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1. Pediatric HIV/AIDS Cases* in Florida, through 2008 Bureau of HIV/AIDS
HIV/AIDS Surveillance Section
(850) 245-4430 Pediatric HIV/AIDS Cases* in Florida, through 2008
Bureau of HIV/AIDS
HIV/AIDS Surveillance Section
(850) 245-4430 or SC 205-4430
*HIV/AIDS cases infected UNDER 13 years of age.
Includes adult HIV/AIDS cases, diagnosed with a pediatric risk
AFTER 12 yrs of age. Data as of 08/25/09.
Due to reporting lags, 2008 data are provisional.Pediatric HIV/AIDS Cases* in Florida, through 2008
Bureau of HIV/AIDS
HIV/AIDS Surveillance Section
(850) 245-4430 or SC 205-4430
*HIV/AIDS cases infected UNDER 13 years of age.
Includes adult HIV/AIDS cases, diagnosed with a pediatric risk
AFTER 12 yrs of age. Data as of 08/25/09.
Due to reporting lags, 2008 data are provisional.
2. Pediatric AIDS Cases by Age Group and Year of Diagnosis, Florida, 1990-2008* Pediatric AIDS Cases by Age Group and Year of Diagnosis, Florida, 1990-2008* (N=1,430)
The incidence of AIDS in children under age two reached a high of 113 cases in 1992; this decreased to only two cases for children under the age of two in 2006 (Figure 2). HIV testing of pregnant women, combined with the introduction of zidovudine (ZDV) to prevent perinatal HIV transmission, has resulted in a 86% (Figure 9) reduction in perinatal HIV/AIDS cases in infants born in Florida since 1992. Consequently, it is important for all pregnant women to know their HIV status. This is substantiated by the fact that 96% of the 2,252 pediatric HIV/AIDS cases reported in Florida through 2007 were perinatally acquired. Florida law requires health care providers who attend a pregnant woman to test her for HIV at the initial prenatal care visit and again at 28 32 weeks gestation, unless she refuses. Pregnancy Risk Assessment Monitoring System data (PRAMS) indicate that in 2003, 89.6% of pregnant women received an HIV test during pregnancy. Pediatric AIDS cases reported at age two and older have also sharply declined since 1994 (Figure 2). This is partially due to the maternal use of antiretroviral treatment to prevent perinatal transmission of HIV, as well as the use of prophylactic medicines in HIV-infected pediatric cases to prevent AIDS opportunistic infections.
YR <2 yrs >=2 yrs.
90 72 45
91 82 44
92 113 66
93 88 68
94 87 68
95 52 56
96 44 67
97 26 41
98 16 34
99 19 30
00 4 31
01 9 30
02 8 28
03 3 31
04 4 26
05 3 28
06 2 32
07 0 34
08 3 37
These data represent a 81% decline in pediatric AIDS cases diagnosed from 1992 (N=178) to 2008 (N=34).
*Due to reporting lags, 2008 data are provisional. Data as of 08/25/09Pediatric AIDS Cases by Age Group and Year of Diagnosis, Florida, 1990-2008* (N=1,430)
The incidence of AIDS in children under age two reached a high of 113 cases in 1992; this decreased to only two cases for children under the age of two in 2006 (Figure 2). HIV testing of pregnant women, combined with the introduction of zidovudine (ZDV) to prevent perinatal HIV transmission, has resulted in a 86% (Figure 9) reduction in perinatal HIV/AIDS cases in infants born in Florida since 1992. Consequently, it is important for all pregnant women to know their HIV status. This is substantiated by the fact that 96% of the 2,252 pediatric HIV/AIDS cases reported in Florida through 2007 were perinatally acquired. Florida law requires health care providers who attend a pregnant woman to test her for HIV at the initial prenatal care visit and again at 28 32 weeks gestation, unless she refuses. Pregnancy Risk Assessment Monitoring System data (PRAMS) indicate that in 2003, 89.6% of pregnant women received an HIV test during pregnancy. Pediatric AIDS cases reported at age two and older have also sharply declined since 1994 (Figure 2). This is partially due to the maternal use of antiretroviral treatment to prevent perinatal transmission of HIV, as well as the use of prophylactic medicines in HIV-infected pediatric cases to prevent AIDS opportunistic infections.
YR <2 yrs >=2 yrs.
90 72 45
91 82 44
92 113 66
93 88 68
94 87 68
95 52 56
96 44 67
97 26 41
98 16 34
99 19 30
00 4 31
01 9 30
02 8 28
03 3 31
04 4 26
05 3 28
06 2 32
07 0 34
08 3 37
These data represent a 81% decline in pediatric AIDS cases diagnosed from 1992 (N=178) to 2008 (N=34).
*Due to reporting lags, 2008 data are provisional. Data as of 08/25/09
3. Pediatric AIDS Cases, By Age Group and Year of Diagnosis, Florida, 1990-2008* Pediatric AIDS Cases, By Age Group and Year of Diagnosis, Florida, 1990-2008* (N=1,430)
As time goes on, the pediatric HIV case are more likely to NOT develop AIDS until after age 12.
*2008 data are provisional. Data as of 08/25/09.
Age 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08
<1 yrs 53 55 80 66 54 32 29 22 13 14 4 5 8 3 4 3 2 0 2
1-5 yrs 49 55 68 65 70 44 47 19 15 15 8 7 5 5 2 1 1 2 3
6-12 yrs 14 14 27 20 23 26 25 16 13 11 11 15 9 8 6 2 5 1 3
13+ yrs 1 2 3 5 8 6 10 10 9 9 12 12 14 18 18 25 26 31 32
Pediatric AIDS Cases, By Age Group and Year of Diagnosis, Florida, 1990-2008* (N=1,430)
As time goes on, the pediatric HIV case are more likely to NOT develop AIDS until after age 12.
*2008 data are provisional. Data as of 08/25/09.
Age 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08
<1 yrs 53 55 80 66 54 32 29 22 13 14 4 5 8 3 4 3 2 0 2
1-5 yrs 49 55 68 65 70 44 47 19 15 15 8 7 5 5 2 1 1 2 3
6-12 yrs 14 14 27 20 23 26 25 16 13 11 11 15 9 8 6 2 5 1 3
13+ yrs 1 2 3 5 8 6 10 10 9 9 12 12 14 18 18 25 26 31 32
4. Percent of Pediatric AIDS Cases, By Age Group and Year of Diagnosis, Florida, 1990-2008* Percent of Pediatric AIDS Cases, By Age Group and Year of Diagnosis, Florida, 1990-2008* (N=1,430)
There has been a steady decrease in the number of diagnosed pediatric AIDS cases since 1992. Additionally, there has also been a steady decrease in the number of pediatric AIDS cases in those under six years of age (Figure 3). However, the percentage of new AIDS cases for those over age 12 has shown an increasing trend from 1% in 1990 to 80% in 2008 (Figure 4). This trend is most likely attributable to early diagnosis of HIV (prior to birth or shortly after) along with the increased use of antiretroviral and other medical therapies that help to delay the onset of AIDS. Since the total number of cases has fallen so steeply in the lower age groups, the actual number of AIDS cases diagnosed in 2008 over the age of twelve is 32, compared to only 1 in 1990.
Age 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08
<1 yrs 45 44 45 42 35 30 26 33 26 29 11 13 22 9 13 10 6 0 5
1-5 yrs 42 44 38 42 45 41 42 28 30 31 23 18 14 15 7 3 3 6 8
6-12 yrs 12 11 15 13 15 24 23 24 26 22 31 38 25 24 20 6 15 3 8
13+ yrs 1 2 2 3 5 6 9 15 18 18 35 31 39 53 60 81 76 91 80
As time goes on, the pediatric HIV case are more likely to NOT develop AIDS until after age 12.
*2008 data are provisional. Data as of 08/25/09.Percent of Pediatric AIDS Cases, By Age Group and Year of Diagnosis, Florida, 1990-2008* (N=1,430)
There has been a steady decrease in the number of diagnosed pediatric AIDS cases since 1992. Additionally, there has also been a steady decrease in the number of pediatric AIDS cases in those under six years of age (Figure 3). However, the percentage of new AIDS cases for those over age 12 has shown an increasing trend from 1% in 1990 to 80% in 2008 (Figure 4). This trend is most likely attributable to early diagnosis of HIV (prior to birth or shortly after) along with the increased use of antiretroviral and other medical therapies that help to delay the onset of AIDS. Since the total number of cases has fallen so steeply in the lower age groups, the actual number of AIDS cases diagnosed in 2008 over the age of twelve is 32, compared to only 1 in 1990.
Age 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08
<1 yrs 45 44 45 42 35 30 26 33 26 29 11 13 22 9 13 10 6 0 5
1-5 yrs 42 44 38 42 45 41 42 28 30 31 23 18 14 15 7 3 3 6 8
6-12 yrs 12 11 15 13 15 24 23 24 26 22 31 38 25 24 20 6 15 3 8
13+ yrs 1 2 2 3 5 6 9 15 18 18 35 31 39 53 60 81 76 91 80
As time goes on, the pediatric HIV case are more likely to NOT develop AIDS until after age 12.
*2008 data are provisional. Data as of 08/25/09.
5. Cumulative Reported Pediatric AIDS Cases By County, Florida, Reported through 2008
Florida reported 1,784 pediatric (<13 years) AIDS cases through 2008, with the majority (63%) of these cases reported from Miami-Dade (N=584), Broward (N=312) and Palm Beach (N=235) counties (Figure 16). Cumulative Reported Pediatric AIDS CasesBy County, Florida, Reported through 2008
Florida reported 1,784 pediatric (<13 years) AIDS cases through 2008, with the majority (63%) of these cases reported from Miami-Dade (N=584), Broward (N=312) and Palm Beach (N=235) counties (Figure 16).
6. Cumulative Reported Pediatric HIV (not AIDS) Cases By County, Florida, Reported through 2008
Florida has reported a total of 596 pediatric (infected under 13 years) HIV cases from July 1997 through 2008 (Figure 16). The majority (53%) of these cases were reported from Miami-Dade (N=174), Broward (N=83) and Palm Beach (N=55) counties. Other counties with a high number of reported HIV pediatric cases included: Orange (N=47), Hillsborough (N=39), Duval (N=31) and St. Lucie (N=18). Cumulative Reported Pediatric HIV (not AIDS) CasesBy County, Florida, Reported through 2008
Florida has reported a total of 596 pediatric (infected under 13 years) HIV cases from July 1997 through 2008 (Figure 16). The majority (53%) of these cases were reported from Miami-Dade (N=174), Broward (N=83) and Palm Beach (N=55) counties. Other counties with a high number of reported HIV pediatric cases included: Orange (N=47), Hillsborough (N=39), Duval (N=31) and St. Lucie (N=18).
7. In 2007, a total of 87 AIDS cases were reported in children younger than 13 years of age. Most of these cases were perinatally acquired. Florida and New York reported the largest number of cases. Thirty-one states did not report any pediatric AIDS cases.In 2007, a total of 87 AIDS cases were reported in children younger than 13 years of age. Most of these cases were perinatally acquired. Florida and New York reported the largest number of cases. Thirty-one states did not report any pediatric AIDS cases.
8. As of December 31, 2007, 2,527 children were reported to be living with HIV infection (not AIDS) from 53 areas (47 states, the District of Columbia, and 5 U.S. dependent areas) that conducted confidential name-based HIV infection case surveillance in 2007. An additional 881 children in the United States and dependent areas were reported to be living with AIDS.
Note:
In 2007, the District of Columbia and the following 47 states and 5 US dependent areas conducted HIV case surveillance and reported cases of HIV infection in adults, adolescents, and children to CDC: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, Wyoming, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.As of December 31, 2007, 2,527 children were reported to be living with HIV infection (not AIDS) from 53 areas (47 states, the District of Columbia, and 5 U.S. dependent areas) that conducted confidential name-based HIV infection case surveillance in 2007. An additional 881 children in the United States and dependent areas were reported to be living with AIDS.
Note:
In 2007, the District of Columbia and the following 47 states and 5 US dependent areas conducted HIV case surveillance and reported cases of HIV infection in adults, adolescents, and children to CDC: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, Wyoming, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.
9. Pediatric AIDS Cases By Year of Report, By State, 2007 United States (pediatric AIDS)
Florida ranks second, behind New York, in the number of pediatric AIDS cases reported in 2007 (Table 7). Florida also ranks second in cumulative cases, followed by New Jersey and California.
United States (pediatric AIDS)
Florida ranks second, behind New York, in the number of pediatric AIDS cases reported in 2007 (Table 7). Florida also ranks second in cumulative cases, followed by New Jersey and California.
10. United States
Pediatric (Ages <13) AIDS Cases
By Race/Ethnicity
Diagnosed through 2007* (N=9,209)
White 1602
Black 2699
Hispanic 1757
Other 86
2000 Population
By Race/Ethnicity
(Ages <13) (N=52,190,294)
White Black Hispanic Other
31,252,968 7,722,865 9,297,660 3,916,801
*These numbers do not represent actual cases in persons with a diagnosis of AIDS. Rather, these
numbers are point estimates of cases diagnosed that have been adjusted for reporting delays. The
estimates have not been adjusted for incomplete reporting.
2008 data not available.
United States
Pediatric (Ages <13) AIDS Cases
By Race/Ethnicity
Diagnosed through 2007* (N=9,209)
White 1602
Black 2699
Hispanic 1757
Other 86
2000 Population
By Race/Ethnicity
(Ages <13) (N=52,190,294)
White Black Hispanic Other
31,252,968 7,722,865 9,297,660 3,916,801
*These numbers do not represent actual cases in persons with a diagnosis of AIDS. Rather, these
numbers are point estimates of cases diagnosed that have been adjusted for reporting delays. The
estimates have not been adjusted for incomplete reporting.
2008 data not available.
11. FLORIDA
Pediatric HIV/AIDS Cases*
By Race/Ethnicity
Reported through 2008 (N=2,374)
2008 Florida
White 252
Black 1774
Hispanic 315
Other 33
Population Estimates
(Ages <13)
(N= 2,968,429)
White Black Hispanic Other
1,467,931 634,425 774,632 104,118
Note: 2008 data are provisional. 2008 Population Estimates, DOH, Office of Planning, Evaluation and Data AnalysisFLORIDA
Pediatric HIV/AIDS Cases*
By Race/Ethnicity
Reported through 2008 (N=2,374)
2008 Florida
White 252
Black 1774
Hispanic 315
Other 33
Population Estimates
(Ages <13)
(N= 2,968,429)
White Black Hispanic Other
1,467,931 634,425 774,632 104,118
Note: 2008 data are provisional. 2008 Population Estimates, DOH, Office of Planning, Evaluation and Data Analysis
12. Cumulative Pediatric (<13 yr.) HIV/AIDS Cases
By Exposure Category
United States*
(AIDS cases reported thru 2007)
(N=9,209)
Other Pediatric Risk** 775
Perinatally Acquired 8434
Florida
(reported thru 2008)
(N=2,374)
Other Pediatric Risk** 124
Perinatally Acquired 2250
Ninety-five percent of the 2,374 pediatric HIV/AIDS cases reported in Florida through 2008 were perinatally acquired (Figure 6). Four percent were related to other confirmed risks, which include hemophilia, transfusion or pediatric sexual abuse cases. The remaining 1% is pending investigation to determine mode of transmission.
*US data include estimated AIDS cases from the US and DC. 2008 data not available.
**Other Pediatric Risk includes sex with male or receipt of blood products.
Cumulative Pediatric (<13 yr.) HIV/AIDS Cases
By Exposure Category
United States*
(AIDS cases reported thru 2007)
(N=9,209)
Other Pediatric Risk** 775
Perinatally Acquired 8434
Florida
(reported thru 2008)
(N=2,374)
Other Pediatric Risk** 124
Perinatally Acquired 2250
Ninety-five percent of the 2,374 pediatric HIV/AIDS cases reported in Florida through 2008 were perinatally acquired (Figure 6). Four percent were related to other confirmed risks, which include hemophilia, transfusion or pediatric sexual abuse cases. The remaining 1% is pending investigation to determine mode of transmission.
*US data include estimated AIDS cases from the US and DC. 2008 data not available.
**Other Pediatric Risk includes sex with male or receipt of blood products.
13. Cumulative Pediatric HIV/AIDS Cases By Expanded Exposure Category Florida, Reported through 2008 (N=2,374)
Ninety-five percent of the 2,252 pediatric HIV/AIDS cases reported through 2007 were perinatally acquired (Figure 6). Four percent were related to other confirmed risks, which include hemophilia, transfusion or pediatric sexual abuse cases. The remaining 1% is pending investigation to determine mode of transmission.
22% Mom-IDU 12% Mom-Sex w/ IDU 2% Mom-sex w/ Male Sex with Male 33% Mom-sex w/ person w/ HIV/AIDS
286 58 788
1% Mom-Blood Recipient <1% Mom-sex w/ blood recipient 24% Mom-HIV/AIDS, Risk Unknown 2% Ped-Hemophilia*
26 2 577 41
1% Ped-Transfus/Transplant* 1% Ped-Confirmed Other* 1% Ped-No Identified Risk*
31 15 37
*Note: 5.2% (exploded pieces) are NOT perinatal transmission cases
Cumulative Pediatric HIV/AIDS Cases By Expanded Exposure Category Florida, Reported through 2008 (N=2,374)
Ninety-five percent of the 2,252 pediatric HIV/AIDS cases reported through 2007 were perinatally acquired (Figure 6). Four percent were related to other confirmed risks, which include hemophilia, transfusion or pediatric sexual abuse cases. The remaining 1% is pending investigation to determine mode of transmission.
22% Mom-IDU 12% Mom-Sex w/ IDU 2% Mom-sex w/ Male Sex with Male 33% Mom-sex w/ person w/ HIV/AIDS
286 58 788
1% Mom-Blood Recipient <1% Mom-sex w/ blood recipient 24% Mom-HIV/AIDS, Risk Unknown 2% Ped-Hemophilia*
26 2 577 41
1% Ped-Transfus/Transplant* 1% Ped-Confirmed Other* 1% Ped-No Identified Risk*
31 15 37
*Note: 5.2% (exploded pieces) are NOT perinatal transmission cases
14. The majority (78%) of the perinatally acquired cases were black. A total of 164 of these cases were diagnosed with AIDS for the first time as an adult (>12 years of age). This indicates that more children who are born with HIV are now living into their teens prior to developing AIDS. The majority (78%) of the perinatally acquired cases were black. A total of 164 of these cases were diagnosed with AIDS for the first time as an adult (>12 years of age). This indicates that more children who are born with HIV are now living into their teens prior to developing AIDS.
15. Prevalence of AIDS-Defining Conditions Most Commonly Reported Among Pediatric Cases Florida, Reported through 2008* AIDS-Defining Conditions
Of the 2,374 pediatric HIV/AIDS cases reported through 2008, 1,792 (75%) have developed AIDS. The most commonly reported AIDS-defining conditions among all pediatric AIDS cases reported through 2008 are listed below (Table 5). Some children may have had more than one condition; therefore the total exceeds 100%. Nearly one-third (28%) of children with AIDS have been diagnosed with pneumocystis pneumonia (PCP). One-fourth (25%) were diagnosed with recurrent bacterial infections, 23% with esophageal candidiasis and 21% with wasting syndrome. The list of conditions presented is based on cumulative data since the beginning of the epidemic; however, the most commonly reported conditions for children diagnosed in 2008 have not changed much from those reported in earlier years.
DISEASE / CONDITION NUMBER % OF CASES
Pneumocystis pneumonia 484 28%
Bacterial infections 432 25%
Candidiasis, esophageal 394 23%
Wasting syndrome 362 21%
Lymphoid interstitial pneumonia 302 17%
HIV encephalopathy 253 15%
Cytomegalovirus disease 143 8%
Herpes simplex 112 6%
Candidiasis, bronchi or lungs 84 5%
Cryptosporidiosis 81 5%
CD4 immune deficiency (only) 179 10%
Note: Data are not mutually exclusive, many cases have more than one disease.
AIDS-Defining Conditions
Of the 2,374 pediatric HIV/AIDS cases reported through 2008, 1,792 (75%) have developed AIDS. The most commonly reported AIDS-defining conditions among all pediatric AIDS cases reported through 2008 are listed below (Table 5). Some children may have had more than one condition; therefore the total exceeds 100%. Nearly one-third (28%) of children with AIDS have been diagnosed with pneumocystis pneumonia (PCP). One-fourth (25%) were diagnosed with recurrent bacterial infections, 23% with esophageal candidiasis and 21% with wasting syndrome. The list of conditions presented is based on cumulative data since the beginning of the epidemic; however, the most commonly reported conditions for children diagnosed in 2008 have not changed much from those reported in earlier years.
DISEASE / CONDITION NUMBER % OF CASES
Pneumocystis pneumonia 484 28%
Bacterial infections 432 25%
Candidiasis, esophageal 394 23%
Wasting syndrome 362 21%
Lymphoid interstitial pneumonia 302 17%
HIV encephalopathy 253 15%
Cytomegalovirus disease 143 8%
Herpes simplex 112 6%
Candidiasis, bronchi or lungs 84 5%
Cryptosporidiosis 81 5%
CD4 immune deficiency (only) 179 10%
Note: Data are not mutually exclusive, many cases have more than one disease.
16. Perinatal HIV/AIDS Cases Data by Year of Birth
17. The estimated number of AIDS cases diagnosed among persons perinatally exposed to HIV peaked in 1992 and has decreased in recent years. The decline in these cases is likely associated with the implementation of Public Health Service guidelines for the universal counseling and voluntary HIV testing of pregnant women and the use of antiretroviral therapy for pregnant women and newborn infants (MMWR 2002;51(No. RR-18)). Other contributing factors are the effective treatment of HIV infections that slow progression to AIDS and the use of prophylaxis to prevent AIDS opportunistic infections among children. The estimated number of AIDS cases diagnosed among persons perinatally exposed to HIV peaked in 1992 and has decreased in recent years.The decline in these cases is likely associated with the implementation of Public Health Service guidelines for the universal counseling and voluntary HIV testing of pregnant women and the use of antiretroviral therapy for pregnant women and newborn infants (MMWR 2002;51(No. RR-18)). Other contributing factors are the effective treatment of HIV infections that slow progression to AIDS and the use of prophylaxis to prevent AIDS opportunistic infections among children.
18. Perinatal HIV/AIDS Cases by Year of Birth
Reported in Florida*, 1977-2008** (N=2,306)
State
77 1
78 3
79 10
80 16
81 34
82 31
83 54
84 64
85 92
86 97
87 133
88 158
89 180
90 200
91 188
92 204
93 162
94 144
95 98
96 66
97 80
98 61
99 37
00 39
01 44
02 19
03* 20
04 16
05 13
06 16
07 17
08 9
Of the 2,306 perinatally infected babies born through 2008, 1 was born as early as 1977 (Figure 9). Since that time, the birth of HIV-infected babies continued to rise through 1992. In April 1994, the Public Health Service released guidelines for ZDV use to reduce perinatal HIV transmission, and in 1995 recommendations for HIV counseling and voluntary testing for pregnant women were published. The mandatory offering of HIV testing to pregnant women became law in Florida in October 1996. Since then, the percent of perinatally infected children who received ZDV or whose mothers received ZDV has increased markedly. Through enhanced perinatal surveillance systems, it has been documented that ZDV use among exposed infants and mothers of HIV-infected children has increased at the prenatal, intrapartum, delivery and neonatal stages. In the past few years, the use of other medical therapies, including protease inhibitors has supplemented the use of ZDV for both infected mothers and their babies. The use of these medical therapies has been accompanied by a decrease in the number of perinatally HIV-infected children and is responsible for the dramatic decline in perinatally acquired HIV/AIDS since 1994. Furthermore, as noted in detail later in this text, numerous initiatives have contributed to the reduction in these cases: provider education, social marketing etc. These initiatives have helped to further educate local providers in the importance of testing pregnant women for HIV and then offering effective treatment during the pregnancy and at delivery to further decrease the chances of vertical transmission. As a result, significant decreases in annual perinatal HIV-infected births have been observed since 1997, with a leveling trend since 2002 until 2008, where another sharp decrease occurred.
Note: These data represent a 96% decline in HIV-perinatally infected births from 1992 (N=204) to 2008 (N=9)
*Includes all perinatal HIV/AIDS cases diagnosed in Florida, regardless of place of birth.
**HIV Infection Reporting began July, 2007. 2008 data are provisional. Data as of 09/30/09.Perinatal HIV/AIDS Cases by Year of Birth
Reported in Florida*, 1977-2008** (N=2,306)
State
77 1
78 3
79 10
80 16
81 34
82 31
83 54
84 64
85 92
86 97
87 133
88 158
89 180
90 200
91 188
92 204
93 162
94 144
95 98
96 66
97 80
98 61
99 37
00 39
01 44
02 19
03* 20
04 16
05 13
06 16
07 17
08 9
Of the 2,306 perinatally infected babies born through 2008, 1 was born as early as 1977 (Figure 9). Since that time, the birth of HIV-infected babies continued to rise through 1992. In April 1994, the Public Health Service released guidelines for ZDV use to reduce perinatal HIV transmission, and in 1995 recommendations for HIV counseling and voluntary testing for pregnant women were published. The mandatory offering of HIV testing to pregnant women became law in Florida in October 1996. Since then, the percent of perinatally infected children who received ZDV or whose mothers received ZDV has increased markedly. Through enhanced perinatal surveillance systems, it has been documented that ZDV use among exposed infants and mothers of HIV-infected children has increased at the prenatal, intrapartum, delivery and neonatal stages. In the past few years, the use of other medical therapies, including protease inhibitors has supplemented the use of ZDV for both infected mothers and their babies. The use of these medical therapies has been accompanied by a decrease in the number of perinatally HIV-infected children and is responsible for the dramatic decline in perinatally acquired HIV/AIDS since 1994. Furthermore, as noted in detail later in this text, numerous initiatives have contributed to the reduction in these cases: provider education, social marketing etc. These initiatives have helped to further educate local providers in the importance of testing pregnant women for HIV and then offering effective treatment during the pregnancy and at delivery to further decrease the chances of vertical transmission. As a result, significant decreases in annual perinatal HIV-infected births have been observed since 1997, with a leveling trend since 2002 until 2008, where another sharp decrease occurred.
Note: These data represent a 96% decline in HIV-perinatally infected births from 1992 (N=204) to 2008 (N=9)
*Includes all perinatal HIV/AIDS cases diagnosed in Florida, regardless of place of birth.
**HIV Infection Reporting began July, 2007. 2008 data are provisional. Data as of 09/30/09.
19. Mothers Exposure Category by Year of Childs Birth for Perinatally Acquired HIV/AIDS Reported in Florida*, Born through 2008** (N=2,306) Mothers Exposure Category by Year of Childs Birth for Perinatally Acquired HIV/AIDS Reported in Florida*, Born through 2008** (N=2,306)
Distribution of the mothers exposure category has changed over time for children who were infected perinatally. In the early 1980s, many of these women were exposed to HIV through injection drug use or heterosexual contact (Figure 7). From 1990, the risk of injection use decreased as the risk of heterosexual contact continued to increase. Since 1992 a steady decline was observed for all risks as the annual number of perinatal cases decreased, due to improved prophylaxis against OIs and the use of combination antiretroviral therapy by pregnant women with HIV since 1994. Throughout the entire reporting period, many of the mothers risks were unknown. Most of the cases reported without a risk will be reclassified to the recognized risk categories as further information is reported. A review of data on women who were initially reported with no identified risk and later reclassified, suggests that greater than 85% of women with no identified risk were exposed through heterosexual contact. Since perinatal data revolves around the childs birth, the following data are based on year of birth, not year of report.Mothers Exposure Category by Year of Childs Birth for Perinatally Acquired HIV/AIDSReported in Florida*, Born through 2008** (N=2,306)
Distribution of the mothers exposure category has changed over time for children who were infected perinatally. In the early 1980s, many of these women were exposed to HIV through injection drug use or heterosexual contact (Figure 7). From 1990, the risk of injection use decreased as the risk of heterosexual contact continued to increase. Since 1992 a steady decline was observed for all risks as the annual number of perinatal cases decreased, due to improved prophylaxis against OIs and the use of combination antiretroviral therapy by pregnant women with HIV since 1994. Throughout the entire reporting period, many of the mothers risks were unknown. Most of the cases reported without a risk will be reclassified to the recognized risk categories as further information is reported. A review of data on women who were initially reported with no identified risk and later reclassified, suggests that greater than 85% of women with no identified risk were exposed through heterosexual contact. Since perinatal data revolves around the childs birth, the following data are based on year of birth, not year of report.
20. Among children who were infected perinatally with HIV/AIDS, the distribution of their mothers exposure categories has changed over time (Figure 8). Of the perinatal HIV and AIDS cases who were born through 1994, 47% were attributed to the mothers exposure to HIV through heterosexual contact, compared to 61% for those born 1995-2008. Injection drug use accounted for 25% of the cases born through 1994, but only 14% for those born between 1995-2008. Cases where the mothers risk was unknown represented less than one-third of the cases born through 1994 and less than one-fourth of the cases born during 1995-2008.
Mothers Exposure Category for
Perinatally Acquired HIV/AIDS (N=2,306)
By Year of Childs Birth, Reported in Florida*
Born 1977-1994
(N =1,771)
Mother's risk not specified Heterosexual contact Injecting drug use Transfusion
475 828 446 22
Born 1995-2008*
(N =535)
Mother's risk not specified Heterosexual contact Injecting drug use Transfusion
127 329 75 4
Among children who were infected perinatally with HIV/AIDS, the distribution of their mothers exposure categories has changed over time (Figure 8). Of the perinatal HIV and AIDS cases who were born through 1994, 47% were attributed to the mothers exposure to HIV through heterosexual contact, compared to 61% for those born 1995-2008. Injection drug use accounted for 25% of the cases born through 1994, but only 14% for those born between 1995-2008. Cases where the mothers risk was unknown represented less than one-third of the cases born through 1994 and less than one-fourth of the cases born during 1995-2008.
Mothers Exposure Category for
Perinatally Acquired HIV/AIDS (N=2,306)
By Year of Childs Birth, Reported in Florida*
Born 1977-1994
(N =1,771)
Mother's risk not specified Heterosexual contact Injecting drug use Transfusion
475 828 446 22
Born 1995-2008*
(N =535)
Mother's risk not specified Heterosexual contact Injecting drug use Transfusion
127 329 75 4
21. Perinatal HIV/AIDS cases by Race/Ethnicity
Of the 2,286pediatric HIV/AIDS cases reported through 2008, 9% were white, 77% were black and 13% were Hispanic. When compared with the general population of persons less than 13 years of age, blacks are disproportionately affected by HIV/AIDS.
FLORIDA
Perinatal HIV/AIDS Cases
By Race/Ethnicity
Born through 2007* (N=2,306)
White 214
Black 1759
Hispanic 299
Other 34
2008 Florida
Population Estimates
(Ages <13)
(N= 2,968,429)
White Black Hispanic Other
1,467,931 634,425 774,632 104,118
Perinatal HIV/AIDS cases by Race/Ethnicity
Of the 2,286pediatric HIV/AIDS cases reported through 2008, 9% were white, 77% were black and 13% were Hispanic. When compared with the general population of persons less than 13 years of age, blacks are disproportionately affected by HIV/AIDS.
FLORIDA
Perinatal HIV/AIDS Cases
By Race/Ethnicity
Born through 2007* (N=2,306)
White 214
Black 1759
Hispanic 299
Other 34
2008 Florida
Population Estimates
(Ages <13)
(N= 2,968,429)
White Black Hispanic Other
1,467,931 634,425 774,632 104,118
22. Perinatally Acquired HIV (not AIDS) Cases by Age at Diagnosis (N=618) Florida, Born through 2008 Perinatally Acquired HIV (not AIDS) Cases by Age at Diagnosis (N=599) Florida, Born through 2008
One third (34%, N=210) of the 618 perinatal HIV (not AIDS) cases born through 2008 were diagnosed less than the first 6 months of life (Figure 11). One-half (50%, N=308) of these perinatal HIV cases were diagnosed under the age of two. Furthermore, 24 (4%) were diagnosed with a perinatal risk after the age of 12. As already noted, early diagnosis of HIV is the key to infected children living longer as well as prolonging the onset of AIDS.Perinatally Acquired HIV (not AIDS) Cases by Age at Diagnosis (N=599)Florida, Born through 2008
One third (34%, N=210) of the 618 perinatal HIV (not AIDS) cases born through 2008 were diagnosed less than the first 6 months of life (Figure 11). One-half (50%, N=308) of these perinatal HIV cases were diagnosed under the age of two. Furthermore, 24 (4%) were diagnosed with a perinatal risk after the age of 12. As already noted, early diagnosis of HIV is the key to infected children living longer as well as prolonging the onset of AIDS.
23. Perinatally Acquired AIDS Cases by Age at Diagnosis (N=1,684) Florida, Born through 2008 Perinatally Acquired AIDS Cases by Age at Diagnosis (N=1,684) Florida, Born through 2008
More than one half (52%) (N=868) of the perinatal AIDS cases born through 2008 (N=1,684), were diagnosed with AIDS prior to the age of two (Figure 10). The number of AIDS cases diagnosed after age two decreases by age. Thirteen percent (N=220) of the cumulative AIDS cases were not diagnosed with AIDS until after the age of twelve (up from 5% in 2003). Perinatally Acquired AIDS Cases by Age at Diagnosis (N=1,684)Florida, Born through 2008
More than one half (52%) (N=868) of the perinatal AIDS cases born through 2008 (N=1,684), were diagnosed with AIDS prior to the age of two (Figure 10). The number of AIDS cases diagnosed after age two decreases by age. Thirteen percent (N=220) of the cumulative AIDS cases were not diagnosed with AIDS until after the age of twelve (up from 5% in 2003).
24. AIDS-Defining Conditions for Perinatally Acquired AIDS Cases (aged <2 yr.) by Age at Diagnosis For Florida, Born Through 2008 (N=868) AIDS-Defining Conditions for Perinatally Acquired AIDS Cases (aged <2 yr.) by Age at Diagnosis For Florida, Born Through 2008 (N=868)
The peak of PCP in children with perinatally acquired AIDS is four months of age (Figure 14). The age at diagnosis for the other AIDS-defining conditions is much more evenly distributed during the first two years of life. Because of the early presentation of PCP, recommendations for all perinatally HIV-exposed children are for PCP prophylaxis to begin at four to six weeks of age. Once the child is proven to be uninfected, the PCP prophylaxis is discontinued. Early diagnosis, treatment and care of an HIV perinatally infected child is crucial in delaying the onset of AIDS.
MONTHS 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
PCP 7 9 13 45 88 55 34 17 7 12 11 4 2 4 4 3 4 4 4 7 1 1 2 4
Other 9 11 25 27 33 37 16 30 37 39 23 19 26 26 15 28 20 22 15 10 17 16 9 16
AIDS-Defining Conditions for Perinatally Acquired AIDS Cases (aged <2 yr.)by Age at Diagnosis For Florida, Born Through 2008 (N=868)
The peak of PCP in children with perinatally acquired AIDS is four months of age (Figure 14). The age at diagnosis for the other AIDS-defining conditions is much more evenly distributed during the first two years of life. Because of the early presentation of PCP, recommendations for all perinatally HIV-exposed children are for PCP prophylaxis to begin at four to six weeks of age. Once the child is proven to be uninfected, the PCP prophylaxis is discontinued. Early diagnosis, treatment and care of an HIV perinatally infected child is crucial in delaying the onset of AIDS.
MONTHS 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
PCP 7 9 13 45 88 55 34 17 7 12 11 4 2 4 4 3 4 4 4 7 1 1 2 4
Other 9 11 25 27 33 37 16 30 37 39 23 19 26 26 15 28 20 22 15 10 17 16 9 16
25. Perinatal AIDS Cases by Age Group and Year of Birth, Florida, 1990-2008* Perinatal AIDS Cases by Age Group and Year of Birth, Florida, 1990-2008*
N=888
YR <2 yrs >=2 yrs.
90 86 73
91 85 68
92 120 46
93 75 40
94 69 23
95 41 23
96 21 9
97 24 9
98 15 7
99 11 3
00 4 5
01 8 3
02 5 1
03 3 0
04 4 1
05 2 0
06 1 0
07 1 0
08 2 0
These data represent a 99% decline in HIV-perinatally infected births from 1992 (N=166) to 2008 (N=2).
* 2008 data are provisional. Data as of 09/30/09.
Perinatal AIDS Cases by Age Group and Year of Birth, Florida, 1990-2008*
N=888
YR <2 yrs >=2 yrs.
90 86 73
91 85 68
92 120 46
93 75 40
94 69 23
95 41 23
96 21 9
97 24 9
98 15 7
99 11 3
00 4 5
01 8 3
02 5 1
03 3 0
04 4 1
05 2 0
06 1 0
07 1 0
08 2 0
These data represent a 99% decline in HIV-perinatally infected births from 1992 (N=166) to 2008 (N=2).
* 2008 data are provisional. Data as of 09/30/09.
26. Living Perinatal AIDS or HIV (not AIDS) Born through 2008, by County of Diagnosis Florida, (N=1,446)
Florida reported 1,446 pediatric (<13 years) AIDS or HIV cases through 2008, with the majority (62%) of these cases reported from Miami-Dade (N=401), Broward (N=243) Palm Beach (N=151) and Hillsborough (N=99) counties. Data as of 09/30/09Living Perinatal AIDS or HIV (not AIDS)Born through 2008, by County of DiagnosisFlorida, (N=1,446)
Florida reported 1,446 pediatric (<13 years) AIDS or HIV cases through 2008, with the majority (62%) of these cases reported from Miami-Dade (N=401), Broward (N=243) Palm Beach (N=151) and Hillsborough (N=99) counties. Data as of 09/30/09
27. Prevalence of Perinatal HIV/AIDS Cases in Florida
As of December 31, 2008, there were 1,426 perinatal HIV/AIDS cases reported in Florida, born through 2008 and presumed to be living (Figure 20). Their current ages range from 0 to 29 years. Overall, 830 (58%) have developed AIDS. As expected, the majority of the cases under age 13 are diagnosed with HIV (not AIDS) and the majority of cases ages 13 and older have developed AIDS. (In recent years, this age with the majority of AIDS cases started at 10 years). Access to antiretroviral medications and prophylaxis against opportunistic infections has aided in prolonging the life of many of these perinatal cases.Prevalence of Perinatal HIV/AIDS Cases in Florida
As of December 31, 2008, there were 1,426 perinatal HIV/AIDS cases reported in Florida, born through 2008 and presumed to be living (Figure 20). Their current ages range from 0 to 29 years. Overall, 830 (58%) have developed AIDS. As expected, the majority of the cases under age 13 are diagnosed with HIV (not AIDS) and the majority of cases ages 13 and older have developed AIDS. (In recent years, this age with the majority of AIDS cases started at 10 years). Access to antiretroviral medications and prophylaxis against opportunistic infections has aided in prolonging the life of many of these perinatal cases.
28. Perinatal HIV/AIDS Cases, Born 2000-2008 By Area of Birth and Reported in Florida Perinatal HIV/AIDS Cases, Born 2000-2008 By Area of Birth and Reported in Florida
Although there have been significant decreases in perinatal HIV cases since 1992, each of the top reporting areas have reported at least one since 2000 (Table 6). As noted above, efforts will continue to be made to educate providers about the value of knowing the HIV status of all pregnant women during prenatal care and at delivery, and for those pregnant women testing positive for HIV, to offer the best treatment available to prevent vertical transmission.
AREA of BIRTH # OF CASES % OF TOTAL
Area 01* 4 2%
Area 03* 4 2%
Area 08 (Lee Only) 4 2%
Area 08 (not Lee)* 2 1%
Area 15* 13 8%
Broward County 29 17%
Duval County 15 9%
Hillsborough/Pinellas 11 7%
Miami-Dade County 41 24%
Orange County 14 8%
Palm Beach County 15 9%
Polk 4 2%
REMAINDER OF STATE 14 8%
TOTAL CASES 169 100%
*Area 1 = Escambia, Okaloosa, Santa Rosa & Walton Counties;
*Area 3 = Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee, & Union Counties;
* Area 8 (not Lee) = Charlotte, Colier, DeSoto, Glades, Hendry & Sarasota Counties.
*Area 15 = St. Lucie, Indian River, Martin, and Okeechobee Counties.
*A total of 23 perinatal cases reported in Florida were born outside of Florida and NOT included in these data.
10 of the 23 were born outside of the US.
Perinatal HIV/AIDS Cases, Born 2000-2008By Area of Birth and Reported in Florida
Although there have been significant decreases in perinatal HIV cases since 1992, each of the top reporting areas have reported at least one since 2000 (Table 6). As noted above, efforts will continue to be made to educate providers about the value of knowing the HIV status of all pregnant women during prenatal care and at delivery, and for those pregnant women testing positive for HIV, to offer the best treatment available to prevent vertical transmission.
AREA of BIRTH # OF CASES % OF TOTAL
Area 01* 4 2%
Area 03* 4 2%
Area 08 (Lee Only) 4 2%
Area 08 (not Lee)* 2 1%
Area 15* 13 8%
Broward County 29 17%
Duval County 15 9%
Hillsborough/Pinellas 11 7%
Miami-Dade County 41 24%
Orange County 14 8%
Palm Beach County 15 9%
Polk 4 2%
REMAINDER OF STATE 14 8%
TOTAL CASES 169 100%
*Area 1 = Escambia, Okaloosa, Santa Rosa & Walton Counties;
*Area 3 = Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee, & Union Counties;
* Area 8 (not Lee) = Charlotte, Colier, DeSoto, Glades, Hendry & Sarasota Counties.
*Area 15 = St. Lucie, Indian River, Martin, and Okeechobee Counties.
*A total of 23 perinatal cases reported in Florida were born outside of Florida and NOT included in these data.
10 of the 23 were born outside of the US.
29. Percent of Perinatal HIV (not AIDS) and AIDS
Cases By Age of HIV or AIDS Diagnosis
Born in and Reported in Florida, 2000-2008 (N=170)
As of 09/30/09, A total of 193 children born 2000-2008 have been reported with perinatally acquired HIV in Florida. A total of 170 (88%) were actually born in Florida. The following analysis will focus on the 170 perinatal HIV/AIDS cases who were born and reported in Florida.
Eighty percent (N=136) of the 170 perinatal cases born in Florida between 2000-2008 have not yet developed AIDS. The remaining 34 have. Sixty five percent (65%, N=89) of the HIV (not AIDS) cases perinatally infected and born in Florida during this period were diagnosed with HIV within the first 6 months of life (Figure 12). Seventy nine percent (79%, N=107) were diagnosed within the first year of life. Seventy-six percent (N=26) of 34 AIDS cases developed AIDS within the first year of life. The onset of AIDS can be postponed in children perinatally infected with HIV if early detection and treatment occurs. Florida law states that women are to be tested for HIV at their initial prenatal care visit, again at 28 - 32 weeks, and at labor and delivery if there was no test documented after 27 weeks gestation. Twenty percent of mothers of infected infants had an initial negative HIV test, meaning the mother contracted HIV during the pregnancy. It is critical that all pregnant women receive a second HIV test in the third trimester.
HIV (not AIDS) Cases (N=135)
0-5 months 6-12 months 1 year 2+ years
Age 89 17 16 13
AIDS Cases (N=34)
0-5 months 6-12 months 1 year 2+ years
Age 15 11 3 5Percent of Perinatal HIV (not AIDS) and AIDS
Cases By Age of HIV or AIDS Diagnosis
Born in and Reported in Florida, 2000-2008 (N=170)
As of 09/30/09, A total of 193 children born 2000-2008 have been reported with perinatally acquired HIV in Florida. A total of 170 (88%) were actually born in Florida. The following analysis will focus on the 170 perinatal HIV/AIDS cases who were born and reported in Florida.
Eighty percent (N=136) of the 170 perinatal cases born in Florida between 2000-2008 have not yet developed AIDS. The remaining 34 have. Sixty five percent (65%, N=89) of the HIV (not AIDS) cases perinatally infected and born in Florida during this period were diagnosed with HIV within the first 6 months of life (Figure 12). Seventy nine percent (79%, N=107) were diagnosed within the first year of life. Seventy-six percent (N=26) of 34 AIDS cases developed AIDS within the first year of life. The onset of AIDS can be postponed in children perinatally infected with HIV if early detection and treatment occurs. Florida law states that women are to be tested for HIV at their initial prenatal care visit, again at 28 - 32 weeks, and at labor and delivery if there was no test documented after 27 weeks gestation. Twenty percent of mothers of infected infants had an initial negative HIV test, meaning the mother contracted HIV during the pregnancy. It is critical that all pregnant women receive a second HIV test in the third trimester.
HIV (not AIDS) Cases (N=135)
0-5 months 6-12 months 1 year 2+ years
Age 89 17 16 13
AIDS Cases (N=34)
0-5 months 6-12 months 1 year 2+ years
Age 15 11 3 5
30. Time of Maternal HIV Testing Among Perinatal HIV/AIDS Cases Born in and Reported in Florida, 2000-2008 (N=170) Time of Maternal HIV Testing Among Perinatal HIV/AIDS Cases Born in and Reported in Florida, 2000-2008 (N=170)
It is important for HIV-infected pregnant women to know their HIV status so they can make informed decisions about the use of ZDV and other antiretroviral therapy to reduce perinatal transmission of HIV to their infants. Seventy-three percent (N=124) of women who gave birth in Florida to children diagnosed with HIV between 2000 and 2008 knew their HIV status before their child was born (Table 3). Four percent were diagnosed at delivery. Twenty-seven percent (N=46) did not know their status until after their child was born. The data demonstrate that in most instances, these women received no prenatal care and presented at the hospital ready to deliver, with no time for HIV assessment. Oftentimes, the mother receives no HIV test, even after delivery. In other instances, pregnant women were diagnosed HIV negative during pregnancy, were never re-tested prior to delivery, and a negative HIV status was assumed. These perinatal cases are usually not identified as being infected until a year or more after birth, when they or their mother get sick and get tested. In many instances, it was the diagnosis of the child that led to the diagnosis of the mother. These data stress the importance of offering HIV testing, preferably with a rapid test, at labor and delivery to women of unknown HIV status. Florida law requires women who appear at delivery with no record of an HIV test during pregnancy to be tested for HIV. The Florida Department of Health contracts with the Florida/Caribbean AIDS Education and Training Center (AETC) to educate health care providers who care for pregnant women, about HIV testing and treatment guidelines. Time of Maternal HIV TestingAmong Perinatal HIV/AIDS CasesBorn in and Reported in Florida, 2000-2008 (N=170)
It is important for HIV-infected pregnant women to know their HIV status so they can make informed decisions about the use of ZDV and other antiretroviral therapy to reduce perinatal transmission of HIV to their infants. Seventy-three percent (N=124) of women who gave birth in Florida to children diagnosed with HIV between 2000 and 2008 knew their HIV status before their child was born (Table 3). Four percent were diagnosed at delivery. Twenty-seven percent (N=46) did not know their status until after their child was born. The data demonstrate that in most instances, these women received no prenatal care and presented at the hospital ready to deliver, with no time for HIV assessment. Oftentimes, the mother receives no HIV test, even after delivery. In other instances, pregnant women were diagnosed HIV negative during pregnancy, were never re-tested prior to delivery, and a negative HIV status was assumed. These perinatal cases are usually not identified as being infected until a year or more after birth, when they or their mother get sick and get tested. In many instances, it was the diagnosis of the child that led to the diagnosis of the mother. These data stress the importance of offering HIV testing, preferably with a rapid test, at labor and delivery to women of unknown HIV status. Florida law requires women who appear at delivery with no record of an HIV test during pregnancy to be tested for HIV. The Florida Department of Health contracts with the Florida/Caribbean AIDS Education and Training Center (AETC) to educate health care providers who care for pregnant women, about HIV testing and treatment guidelines.
31.
Percent of Pregnant Women Giving Birth
To a Child Diagnosed with HIV in Florida and
Were Known to be HIV Positive Prior to Delivery
By Year of Birth 2000-2008* (123 of 170 births (73%))
The percent of pregnant women giving birth to a child diagnosed with HIV and who knew their HIV status prior to birth has increased from 82% in 2000 to 89% in 2008 (Figure 13). As the number of perinatal HIV cases has decreased each year, those who are born HIV-infected are more likely to be born to a mother whose HIV status was not known prior to birth. Oftentimes, these are mothers who had no prenatal care, lacked the second HIV test required later in their pregnancy and/or arrive at the hospital on the day of delivery with little time to assess her HIV status prior to delivery. This may be evident by the observed increase since 2004. Based on recommendations from the CDC, Florida has a priority initiative to reduce HIV transmission from mother to children by promoting voluntary maternal testing and antiretroviral therapy. As previously noted (Figure 4), the percent of perinatal AIDS cases being diagnosed later in life has increased over the past five years. These data further demonstrate the positive benefits of knowing the HIV status of the mother at birth and treating HIV-infected children with antiretrovirals and other prophylactic therapies shortly after birth; thus delaying the onset of AIDS.
YR #born %moms knew status
00 (N=27) 82
01 (N=37) 78
02 (N=19) 63
03 (N=19) 68
04 (N=13) 54
05 (N=13) 77
06 (N=16) 75
07 (N=17) 68
08 (N=9) 89
Percent of Pregnant Women Giving Birth
To a Child Diagnosed with HIV in Florida and
Were Known to be HIV Positive Prior to Delivery
By Year of Birth 2000-2008* (123 of 170 births (73%))
The percent of pregnant women giving birth to a child diagnosed with HIV and who knew their HIV status prior to birth has increased from 82% in 2000 to 89% in 2008 (Figure 13). As the number of perinatal HIV cases has decreased each year, those who are born HIV-infected are more likely to be born to a mother whose HIV status was not known prior to birth. Oftentimes, these are mothers who had no prenatal care, lacked the second HIV test required later in their pregnancy and/or arrive at the hospital on the day of delivery with little time to assess her HIV status prior to delivery. This may be evident by the observed increase since 2004. Based on recommendations from the CDC, Florida has a priority initiative to reduce HIV transmission from mother to children by promoting voluntary maternal testing and antiretroviral therapy. As previously noted (Figure 4), the percent of perinatal AIDS cases being diagnosed later in life has increased over the past five years. These data further demonstrate the positive benefits of knowing the HIV status of the mother at birth and treating HIV-infected children with antiretrovirals and other prophylactic therapies shortly after birth; thus delaying the onset of AIDS.
YR #born %moms knew status
00 (N=27) 82
01 (N=37) 78
02 (N=19) 63
03 (N=19) 68
04 (N=13) 54
05 (N=13) 77
06 (N=16) 75
07 (N=17) 68
08 (N=9) 89
32. Possible Missed Opportunities to Prevent Perinatal Transmission of HIV Among HIV/AIDS Cases Born in and Reported in Florida, 2000-2008**** (N=170) Possible Missed Opportunities to Prevent Perinatal Transmission of HIV Among HIV/AIDS Cases Born in and Reported in Florida, 2000-2008**** (N=170)
There are several possible missed opportunities where interventions could have taken place to prevent HIV perinatal transmission among infants born during 2000 2008 (Table 4). These data include 23 immigration cases born outside of Florida (12% of total births reported in Florida). These cases are counted in the Florida data because they were diagnosed with HIV as a resident in Florida, however, since the pregnancy and birth did not take place in Florida, the women did not access services in Florida during pregnancy.
Other missed opportunities include: inadequate prenatal care, no prenatal antiretroviral therapies (ART), no ART at delivery, and/or no neonatal ART (with in the first 6 weeks of the infants life). Other contributing factors include that some of the mothers breast-fed, abused drugs, or acquired a sexually transmitted disease (STD) during her pregnancy or a combination of the above.
Missed Opportunities Number Percent
Immigrant Peds (born outside of Florida)* 23 N/A*
Mom's HIV Status NOT Known Before Birth 46 27%
Inadequate Prenatal Care** 113 66%
No Prenatal ART 109 64%
No ART at Delivery 87 51%
Non-Caesarean Birth 76 45%
No Neonatal ART 61 36%
Breast Fed 18 11%
Other Contributing Factors Number*** Percent
Mom was a substance abuser 43 25%
Mom acquired an STD 60 35%
Total Born & Reported in Florida, Born 2000-2008 170
*A total of 193 peds reported in Florida were born from 2000 through 2008.
Of these, 23 (12%) were born outside of Florida. Of these 23, 10 were known to be born outside of the US.
** Inadequate prenatal care indicates prenatal care after the 4th month and less than 5 visits
***The same child can be in multiple categories
****2008 data are not complete due to reporting lag.
Possible Missed Opportunities to Prevent Perinatal Transmission of HIV Among HIV/AIDS CasesBorn in and Reported in Florida, 2000-2008**** (N=170)
There are several possible missed opportunities where interventions could have taken place to prevent HIV perinatal transmission among infants born during 2000 2008 (Table 4). These data include 23 immigration cases born outside of Florida (12% of total births reported in Florida). These cases are counted in the Florida data because they were diagnosed with HIV as a resident in Florida, however, since the pregnancy and birth did not take place in Florida, the women did not access services in Florida during pregnancy.
Other missed opportunities include: inadequate prenatal care, no prenatal antiretroviral therapies (ART), no ART at delivery, and/or no neonatal ART (with in the first 6 weeks of the infants life). Other contributing factors include that some of the mothers breast-fed, abused drugs, or acquired a sexually transmitted disease (STD) during her pregnancy or a combination of the above.
Missed Opportunities Number Percent
Immigrant Peds (born outside of Florida)* 23 N/A*
Mom's HIV Status NOT Known Before Birth 46 27%
Inadequate Prenatal Care** 113 66%
No Prenatal ART 109 64%
No ART at Delivery 87 51%
Non-Caesarean Birth 76 45%
No Neonatal ART 61 36%
Breast Fed 18 11%
Other Contributing Factors Number*** Percent
Mom was a substance abuser 43 25%
Mom acquired an STD 60 35%
Total Born & Reported in Florida, Born 2000-2008 170
*A total of 193 peds reported in Florida were born from 2000 through 2008.
Of these, 23 (12%) were born outside of Florida. Of these 23, 10 were known to be born outside of the US.
** Inadequate prenatal care indicates prenatal care after the 4th month and less than 5 visits
***The same child can be in multiple categories
****2008 data are not complete due to reporting lag.
33. Nationality of Mother and Child of
Perinatally HIV-Infected Cases
Reported in Florida (N=193)
Born 2000-2008
Mother
Non-US Born 57
US Born 135
Child
Non-US Born 15
US Born 177
Nationality of Mother and Child of
Perinatally HIV-Infected Cases
Reported in Florida (N=193)
Born 2000-2008
Mother
Non-US Born 57
US Born 135
Child
Non-US Born 15
US Born 177
34. Mothers of Perinatally HIV-Infected Cases
According to Receipt of
Prenatal Care OR Prenatal ART*
Born in and Reported in Florida, 2000-2008**
And Moms HIV status was known prior to delivery (N=170)
Adequate Prenatal Care (starting by the 4th month with 5+ visits (66% NO)
Prenatal ART (any AZT and/or antiretrovirals) (64% NO) Mothers of Perinatally HIV-Infected Cases
According to Receipt of
Prenatal Care OR Prenatal ART*
Born in and Reported in Florida, 2000-2008**
And Moms HIV status was known prior to delivery (N=170)
Adequate Prenatal Care (starting by the 4th month with 5+ visits (66% NO)
Prenatal ART (any AZT and/or antiretrovirals) (64% NO)
35. Mothers of Perinatally HIV-Infected Cases
According to Receipt of
Caesarean Delivery and/or ART at Delivery
Born in and Reported in Florida, 2000-2008**
And Moms HIV status was known prior to delivery (N=170)
Caesarean Delivery (45% NO)
ART (any AZT and/or antiretrovirals) at Delivery (51% NO)
Mothers of Perinatally HIV-Infected Cases
According to Receipt of
Caesarean Delivery and/or ART at Delivery
Born in and Reported in Florida, 2000-2008**
And Moms HIV status was known prior to delivery (N=170)
Caesarean Delivery (45% NO)
ART (any AZT and/or antiretrovirals) at Delivery (51% NO)
36. Percent of Mothers of Perinatally HIV-Infected Cases
Who Abused Drugs or Had an STD During Pregnancy
Born in and Reported in Florida, 2000-2008 (N=169)
Abused Drugs (25% YES) or
Had an STD During Pregnancy (36% YES)
Or both (12% YES)
Percent of Mothers of Perinatally HIV-Infected Cases
Who Abused Drugs or Had an STD During Pregnancy
Born in and Reported in Florida, 2000-2008 (N=169)
Abused Drugs (25% YES) or
Had an STD During Pregnancy (36% YES)
Or both (12% YES)
37. Perinatally HIV-Infected Cases
Status of Receiving Neonatal Drugs and Breastfeeding
Born in and Reported in Florida, 2000-2008 (N=169)
Received Neonatal Drugs (36% NO) and
Breastfed (11% YES)
Perinatally HIV-Infected Cases
Status of Receiving Neonatal Drugs and Breastfeeding
Born in and Reported in Florida, 2000-2008 (N=169)
Received Neonatal Drugs (36% NO) and
Breastfed (11% YES)
38. HIV/AIDS Pediatric Cases
By Expanded Modes of Exposure
Born in and Reported in 2000-2008
South Florida Counties (N=85), Florida
A total of 85 perinatal HIV/AIDS cases born between 2000 and 2008, were reported in Miami-Dade, Broward and Palm Beach counties. This represents 50% of the 169 perinatal HIV and AIDS cases born in Florida during this time period. All of the pediatric HIV/AIDS cases reported from these three counties were perinatally acquired. However, there is some variation in the mode of exposures of the mother by county (Figure 17).
Miami-Dade (N=41)
M-IDU M-Sx Risk M-Other Risk
3 30 8
Broward (N=29)
M-IDU M-Sx Risk M-Other Risk
2 20 7
Palm Beach (N=15)
M-IDU M-Sx Risk M-Other Risk
3 11 1
HIV/AIDS Pediatric Cases
By Expanded Modes of Exposure
Born in and Reported in 2000-2008
South Florida Counties (N=85), Florida
A total of 85 perinatal HIV/AIDS cases born between 2000 and 2008, were reported in Miami-Dade, Broward and Palm Beach counties. This represents 50% of the 169 perinatal HIV and AIDS cases born in Florida during this time period. All of the pediatric HIV/AIDS cases reported from these three counties were perinatally acquired. However, there is some variation in the mode of exposures of the mother by county (Figure 17).
Miami-Dade (N=41)
M-IDU M-Sx Risk M-Other Risk
3 30 8
Broward (N=29)
M-IDU M-Sx Risk M-Other Risk
2 20 7
Palm Beach (N=15)
M-IDU M-Sx Risk M-Other Risk
3 11 1
39. HIV/AIDS Pediatric Cases
By Age at First Diagnosis
Born in and Reported in 2000-2008
South Florida Counties (N=85), Florida
Eighty percent (68 of 85) of the perinatal HIV/AIDS cases born and reported in South Florida were diagnosed within the first year of life (Figure 18). As noted earlier, an early diagnosis of perinatally acquired HIV infection allows the opportunity of early treatment, thus possibly prolonging the onset of AIDS.
Miami-Dade (N=41)
Age 0 Age 1 2+
34 6 1
Broward (N=29)
Age 0 Age 1 Age 2-4
25 1 3
Palm Beach (N=15)
Age 0 Age 1 Age 2-4
9 1 5
HIV/AIDS Pediatric Cases
By Age at First Diagnosis
Born in and Reported in 2000-2008
South Florida Counties (N=85), Florida
Eighty percent (68 of 85) of the perinatal HIV/AIDS cases born and reported in South Florida were diagnosed within the first year of life (Figure 18). As noted earlier, an early diagnosis of perinatally acquired HIV infection allows the opportunity of early treatment, thus possibly prolonging the onset of AIDS.
Miami-Dade (N=41)
Age 0 Age 1 2+
34 6 1
Broward (N=29)
Age 0 Age 1 Age 2-4
25 1 3
Palm Beach (N=15)
Age 0 Age 1 Age 2-4
9 1 5
40. HIV/AIDS Pediatric Cases
By Race/Ethnicity
Born in and Reported in 2000-2008
South Florida Counties (N=85), Florida
As previously mentioned, pediatric AIDS in Florida disproportionately affects non-Hispanic blacks. In South Florida, 80%, (68 of 85) of the pediatric HIV/AIDS cases were among blacks (Figure 19). These data differ greatly from the population by race/ethnicity for women of childbearing age (15-44) living in these counties (Table 7).
Miami-Dade (N=41)
White Black Hispanic Other
1 34 6 0
Broward (N=29)
White Black Hispanic Other
1 24 3 1
Palm Beach (N=15)
White Black Hispanic Other
3 10 2 0
HIV/AIDS Pediatric Cases
By Race/Ethnicity
Born in and Reported in 2000-2008
South Florida Counties (N=85), Florida
As previously mentioned, pediatric AIDS in Florida disproportionately affects non-Hispanic blacks. In South Florida, 80%, (68 of 85) of the pediatric HIV/AIDS cases were among blacks (Figure 19). These data differ greatly from the population by race/ethnicity for women of childbearing age (15-44) living in these counties (Table 7).
Miami-Dade (N=41)
White Black Hispanic Other
1 34 6 0
Broward (N=29)
White Black Hispanic Other
1 24 3 1
Palm Beach (N=15)
White Black Hispanic Other
3 10 2 0
41. HIV Status for Babies KNOWN to be Born
To an HIV-Infected Mother in Florida, 2008 (N=609)
*Note: 1.5% (N=9) (exploded pieces are Infected with HIV/AIDS), as of 09/30/09HIV Status for Babies KNOWN to be Born
To an HIV-Infected Mother in Florida, 2008 (N=609)
*Note: 1.5% (N=9) (exploded pieces are Infected with HIV/AIDS), as of 09/30/09
42. Prevention is the Key to Success
Without appropriate medical therapy, about 30% of babies born to pregnant women with HIV in Florida will be diagnosed with HIV. Infection can occur at any time during the pregnancy (usually preceding or during delivery), and can also occur through breastfeeding. Because infection can occur through breast milk, women with HIV are strongly encouraged not to breast feed their children. Even with proper prenatal care and treatment, approximately 2% of babies born to HIV-infected women will become infected. Prevention is the key to success (Figure 21).Prevention is the Key to Success
Without appropriate medical therapy, about 30% of babies born to pregnant women with HIV in Florida will be diagnosed with HIV. Infection can occur at any time during the pregnancy (usually preceding or during delivery), and can also occur through breastfeeding. Because infection can occur through breast milk, women with HIV are strongly encouraged not to breast feed their children. Even with proper prenatal care and treatment, approximately 2% of babies born to HIV-infected women will become infected. Prevention is the key to success (Figure 21).
43. Perinatal Programs Perinatal Prevention is focused on:
Prevention Services for women of child bearing age.
Education and technical assistance for clinicians who treat pregnant women.
44. Perinatal Programs:
The Targeted Outreach for Pregnant Women Act (TOPWA) program.
The Florida/Caribbean AIDS Education and Training Center project conducts trainings of perinatal service providers.
The University of Florida project evaluates the perinatal HIV prevention program and conducts chart reviews.
Collaboration with state agencies and organizations to ensure that perinatal HIV issues are addressed.
Perinatal social marketing campaign.
Women and Children: The Perinatal HIV Program is located on the Bureau of HIV/AIDS internet site
Perinatal Programs:
The Targeted Outreach for Pregnant Women Act (TOPWA) program.
The Florida/Caribbean AIDS Education and Training Center project conducts trainings of perinatal service providers.
The University of Florida project evaluates the perinatal HIV prevention program and conducts chart reviews.
Collaboration with state agencies and organizations to ensure that perinatal HIV issues are addressed.
Perinatal social marketing campaign.
Women and Children: The Perinatal HIV Program is located on the Bureau of HIV/AIDS internet site
45. AETC staff work to:
educate medical professionals who provide care for HIV-infected pregnant women and their babies.
Assist hospitals in implementing rapid HIV testing in labor & delivery units.
AETC staff work to:
educate medical professionals who provide care for HIV-infected pregnant women and their babies.
Assist hospitals in implementing rapid HIV testing in labor & delivery units.
AETC staff work to:
educate medical professionals who provide care for HIV-infected pregnant women and their babies.
Assist hospitals in implementing rapid HIV testing in labor & delivery units.
46. TOPWA:
7 programs (3 also have jail components)
Conducts outreach to high-risk pregnant women and actively links them with services
Offers on-site pregnancy and HIV testing.
Assists mothers with obtaining family planning services if they choose to delay the birth of a subsequent baby
TOPWA:
7 programs (3 also have jail components)
Conducts outreach to high-risk pregnant women and actively links them with services
Offers on-site pregnancy and HIV testing.
Assists mothers with obtaining family planning services if they choose to delay the birth of a subsequent baby
47. Map of Targeted Outreach for Pregnant Women Act (TOPWA)
Contract Providers
Map of Targeted Outreach for Pregnant Women Act (TOPWA)
Contract Providers
48. Over 32,000 high-risk or HIV-infected pregnant women have been enrolled in TOPWA and assessed to determine their level of risk and service needs. Figure 22 shows the race/ethnicity of women screened for and enrolled in the TOPWA program. The programs emphasis on minority groups reflects the high numbers of non-white women becoming infected with HIV in Florida, and the Department of Healths commitment to eliminate racial and ethnic health disparities. Over 32,000 high-risk or HIV-infected pregnant women have been enrolled in TOPWA and assessed to determine their level of risk and service needs. Figure 22 shows the race/ethnicity of women screened for and enrolled in the TOPWA program. The programs emphasis on minority groups reflects the high numbers of non-white women becoming infected with HIV in Florida, and the Department of Healths commitment to eliminate racial and ethnic health disparities.
49. Figure 23 shows the age of women screened for and enrolled in the TOPWA program. Although 49% of women screened for TOPWA are age twenty-four and under, 61% of enrolled women are in this age group, reflecting TOPWAs focus on the most at-risk pregnant women. Figure 23 shows the age of women screened for and enrolled in the TOPWA program. Although 49% of women screened for TOPWA are age twenty-four and under, 61% of enrolled women are in this age group, reflecting TOPWAs focus on the most at-risk pregnant women.
50. PRAMS: Healthcare Provider Discussions About HIV Testing, and Pregnant Women Tested for HIV in Florida, 2000-2007* Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) indicate that Floridas HIV testing rates for pregnant women have increased significantly over the past few years. PRAMS is a joint surveillance project between the Florida Department of Health and the Centers for Disease Control and Prevention designed to monitor the physical, economic, and social health of Floridas mothers and newborns. Figure 21 shows the percentage of women surveyed who state their prenatal care provider discussed HIV testing with them and the percentage of women who state they were tested for HIV, during their most recent pregnancy.Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) indicate that Floridas HIV testing rates for pregnant women have increased significantly over the past few years. PRAMS is a joint surveillance project between the Florida Department of Health and the Centers for Disease Control and Prevention designed to monitor the physical, economic, and social health of Floridas mothers and newborns. Figure 21 shows the percentage of women surveyed who state their prenatal care provider discussed HIV testing with them and the percentage of women who state they were tested for HIV, during their most recent pregnancy.
51. Prenatal HIV Testing Among Women
Delivering a Live Birth, Florida, 1996-2007
Comment: Floridas percentage of childbearing women tested perinatally for HIV is the highest in the U.S., which has probably contributed to the continued decline in pediatric HIV/AIDS cases. Source: Florida Pregnancy Risk Assessment Monitoring System (PRAMS),(2006 or 2008 not available, 2007 had half of normal sample size). http://www.doh.state.fl.us/disease_ctrl/epi/Chronic_Disease/PRAMS/Data_Books.htmPrenatal HIV Testing Among Women
Delivering a Live Birth, Florida, 1996-2007
Comment: Floridas percentage of childbearing women tested perinatally for HIV is the highest in the U.S., which has probably contributed to the continued decline in pediatric HIV/AIDS cases. Source: Florida Pregnancy Risk Assessment Monitoring System (PRAMS),(2006 or 2008 not available, 2007 had half of normal sample size).http://www.doh.state.fl.us/disease_ctrl/epi/Chronic_Disease/PRAMS/Data_Books.htm
52. HIV Seroprevalence among Childbearing Women
by Survey Cycle and Mothers Race
Florida, 1988-1995
*Number Positive/Number Tested x 1,000.
Survey Cycles are October through March, except for the last cycle which was 10/95-12/95.
This survey ended in 1995.
1988 1989 1990 1992 1992 1993 1994 1995
White 1.4 1.6 1.7 2.3 1.7 1 1 1.2
Black 16.2 16.3 16.2 17.1 18 17.4 15.3 14.3
Total 4.5 4.6 4.9 5.4 5.5 4.7 4.3 4.1
HIV Seroprevalence among Childbearing Women
by Survey Cycle and Mothers Race
Florida, 1988-1995
*Number Positive/Number Tested x 1,000.
Survey Cycles are October through March, except for the last cycle which was 10/95-12/95.
This survey ended in 1995.
1988 1989 1990 1992 1992 1993 1994 1995
White 1.4 1.6 1.7 2.3 1.7 1 1 1.2
Black 16.2 16.3 16.2 17.1 18 17.4 15.3 14.3
Total 4.5 4.6 4.9 5.4 5.5 4.7 4.3 4.1
53. HIV/AIDS Cases Among
Women of Childbearing Age (Ages 15-44)
by Race/Ethnicity and Year of Report
Florida, 1999-2008
Comment: Although the majority of HIV cases among women are black, the percent of black female HIV cases has decreased from 77% in 1999 to 68% in 2008. Decreases have been observed among both white and Hispanic female HIV cases over this same time period.
*Other races represent less than 1% of the cases and are not included. Data as of 08/25/09
Year 99 00 01 02 03 04 05 06 07 08
White, non Hispanic 311 282 272 261 266 221 195 194 239 201
Black, non-Hispanic 1837 1564 1423 1325 1172 977 861 753 880 824
Hispanic 215 210 238 222 224 179 189 172 184 168
HIV/AIDS Cases Among
Women of Childbearing Age (Ages 15-44)
by Race/Ethnicity and Year of Report
Florida, 1999-2008
Comment: Although the majority of HIV cases among women are black, the percent of black female HIV cases has decreased from 77% in 1999 to 68% in 2008. Decreases have been observed among both white and Hispanic female HIV cases over this same time period.
*Other races represent less than 1% of the cases and are not included. Data as of 08/25/09
Year 99 00 01 02 03 04 05 06 07 08
White, non Hispanic 311 282 272 261 266 221 195 194 239 201
Black, non-Hispanic 1837 1564 1423 1325 1172 977 861 753 880 824
Hispanic 215 210 238 222 224 179 189 172 184 168
54. HIV/AIDS Cases Among
Women of Childbearing Age (Ages 15-44)
by Age of Diagnosis and Year of Report
Florida, 1999-2008
Decreases in newly diagnosis HIV/AIDS cases among women ages 15-44 have been observed by all age groups.
Year 99 00 01 02 03 04 05 06 07 08
15-24 488 439 382 381 357 288 287 252 266 254
25-29 430 348 351 301 299 235 208 204 217 212
30-39 1038 934 898 792 683 568 488 421 544 476
40-44 440 385 345 375 353 319 287 261 299 267
HIV/AIDS Cases Among
Women of Childbearing Age (Ages 15-44)
by Age of Diagnosis and Year of Report
Florida, 1999-2008
Decreases in newly diagnosis HIV/AIDS cases among women ages 15-44 have been observed by all age groups.
Year 99 00 01 02 03 04 05 06 07 08
15-24 488 439 382 381 357 288 287 252 266 254
25-29 430 348 351 301 299 235 208 204 217 212
30-39 1038 934 898 792 683 568 488 421 544 476
40-44 440 385 345 375 353 319 287 261 299 267
55. HIV/AIDS Cases Among
Women of Childbearing Age (Ages 15-44)
by Mode of Exposure and Year of Report
Florida, 1999-2008
95 96 97 98 99 00 01 02 03 04 05 06 07 08
IDU 287 203 299 483 424 319 282 241 206 154 129 112 123 72
HETERO 592 612 944 2057 1957 1777 1693 1605 1484 1250 1138 1024 1199 1131
HIV/AIDS Cases Among
Women of Childbearing Age (Ages 15-44)
by Mode of Exposure and Year of Report
Florida, 1999-2008
95 96 97 98 99 00 01 02 03 04 05 06 07 08
IDU 287 203 299 483 424 319 282 241 206 154 129 112 123 72
HETERO 592 612 944 2057 1957 1777 1693 1605 1484 1250 1138 1024 1199 1131
56. For Florida HIV/AIDS Surveillance Data
Contact: (850) 245-4444
Lorene Maddox, MPH Ext. 2613
Tracina Bush, AA Ext. 2612
Julia Fitz, MPH Ext. 2373
Internet http://www.floridaaids.org
Intranet http://dohiws.doh.state.fl.us
CDCs Internet site for HIV/AIDS Slides: http://www.cdc.gov/hiv/graphics.htmFor Florida HIV/AIDS Surveillance Data
Contact: (850) 245-4444
Lorene Maddox, MPH Ext. 2613
Tracina Bush, AA Ext. 2612
Julia Fitz, MPH Ext. 2373
Internet http://www.floridaaids.org
Intranet http://dohiws.doh.state.fl.us
CDCs Internet site for HIV/AIDS Slides: http://www.cdc.gov/hiv/graphics.htm
