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HIV/AIDS Among Injection Drug Users* Florida

HIV/AIDS Among Injection Drug Users* Florida. Bureau of HIV/AIDS HIV/AIDS Surveillance Section (850) 245-4430 or SC 205-4430. *IDU data include IDU and MSM/IDU cases Data for 2004, as of 03/20/05.

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HIV/AIDS Among Injection Drug Users* Florida

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  1. HIV/AIDS Among Injection Drug Users*Florida Bureau of HIV/AIDS HIV/AIDS Surveillance Section (850) 245-4430 or SC 205-4430 *IDU data include IDU and MSM/IDU cases Data for 2004, as of 03/20/05

  2. Estimated Number Injection Drug Users (IDUs)According to HIV-Infection Status Title I Eligible Metropolitan Areas, Florida* Number IDUs *Statewide, it is estimated that there are as many as 96,300 IDUs, of whom approximately 18,300 (19%) are HIV infected. (Data are provisional.) Source: Bureau of HIV/AIDS

  3. Presumed Alive IDU and MSM/IDU HIV/AIDS Cases Presumed Living IDU and MSM/IDU HIV/AIDS Cases Florida, Reported through 2004 N=9,467 County totals exclude Department of Corrections cases (N=1,180). Data as of 12/31/2004

  4. HIV Case Reporting • Reflects good demographic information • Tends to represent more recent infections • Not Population Based • Now includes all reported HIV cases regardless of AIDS status • No retroactive reporting prior to July 1997 • Patients are tested on a self-selected basis • Anonymous tests are not reported • Data represents a minimum estimate of HIV prevalence

  5. Males Females Number of IDU* AIDS Cases by Sex and Year of Report, Florida, 1995-2004 M:F Ratio 1995 2.6:1 2004 2.4:1 Comment: AIDS cases tend to represent HIV transmission that occurred many years ago. * IDU data include IDU and MSM/IDU cases Note: NIRs redistributed.

  6. Males Females Number of IDU* HIV Cases (regardless of AIDS status) By Sex and Year of Report, Florida, 1998-2004 M:F Ratio 1998 1.8:1 2004 2.6:1 Comment: * IDU data include IDU and MSM/IDU cases Note: NIRs redistributed.

  7. Living Adult HIV/AIDS Cases (PLWHAs)With IDU* Related RiskFor Selected Counties**, Florida, Data through 2004 Note: NIRs redistributed.

  8. Living Adult HIV/AIDS Cases (PLWHAs)With IDU* Related RiskBy EMA**, Florida, Data through 2004 Note: NIRs redistributed.

  9. Florida Adult AIDS Cases by Mode of Exposure* Reported through 2004 (N =95,179) Adult AIDS Cases by Mode of Exposure* Reported in 2004 (N =5,710) *Note: Exploded pieces are IDU-related AIDS cases **”All other” includes cases under investigation Note: NIRs redistributed.

  10. Adult Male Cases By Mode of Exposure, Florida, 2004 AIDS N=(4,056) HIV (regardless of AIDS status) N=(4,362) HIV data includes those cases that have converted to AIDS. These HIV cases cannot be added with AIDS cases to get combined totals since the categories are not mutually exclusive. Exploded pieces are IDU-related risks. Note: NIRs redistributed.

  11. Adult Female Cases By Mode of Exposure, Florida, 2004 HIV (regardless of AIDS status) N=(1,942) AIDS N=(1,741) HIV data includes those cases that have converted to AIDS. These HIV cases cannot be added with AIDS cases to get combined totals since the categories are not mutually exclusive. Exploded pieces are IDU-related risks. Note: NIRs redistributed.

  12. Cumulative Pediatric HIV/AIDS Cases By “Expanded” Exposure Category Florida, Reported Through 2004 N=1,941 M=mother Msx=mother with a heterosexual risk *Comment: Injection drug use directly or indirectly accounts for 37% of the 1,778 pediatric HIV/AIDS cases among those <13 years of age. (Exploded pieces account for mom’s IDU related risks.) Note: NIRs redistributed.

  13. Living Adult Male HIV/AIDS Cases (PLWHAs) By Race/Ethnicity and Mode of Exposure Florida, Data through 2004 White, non-Hispanic N=(19,335) Black, non-Hispanic N=(22,056) Hispanic N=(10,491) Comment: Among male PLWHAs, the distribution of risk among blacks differs from that among whites and Hispanics. Exploded pieces are IDU-related risks. Note: Adjustments have been made to redistribute NIR cases. Data as of March 20, 2005.

  14. Living Adult Female HIV/AIDS Cases (PLWHAs) By Race/Ethnicity and Mode of Exposure Florida, Data through 2004 White, non-Hispanic N=(3,792) Black, non-Hispanic N=(16,485) Hispanic N=(2,729) Comment: Among female PLWHAs, the distribution of risk among whites differs from that among blacks and Hispanics. Exploded pieces are IDU-related risks. *Other includes hemophilia, transfusion, other pediatric risks and other confirmed risks. Adjustments have been made to redistribute NIR cases. Data as of March 20,2005.

  15. Living Adult Male HIV/AIDS Cases (PLWHAs) By Race/Ethnicity and Mode of Exposure Florida, Data through 2004 White, non-Hispanic N=(18,921) Black, non-Hispanic N=(21,211) Hispanic N=(9,897) Other Hetero Het Sx. w/ IDU MSM IDU Comment: Among male PLWHAs, the distribution of risk among blacks differs from that among whites and Hispanics, with proportionately fewer MSM cases and more IDU-related cases. Exploded pieces are IDU-related risks. Adjustments have been made to redistribute NIR cases. Data as of March 1, 2004. Note: NIRs redistributed.

  16. Living Adult Female HIV/AIDS Cases (PLWHAs) By Race/Ethnicity and Mode of Exposure Florida, Data through 2004 White, non-Hispanic N=(3,689) Black, non-Hispanic N=(15,761) Hispanic N=(2,572) Other Hetero. IDU Het Sx. w/ IDU Comment: Among female PLWHAs, the distribution of risk among blacks differs from that among whites and Hispanics, with proportionately more heterosexual cases and fewer IDU-related cases. Exploded pieces are IDU-related risks. Adjustments have been made to redistribute NIR cases. Data as of March 1, 2004.

  17. Percent of Total SHAS Participants Who Admitted Ever Using Injection Drugs Comment: The decreasing trend in lifetime use of injection drugs is consistent with the trends observed in other indicators. Behavioral survey data provide further evidence to support this.

  18. Drug Injected Most OftenBy SHAS Participants

  19. IDU Participants’ Primary Needle-Sharing Partners Florida SHAS, July 1, 2000-December 31, 2003 MalesN=123 FemalesN=38

  20. Supplement to HIV/AIDS Surveillance (SHAS)* Primary Drug Among Those Using Non-Injection Drugs Within Year Prior to Interview, 2000-2003 MalesN=359 FemalesN=123 *SHAS is a structured interview survey of HIV-positive clients in publicly funded HIV patient care clinics in selected counties.

  21. Youth Risk Behavior Surveillance System (YRBS) Two-stage Random Sample of 4,080 High School Students, Florida, 2003, Selected Substance Abuse, by Grade 9th 10th 11th 12th 5+ drinks in a row in past 30 days 17% 23% 26% 31% Marijuana use in past 30 days 18% 21% 24% 25% Cocaine use (any) in past 30 days 3% 4% 4% 5% Methamphetamines (lifetime use) 6% 7% 6% 7% Injection drug use (lifetime use) 2% 3% 3% 4% Comment: There is a gradient of response for alcohol use, but not for the other categories of substance abuse.

  22. Youth Risk Behavior Surveillance System (YRBSS) Florida, 2003 Total White Black Hispanic 5+ drinks in a row in past 30 days 23% 29% 11% 23% Marijuana use in past 30 days 21% 25% 16% 16% Cocaine use (any) in past 30 days 4% 5% 3% 4% Methamphetamines (lifetime use) 6% 8% 3% 4% Injection drug use (lifetime use) 3% 3% 3% 3% Comment: White high school students tend to report the greatest frequency of substance abuse behavior, except for IDU, perhaps reflecting the economics of access. Substance abuse can cloud judgment, leading to risk taking. NOTE: Dropouts are not captured in the data.

  23. Youth Risk Behavior Surveillance System (YRBS) (Continued) 2001 2003 % Change Used any form of cocaine (lifetime) 8.3% 8.1% -2% Used any form of cocaine (past 30 days) 4.0% 4.0% 0% Injected illegal drug (lifetime) 2.7% 2.9% +7% Comment: Cocaine use increased among high school students, while injection drug use decreased from 1995 to 2001. This trend might provide supporting evidence for trends seen with regard to substance abuse concerning HIV/AIDS morbidity and the SHAS study.

  24. Conclusions • In Florida, more than 10,000 HIV/AIDS cases per year have been reported from 1998-2003, representing a leveling of a downward trend. A marked decreasing trend in HIV cases among IDUs is evident. • The number of persons living with HIV/AIDS has steadily risen to nearly 69,000 cases through 2002. IDUs and MSM/IDUs account for 19% of this total. • The number of PLWHAs is increasing markedly each year for those in each risk group. • PLWHA cases due to MSM predominate, while those due to heterosexual contact are increasing the fastest. • Patterns of HIV/AIDS vary considerably by geographic area, sex, risk, and race/ethnicity. Non-Hispanic blacks are disproportionately impacted by HIV/AIDS. The reasons for this are multi-factorial and complex.

  25. Conclusions (continued) HIV/AIDS deaths are 60% lower than when they peaked in 1995. • There is evidence to suggest that fatality and competing forms of non- injection drug use might be contributing to the observed declines in injection drug use, according to various indicators. • The HIV/AIDS data suggest a higher prevalence of injection drug use among adult blacks, while the behavioral surveillance data suggest a higher prevalence among white high school students. Early patterns of experimentation might partially account for this. • White high school students report a higher prevalence of heavy drinking and other non-injection drug abuse than Hispanics or blacks. • The average ratio of the estimated numbers of MSM to IDUs is approx. 2:1 in the 6 largest MSAs in Florida, which has implications for behavioral surveillance and resource allocation.

  26. Abbreviations • MSM = Men who have Sex with Men • IDU = Injecting Drug User • Het. Sex w/IDU = Heterosexual Sex with Injection Drug User • Het. Sex other risks = Heterosexual Sex with person with other risks • M-IDU = Mother Injection Drug User • Msx-IDU = Mother had Sex with Injection Drug User • Msx-HIV/AIDS = Mother had Sex with someone with HIV/AIDS • M-HIV/AIDS = Mother has HIV/AIDS

  27. For Florida HIV/AIDS Surveillance Data Contact: (850) 245-4444 Lorene Maddox, MPH Ext. 2613 Tracina Bush Ext. 2612 Deslyn Thornhill, MPH Ext. 2517 Internet http://www.doh.state.fl.us/disease_ctrl/aids/index.html Intranet http://dohiws.doh.state.fl.us

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