220 likes | 343 Views
HIV infection among persons in Ontario infected through heterosexual contact. Robert S. Remis, Maraki Fikre Merid Ontario HIV Epidemiologic Monitoring Unit Department of Public Health Sciences University of Toronto Heterosexual HIV Transmission Meeting November 17, 2004.
E N D
HIV infection among persons in Ontario infected through heterosexual contact Robert S. Remis, Maraki Fikre Merid Ontario HIV Epidemiologic Monitoring Unit Department of Public Health Sciences University of Toronto Heterosexual HIV Transmission Meeting November 17, 2004
Methods: Data sources • AIDS cases in Ontario diagnosed 1981-2003 and reported to April 2004 obtained from Public Health Branch, MOHLTC • HIV diagnoses obtained from the HIV Laboratory diagnosed1985-2003
Methods: Data analysis • AIDS: Number and proportion of reported AIDS cases heterosexually acquired by health region and year of diagnosis, 1981-2003 • HIV diagnoses: Number and proportion of HIV diagnoses (adjusted) heterosexually acquired by health region and year of diagnosis, 1985-2003
Methods: Data analysis • HIV model: incidence and prevalence of • HIV infection • First-time HIV diagnoses • AIDS • HIV-related mortality
HIV diagnoses (adjusted) by exposure category and gender, Ontario 1985-2003
HIV diagnoses (adjusted) among heterosexuals by health region, Ontario, 1985-2003
Proportion HR and LR heterosexual among HIV diagnoses, 1985-2003
Proportion heterosexual among HIV diagnoses by sex, 1985-2003
Reported AIDS cases by exposure category and sex,1981-2003 * Proportion EC known = 96.4%
Reported AIDS cases among heterosexual cases by health region, Ontario, 1981-2003
Proportion annual reported AIDS cases among heterosexual cases by sex,1981-2003
Modeled HIV prevalence by exposure category, in Ontario, December 2003
Modeled HIV prevalence among heterosexual cases by sex,1977-2003
Modeled HIV prevalence by exposure category, in Ontario,December 2003
Conclusions • Females important: Proportion heterosexual 36% for HIV and 39% for AIDS cases among females (compared to 5% and 6% for males) • Observed increase over time for both first-time HIV diagnoses (mostly LR) and AIDS cases among persons infected heterosexually • Cases mostly in Toronto and Ottawa
Conclusions • Estimated number of HIV infected persons infected heterosexually • 3,311 or 14% of Ontario (n=23,552) • 1,535 among males (or 8% of total) • 1,743 among females (or 51%) • Overall, persons infected heterosexually increased 1.64 over five years (1998 to 2003), annual increase of 10.4%
Next steps • Study under way to understand increase and patterns of HIV infection among cases in Ontario heterosexually acquired
Objectives • Validate heterosexual cases and NIR • Determine context and factors involved in heterosexual HIV acquisition and likely source of HIV infection (risk factors of sexual partner if any)
Study design • PHU selection: Toronto and Ottawa based on reported number of HIV heterosexual cases • All HIV cases reported from July 1 ,2004 to June 30, 2005 and • random selection of NIR cases (1:2 for Ottawa and 1:10 for Toronto)
Study design • Subject recruitment • Cases referred by PHU nurse or through physician contact and meeting criteria for inclusion • Data collection • Face-to-face interviews using standardized questionnaire • Data sent to OHEMU for analysis
Timeline of study • Ethics approval • Obtained from Toronto PHU • Awaiting U of T and Ottawa PHU • Retrospective data extraction for cases from July 1, 2004 to study commencement
Acknowledgements • Ontario Ministry of Health and Long-Term Care • Frank McGee, coordinator, AIDS Bureau • Lorraine Schiedel, Public Health Division • HIV Laboratory, Central Public Health Laboratory • Carol Swantee, diagnostic data • Keyi Wu, programming