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Data Trends: FPAR & HIV Prevention Project. OPA/OFP HIV Prevention Project Annual Technical Support Conference June 12, 2007 Presented by Kelly Morrison Opdyke, MPH Cicatelli Associates Inc. Learning Objectives. Describe key findings from the 2005 Family Planning Annual Report (FPAR)
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Data Trends:FPAR & HIV Prevention Project OPA/OFP HIV Prevention Project Annual Technical Support Conference June 12, 2007 Presented by Kelly Morrison Opdyke, MPH Cicatelli Associates Inc.
Learning Objectives • Describe key findings from the 2005 Family Planning Annual Report (FPAR) • Review epidemiology of HIV/AIDS in relation to Title X users • Examine national and regional OPA HIV Prevention Project data trends • Compare trends in FPAR and HIV Prevention Project data with national trends
Family Planning Annual Report • The only source of annual, uniform reporting by all Title X service grantees • Enables Title X administrators and grantees to: • Monitor program performance • Comply with federal accountability rules • Guide strategic and financial planning • Estimate impact of Title X-supported activities on key reproductive health outcomes • Published reports available online from OPA: http://opa.osophs.dhhs.gov/titlex/ofp_references.html
FPAR 2005: User Demographics • 5,002,961 family planning users • 95% female, 5% male • 66% below 100% of federal poverty level (FPL) • 60% uninsured • 58% under age 25 • 48% racial and/or ethnic minorities
FPAR 2005: Users by Race/Ethnicity N=5,002,961
FPAR 2005: HIV Testing • HIV test volume increased by 14% in 2005 • 607,974 confidential HIV tests • 519,221 tests among females (85% of all tests) • 88,753 tests among males (15% of all tests) • 1,114 positive confidential tests (0.18%) • 13,349 anonymous HIV tests
FPAR 2005: STD and HIV Testing *Confidential HIV Tests Only
HIV/AIDS among Women Nature of the epidemic • Women of color (especially African American women) are the hardest hit • Younger women are more likely to get HIV • AIDS is a common killer, second only to cancer and heart disease for women Most common modes of transmission • Having sex with a man who has HIV • Sharing injection drug works (needles, etc.) Source: CDC HIV/AIDS among Women Fact Sheet, March 2007
HIV/AIDS among Women • Since 1985 the proportion of estimated AIDS cases diagnosed among women has more than tripled, from 8% in 1985 to 27% in 2004. • In 2004, women of color accounted for 80% of all women estimated to be living with AIDS; black women made up 64% of this total. Source: CDC HIV/AIDS among Women Fact Sheet, March 2007
HIV/AIDS among Youth Nature of the epidemic • 13% of the persons diagnosed with HIV or AIDS in 2004 were age 13-24 years • Young people of racial/ethnic minorities are at increased risk for infection through sexual risk behavior (heterosexual and MSM) Risk Factors • Earlier age at sexual initiation • Higher STD rates Source: CDC HIV/AIDS among Youth Fact Sheet, June 2006
HIV/AIDS Diagnoses by Age Source: CDC Surveillance 2004
HIV Prevention Project (HIVPP) GOAL: • To supplement existing Title X grants, in communities with demonstrated high risk for HIV/AIDS, to implement or expand HIV on‑site prevention counseling, testing, and referral services Cycle 1: Oct 2001 – Aug 2004 34 projects 8 PHS regions (19 states) Cycle 2: Sep 2004 – Sep 2007 63 projects 10 PHS regions (27 states)
HIVPP: Outcome Measures • Number of individual HIV counseling sessions • Number of HIV tests by test mode and type • Confidential v. Anonymous • Standard v. Rapid • Number of positive HIV tests • Number of clients returning for test results and post-test counseling • Number of positive clients referred for Tx/care • HIV testing by race & ethnicity • HIV testing by gender & age group
HIVPP: Counseling Sessions Cycle 1, Periods 1-5 (Oct-01 to Aug-04) and Cycle 2, Periods 1-4 (Sep-04 to Dec-06)
Cycle 2 Cycle 1 HIVPP: Counseling Sessions Cycle 1, Periods 1-5 (Oct-01 to Aug-04) and Cycle 2, Periods 1-4 (Sep-04 to Dec-06)
HIVPP: HIV Tests by Period Cycle 1, Periods 1-5 (Oct-01 to Aug-04) and Cycle 2, Periods 1-4 (Sep-04 to Dec-6)
HIVPP: HIV Tests by Test Mode Cycle 2 Cycle 1 Cycle 1, Periods 1-5 (Oct-01 to Aug-04) and Cycle 2, Periods 1-4 (Sep-04 to Dec-06)
HIVPP: HIV Tests by Test Type %Rapid C2P1: 20% C2P2: 31% C2P3: 41% C2P4: 46% Cycle 2, Periods 1-4: Sep-04 to Dec-06
HIVPP: Return Rate by Test Type Cycle 2, Periods 2-4: July-05 to Dec-06
HIVPP: Testing by Race/Ethnicity Cycle 2, Periods 2-4: July-05 to Dec-06
HIVPP: Positivity by Race/Ethnicity Cycle 2, Periods 2-4: July-05 to Dec-06
HIVPP: Testing by Race/Ethnicity Cycle 2, Periods 2-4: July-05 to Dec-06
HIVPP: Testing by Gender Cycle 2, Periods 1-4: Sep-04 to Dec-06
HIVPP: Testing by Age Group Cycle 2, Periods 2-4: July-05 to Dec-06
HIVPP: Positivity by Region Cycle 2, Periods 1-4: Sep-04 to Dec-06
Summary • HIV testing among FP users is increasing steadily (especially rapid testing) • Racial/ethnic disparities persist, especially among Black/African American users • The HIV positivity rate (>1 per 1,000 tests) in family planning clinics in most regions appears to be cost-effective • HIV prevention strategies should continue to emphasize the importance of the reduction of sexual risk behavior to prevent the spread of infection