
Behavioral Risk Group
Source OAPP and HIV Epidemiology Program.
TG refers to new infections among transgendered
females. There were no new infections among
transgendered males.
17
Rate of New HIV Infections among Repeat Testers
at State-funded HIV Test Sites by Race/Ethnicity
and BRG - LAC, 1997 - 2001
White

Black

Latino




Statistically higher rate than non-starred
race/ethnicity within BRG
Source OAPP and HIV Epidemiology Program,
LAC/DHS.
18
Percent Tested and Testing Positive at
State-funded Test Sites by SPA - LAC, 2001
Testing Positive (N 614)
Tested (N 44,951)
Service Planning Area
Source OAPP, LAC/DHS.
19
Percent Tested and Testing Positive at
State-funded Test Sites by BRG - LAC, 2001
Tested (N 44,967)
Testing Positive (N 657)

Source OAPP, LAC/DHS.
20
Percent Tested and Testing Positive at
State-funded Test Sites by Race/Ethnicity - 2001
Tested (N 44,967)
Testing Positive (N 657)
Race/Ethnicity
Source OAPP, LAC/DHS.
21
Men who have sex with men (MSM)
22
Persons Living with HIV and AIDS Proportion by
Behavioral Risk GroupLos Angeles County, 2003
54
MSM
23
MSM Living with AIDS by SPA and Race/Ethnicity -
as of 12/31/02
N4,516
N1,826
N1,346
N576
N649
N636
N538
N81
24
MSM Living with AIDS by SPA and Race/Ethnicity -
as of 12/31/02
25
Men who have sex with men and women (MSM/W)
26
Persons Living with HIV and AIDS Proportion by
Behavioral Risk GroupLos Angeles County, 2003
MSM/W
12
27
MSM/W Living with AIDS by SPA and Race/Ethnicity
- LAC, as of 12/31/02
N627
N352
N259
N247
N184
N148
N81
N27
28
MSM/W Living with AIDS by SPA and Race/Ethnicity
- LAC, as of 12/31/02
29
Men who have sex with men and are injection drug
users (MSM/IDU)
30
Persons Living with HIV and AIDS Proportion by
Behavioral Risk GroupLos Angeles County, 2003
MSM- IDU
6
31
MSM-IDU Living with AIDS by SPA and
Race/Ethnicity - LAC, as of 12/31/02
N407
N225
N121
N75
N58
N46
N43
N12
32
MSM - IDU Living with AIDS by SPA and
Race/Ethnicity - LAC, as of 12/31/02
33
Heterosexual male injection drug users (HMIDU)
34
Persons Living with HIV and AIDS Proportion by
Behavioral Risk GroupLos Angeles County, 2003
8
HMIDU
35
HMIDU Living with AIDS by SPA and Race/Ethnicity
- LAC, as of 12/31/02
N261
N245
N144
N141
N91
N64
N40
N27
36
HMIDU Living with AIDS by SPA and Race/Ethnicity
- LAC, as of 12/31/02
37
Female injection drug users (FIDU)
38
Persons Living with HIV and AIDS Proportion by
Behavioral Risk GroupLos Angeles County, 2003
3
FIDU
39
FIDU Living with AIDS by SPA and Race/Ethnicity -
LAC, as of 12/31/02
N107
N101
N81
N62
N57
N30
N21
N8
40
FIDU Living with AIDS by SPA and Race/Ethnicity -
LAC, as of 12/31/02
41
Women at Sexual Risk (WSR)
42
Persons Living with HIV and AIDS Proportion by
Behavioral Risk GroupLos Angeles County, 2003
8
WSR
43
WSR Living with AIDS by SPA and Race/Ethnicity -
LAC, as of 12/31/02
N236
N221
N222
N157
N134
N97
N45
N21
44
WSR Living with AIDS by SPA and Race/Ethnicity -
LAC, as of 12/31/02
45
High-Risk Behaviorsin BRGs
46
MSMIDU, MSM, MSMW Unprotected Anal Receptive
Sex in Last 6 Months by BRG LA Young Mens
Survey, 1999 - 2000
MSMW self-identified as bisexual MSM as gay or
homosexual.
47
Percent MSM Living with AIDS Reporting
Unprotected Anal Intercourse (UAI) at Last Sex
and Reporting 10 Sex Partners in Last Year Los
Angeles SHAS, 1998 - 2003
? UAI at last sex ? 10 partners/year
(4)
48
Percent Unprotected Anal Receptive Sex Last 12
Months Among PLWA by BRGLos Angeles SHAS, 2000 -
2003
49
MSMIDU, MSM, MSMW Percent Having Sex by Type of
Partner - APLA, 2001
Note Gay MSM Bisexual MSMW Gay IDU
MSMIDU
50
Percent Ever had an STDby Behavioral Risk Group
Los Angeles SHAS, 2000 - 2003
51
Percent High on Drug/Alcohol at Last Sexby
Behavior Risk Group Los Angeles SHAS, 2000 - 2003
52
MSMIDU, MSM, MSMW Percent High on Drug/Alcohol
at Last Sex LA Young Mens Survey, 1999 - 2000
MSMW self-identified as bisexual MSM as gay or
homosexual.
53
MSMIDU, MSM, MSMW Percent Who Used Drug/Alcohol
During Sex in the last 6 months - APLA, 2001
Note Gay MSM Bisexual MSMW Gay IDU
MSMIDU Always includes Nearly always
Sometimes includes Half the time.
54
Percent Reporting High-Risk Behaviors Among
Transgendered Women in the L.A. Transgender
Health Study 1999 - 2000
In last 6 months, unless otherwise noted.
55
American Indians/ Alaskan Natives
56
Persons Living with AIDS per 1,000 Population by
Race/Ethnicity, LAC
American Indians/Alaskan Natives have 2nd highest
prevalence rate in LAC
HIV/AIDS data from HIV Epidemiology Program, as
of 11/30/2003. 2002 population estimate from
California Department of Finance.
57
American Indians/Alaskan Natives

• Out of 30,000 AI/AN living in LAC, number living
  with AIDS 96 (0.3)
• BRGs and other modes of exposure
• MSM 49
• MSM/W 14
• MSM/IDU 10
• FIDU 5
• HMIDU 5
• WSR 5
• Pediatric 1
• MSW 0
• Unknown/other 11

58
American Indian/Alaskan Native Population and
Living AIDS Cases by SPA - LAC, 2002
Population (N 29,987)
PLWA (N 96)
Service Planning Area
Source HIV Epidemiology Program, LAC/DHS, data
as of April 2002.
59
ACKNOWLEDGMENTS

• Gordon Bunch (HIV Epidemiology Program)
• Amy Wohl (HIV Epidemiology)
• Denise Fearman-Johnson (HIV Epidemiology)
• Virginia Hu (HIV Epidemiology)
• Julie Ann Carlos (OAPP)
• Trista Bingham (HIV Epidemiology) and Curtis
  Croker (Health Assessment and Epidemiology)
• Uyen Bui and Matt Mutchler (APLA)
• Paul Simon (Health Assessment and Epidemiology)
  and Cathy Reback (VNRH)