Missouri St. Louis TGA 2016 HIV Epidemiological Profile

Transcription

1 Missouri St. Louis TGA 2016 HIV Epidemiological Profile St. Louis TGA Part A Planning Council Prepared by the City of St. Louis Department of Health Center for Health Information, Research, and Planning Planning Council, May,

2 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV Disease Prevalence HIV/AIDS Incidence Unmet Need Other Sexually Transmitted Diseases Summary 2

3 Introduction: Purpose To create a better understanding of the HIV/AIDS epidemic in our area Compares trends in HIV/AIDS cases in the last few years To identify subpopulations disproportionately affected by the disease 3

4 Introduction: Sources Mandatory Reporting of HIV & AIDS Cases omissouri Department of Health and Senior Services (MDHSS) o Illinois Department of Public Health (IDPH) HIV/AIDS Reporting System (ehars) oall positive test results o Demographic information Demographic Information (Census) 4

5 TGA - Transitional Grant Area PLWH/A People living with HIV or AIDS MOT Mode of Transmission o MSM Men who have sex with men (includes homosexual and bisexual) o IDU Intravenous drug user o MSM/IDU Men who have sex with men and are intravenous drug users o Hetero Persons infected by a partner of the opposite sex o Peds HIV infected child due to prenatal or perinatal exposure o NIR No indicated risk Introduction: Commonly Used Terms HIV Disease Categorization that includes those with HIV infection and AIDS disease (HIV/AIDS) 5

6 Introduction: Context WHO o People living with HIV (PLWH) o People living with AIDS (PLWA) o People living with HIV Disease (PLWH/A) WHAT o Incidence o Prevalence WHERE omo St. Louis TGA 6

7 Missouri St. Louis TGA 7

8 Demographics: Who do We Save? othe St. Louis Region is the largest urban area in Missouri as of 2010 census, has more than 2,000,000 residents ost. Louis County is the most populated county in the region, with a little over 1,000,000 residents othe region s population is approximately 75 percent White, 20 percent Black, 3 percent Asian, Hispanic is less than 1 percent 8

9 Socio-economic Status o Over 36 percent of the population s household income is less than $50,000 o Approximately 20 percent of the population live below 100 Federal Poverty Level; 10 percent had less than high school education o Over 10 percent of the population are uninsured 9

10 HIV/AIDS Prevalence Those currently living with HIV or AIDS, this includes all cases that have been diagnosed as of 12/31/2016 (MO) 10

11 HIV/AIDS Prevalence COUNTY RACE SEX AGE GROUP MOT SUBPOPULATIONS 11

12 HIV/AIDS Prevalence- County MO, St. Louis TGA HIV Disease Prevalence Rates, Missouri St. Louis TGA County Total Living HIV Disease as of 12/31/2012 Total Living HIV Disease as of 12/31/2013 Total Living HIV Disease as of 12/31/2014 Total Living HIV Disease as of 12/31/2015 Total Living HIV Disease as of 12/31/2016 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate FRANKLIN CO JEFFERSON CO LINCOLN CO ST CHARLES CO ST LOUIS CITY ST LOUIS CO WARREN CO MO-TGA Total *Rates are per 100,000 persons 12

13 HIV/AIDS Epidemic in the MO, St. Louis TGA As of 2016: o o Cumulative HIV/AIDS cases reported in the St. Louis Region: 10,036 o AIDS: 6,549 o Deaths: 3,891 o 3,508 AIDS deaths People living with HIV/AIDS: o 6145 people currently live in the St. Louis Region 13

14 Characteristics of People Living with HIV/AIDS, 2016 Characteristics N % Rates (per 100,000) Sex Race/Ethnicity Male 5,051 82% 497 Female 1,094 18% 100 Total 6, African American % White % Hispanic 169 3% Other 113 2% 109 Unknown Total 6, %

15 HIV/AIDS Prevalence: County MO St. Louis TGA, 2016 Population by County MO St. Louis TGA Prevalence of PLWHA by County MO ST. Louis TGA, 2016 (n=6145) ST LOUIS CO. 47% WARREN CO. 2% FRANKLIN CO. 5% JEFFERSON CO. 10% Disproportionate Impact: 15% of MO St Louis TGA population live in City of St. Louis, while the St. Louis City accounts for 56% of HIV/AIDS cases in the MO St. Louis TGA. ST LOUIS CITY 15% ST CHARLES CO. 18% LINCOLN CO. 3% ST LOUIS CITY 56% ST LOUIS CO. 37% WARREN CO. 0% FRANKLIN CO. 1% JEFFERSON CO. 2% LINCOLN CO. 0% ST CHARLES CO. 4% 15

16 Rate per 100,000 people HIV/AIDS Prevalence Rate MO St. Louis TGA Prevalence Rates of HIV Disease MO, St. Louis MO-TGA Total Years 16

17 HIV/AIDS Prevalence: Race/Ethnicity MO St. Louis TGA Hispanic 3% Population By Race/ethnicity, MO ST. Louis TGA Black 19% Other 5% Other 2% (n=89) Hispanic 3% (n=161) Prevalence PLWH/A by Race/Ethnicity, MO St. Louis TGA, 2016 (n=6145) Unknown 0% (n=2) Disproportionate Impact: Prevalence White rate of HIV Disease among black 73% is approximately 6 times higher than Whites (830.7 cases per 100,000 blacks, vs cases per 100,000 whites) White 39% (n=2389) Black 56% (n=3271) Black White Hispanic Other Black White Hispanic Other Unknown 17

18 HIV/AIDS Prevalence: Sex Population by Sex, MO St. Louis TGA, 2015 Prevalence of PLWH/A by Sex, MO St. Louis TGA, 2016 (n=6145) Female 18% (n=1094) Female 52% Disproportionate Impact: Males have the highest rate Male of HIV disease prevalence in 48% the St. Louis TGA (495.6 per 100,000 males), which is approximately FIVE times more the prevalence rate for females (100.2 per 100,000 females) Male 82% (n=5051) Male Female Male Female 18

19 Characteristics of People Living with HIV/AIDS, 2016 Age Characteristics N % Rates (per 100,000) Under < 1% % % % % Total 6,145 19

20 HIV/AIDS Prevalence: Age Group Population by Age Group, MO ST. Louis TGA Percent of PLWH/A by Age Group MO, St. Louis TGA, & Older 15% Under 13 17% 65 & Older 6% % Under 13 <1% Disproportionate Impact: 28% year olds make up 38% of the PLWH/A % % % % Under & Older Under & Older 20

21 Characteristics of People Living with HIV/AIDS, 2016 MOT White N(%) Black (n(%) Hispanic (n%) Other/Unknown (n(%) Total MSM 1,859(47.0%) 1,920(48.5%) 105(2.7%) 74(1.7%) 3,958 IDU 74(32.6%) 146(64.3%) <5 <5 227 MSM & IDU 84(47.5%) 87(49.2%) <5 <5 177 Heterosexual 199(19.5%) 772(75.5%) 30(2.9%) 21(2.1%) 1,022 Other/NIR 211(27.7%) 509(66.9%) 26(3.4%) 15(2.0%) 761 Total 2,427 3, ,145 21

22 HIV/AIDS Prevalence: MOT Other/Unk/NR 12% (n=761) Prevalence of PLWH/A by MOT, MO St. Louis TGA, 2016 N=6145 Heterosexual 17% (n=1022) MSM & IDU 3% (n=177) IDU 4% MSM 64.4% (n=3958) MSM IDU MSM & IDU Heterosexual Other/Unk/NR 22

23 Percentage HIV/AIDS Prevalence Subpopulation: Males, by Race/Ethnicity 60% 50% 51.9% Prevalence HIV Disease Among Males by Race/Ethnicity, MO St. Louis TGA, 2016 (N=5051) 43.7% 40% 30% 20% 10% 0% 2.7% 1.8% Black White Hispanic Other/Unknown Race Category Other/Unknown was not stratified by Race in this report 23

24 Percentage of Female HIV/AIDS Prevalence Subpopulation: Female, by Race/Ethnicity 80% 74.3% Prevalence of HIV Disease Among Females by Race/Ethnicity, MO St. Louis TGA, 2016 (n=1094) 70% 60% 50% 40% 30% 20% 10% 0% 20.2% 3.1% 2.4% Black White Hispanic Other/Unknown Race *Race category Other/Unknown/NR was not stratified by Gender in this report 24

25 Rate per 100,000 people HIV/AIDS Prevalence Subpopulation: Males, by Known Race/Ethnicity HIV Disease Prevalence Rate Among Males by Know Race/Ethnicity, MO St. Louis TGA 2016 (N=4946) Black Hispanic White Race/Ethnicity Category Other/Unknown was not stratified by Race in this report 25

26 Rate per 100,000 population HIV/AIDS Prevalence Subpopulation: Females, by Known Race (N=1068) HIV Disease Prevalence Rate Among Females by Known Race/Ethnicity MO, St. Louis, TGA Black Hispanic White Race/Ethnicity *Race category Other/Unknown/NR was not stratified by Gender in this report 26

27 Percentage of Male HIV/AIDS Prevalence Subpopulation: Males by MOT & Race HIV Disease Among Males by MOT & Race/Ethnicity MO St. Louis TGA, 2016 (n=5051) 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 84.3% 77.8% 73.3% Disproportionate Impact: MSM reported as the highest risk category among males of all races 8.2% 3.5% 1.6% 3.3% 3.8% 5.9% 1.5% 3.0% 2.6% 11.6% 11.9% 7.7% MSM IDU MSM & IDU Heterosexual Other/Unk/NR MOT Black White Hispanic *Race category Other/Unknown was not stratified by Gender in this report 27

28 Percentage of Female HIV/AIDS Prevalence Subpopulation: Females by MOT & Race 80% HIV Disease Among Females by MOT & Race/Ethnicity, MO St. Louis TGA 2016 (N=1094) 70% 60% 50% 40% 68.4% 64.3% 64.7% Disproportionate Impact: heterosexual reported as the highest risk category among females of all races 30% 25.1% 29.4% 20% 17.2% 18.6% 10% 0% 6.5% 5.9% IDU Heterosexual Other/Unk/NR Race by MOT Black White Hispanic *Race category Other/Unknown was not stratified by Gender in this report 28

29 Percentages HIV/AIDS Prevalence Subpopulation: Age Group & Race/Ethnicity 40% 35% 30% 25% 20% 15% 10% Percentage of HIV Disease by Age Group and Race/Ethnicity MO, St. Louis, 2016 Disproportionate Impact: 45 & older make up 71% of the PLWH/A for White population while in Hispanic 60% of the cases are in age group % 16.0% 16.6% 33.1% 34.5% 28.0% 26.6% 37.2% 20.7% 5% 0% 3.0% 0.1% 0.6% 1.1% Under yrs yrs yrs yrs 55 & older Race/Ethnicity Black White Hispanic Other/Uknw 29

30 HIV/AIDS Incidence Incidence is the number of newly diagnosed cases within a specific time period. 30

31 HIV/AIDS Incidence COUNTY RACE/ETHNICITY SEX AGE GROUP MOT SUBPOPULATIONS 31

32 HIV/AIDS Incidence by County MO St. Louis TGA Missouri St. Louis TGA New HIV/AIDS Diagnosis Rates County HIV Disease Incidence as of 12/31/2012 HIV Disease Incidence as of 12/31/2013 HIV Disease Incidence as of 12/31/2014 HIV Disease Incidence as of 12/31/2015 HIV Disease Incidence as of 12/31/2015 Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate FRANKLIN CO JEFFERSON CO LINCOLN CO ST CHARLES CO ST LOUIS CITY ST LOUIS CO WARREN CO MO-TGA Total *Rates are per 100,000 persons 32

33 HIV/AIDS Incidence by Race/Ethnicity MO St. Louis TGA HIV Incidence AIDS Incidence Race/Ethnicity Cases % Cases % Cases % Cases % Cases % Cases % White % % % % % % Black % % % % % % Hispanic 3 1.7% 4 2.2% 6 2.9% 2 3.8% 3 5.6% 0 0.0% Other 2 1.1% 9 4.8% 8 3.9% 2 3.8% 4 7.4% 1 1.9% Unknown 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% Total

34 Percentage HIV/AIDS Incidence: Race MO St. Louis TGA 80% 70% 60% 50% HIV & AIDS Incidence Comparison, by Race/Ethnicity MO, St. Louis, % 65.2% Disproportionate impact: In Missouri- St. Louis TGA, out of all the newly diagnosed cases of HIV or AIDS, the majority were Black (67% for AIDS and 65% for HIV). 40% 30% 30.8% 27.9% 20% 10% 0% 2.9% 0.0% 3.9% 1.9% 0.0% 0.0% White Black Hispanic Other Unknown Race HIV Incidence (n=204) AIDS Incidence (n=52) 34

35 Rate per 100,000 HIV/AIDS Incidence: Race MO St. Louis TGA HIV & AIDS Incidence Comparison, by Race/Ethnicity MO, St. Louis, Year of Diagnosis White Black Hispanic 35

36 Percentage HIV Incidence Comparison, Race HIV Incidence Comparison by Race/Ethnicity MO, St. Louis-TGA, % 70% 60% 50% 68.2% 62.9% 65.2% Disproportionate impact: Over the past three years the majority of HIV newly diagnosed cases has been consistently black 40% 30% 29.0% 30.1% 27.9% 20% 10% 0% 4.8% 1.7% 2.2% 2.9% 3.9% 1.1% White Black Hispanic Other Race/Ethnicity 2014 (n=178) 2015 (n=186) 2016 (n=204) 36

37 Percentage AIDS Incidence Comparison, Race 80% 70% 60% 50% 40% 30% 30.8% 35.2% AIDS Incidence Comparison from , by Race/Ethnicity MO, St. Louis-TGA 30.8% 61.5% 51.9% 67.3% Disproportionate impact: Over the past three years the majority of AIDS newly diagnosed cases has been consistently black 20% 10% 0% 7.4% 5.6% 3.8% 3.8% 0.0% White Black Hispanic Other Race/Ethnicity 1.9% 2014 (n=52) 2015 (n=54) 2016 (n=52) 37

38 HIV/AIDS Incidence- Sex MO St. Louis, TGA HIV Incidence AIDS Incidence Gender Cases % Cases % Cases % Cases % Cases % Cases % Male % % % % % % Female % % % % % % Total

39 HIV/AIDS Incidence by Sex MO St. Louis-TGA HIV Incidence (n=204) AIDS Incidence (n=52) Female 17% N=34 Female 23% N=12 Male 83% N=170 Male 77% N=40 Male Female Male Female 39

40 Rate per 100,000 People HIV/AIDS Incidence: Sex MO, St. Louis TGA HIV & AIDS Comparison, by sex MO, St. Louis TGA, Male Female 40

41 HIV/AIDS Incidence: Age Group MO St. Louis TGA Missouri St. Louis TGA New HIV/AIDS Diagnosis by Age Group HIV Incidence AIDS Incidence Age Cases % Cases % Cases % Cases % Cases % Cases % Under % 1 0.5% 3 1.5% 0 0.0% 1 1.9% 0 0.0% % % % % % % % % % % % % % % % % % % 65 & Older 0 0.0% 2 1.1% 1 0.5% 0 0.0% 2 3.7% 2 3.8% Total

42 Percentage 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% HIV/AIDS Incidence: Age Group MO, St. Louis TGA Disproportionate impact: About 78% of newly diagnosed HIV cases are in the & age group. 1.5% 0.0% HIV & AIDS Comparison, by Age Group MO, St. Louis TGA, % 17.3% 47.5% 36.5% 20.1% 42.3% Key point: The majority of newly diagnosed AIDS cases are in the older age groups (25-64). 0.5% 3.8% Under & Older Age Groups HIV Incidence (n=204) AIDS Incidence (n=52) 42

43 Percentage HIV Incidence Comparison: Age Group MO, St. Louis TGA 60% 50% HIV Incidence by Age Group MO, St. Louis TGA % 47.3% 47.5% 40% 30% 20% 10% 0% 38.7% 35.2% 30.4% 20.1% 12.4% 10.8% 2.3% 0.5% 1.5% 0.0% 1.1% 0.5% Under & Older Age Group 2014 (n=176) 2015 (n=186) 2016 (n=204) 43

44 AIDS Incidence Comparison: Age Group MO St. Louis TGA 70% 60% AIDS Incidence by Age Group MO, St. Louis- TGA, % 50% 40% 42.6% 36.5% 37.0% 42.3% 30% 25.0% 20% 10% 0% 1.9% 0.0% 0.0% 13.5% 14.8% 17.3% 3.7% 0.0% Under & Older % 44

45 HIV/AIDS Incidence by MOT MO St. Louis TGA Missouri St. Louis TGA New HIV/AIDS Diagnosis by MOT HIV Incidence AIDS Incidence MOT Cases % Cases % Cases % Cases % Cases % Cases % MSM % % % % % % IDU 1 0.6% 5 2.7% 6 2.9% 1 1.9% 2 3.7% 1 1.9% MSM & IDU 6 3.4% 3 1.6% 0 0.0% 2 3.8% 0 0.0% 0 0.0% Heterosexual % % % % % % Other/NIR % % % % % 4 7.4% Total

46 Percentage HIV/AIDS Incidence: MOT MO, St. Louis TGA HIV & AIDS Incidence Comparison, by MOT MO, St. TGA, % 60% 66.7% 59.3% 50% 40% 30% 20% 10% 0% 27.8% 21.6% 2.9% 8.8% 7.4% 1.9% 0.0% 0.0% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission HIV Incidence (n=186) AIDS Incidence (n=54) 46

47 Percentage HIV Incidence: MOT MO, St. Louis TGA 70% 60% 66.7% 63.1% 62.9% HIV Incidence Comparison from , MOT MO, St. Louis TGA 50% 40% 30% 20% 17.0% 22.6% 21.6% 15.9% 10% 0% 10.2% 8.8% 2.7% 2.9% 3.4% 0.6% 1.6% 0.0% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission 2014 (n=176) 2015 (n=186) 2016 (n=204) 47

48 Percentage AIDS Incidence: MOT MO, St. Louis TGA 70% AIDS Incidence Comparison by MOT MO, St. Louis TGA, % 59.3% 59.3% 55.8% 50% 40% 30% 20% 21.2% 20.4% 27.8% 17.3% 16.7% 10% 0% 7.4% 3.7% 3.8% 1.9% 1.9% 0.0% 0.0% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission 2014 (n=52) 2015 (n=54) 2016 (n=52) 48

49 HIV/AIDS Incidence: AGE Group MO, St. Louis TGA, HIV/AIDS Incidence Comparison by Age Group MO, St. Louis TGA Under % 60% 60% 50% 40% 50% 40% 45.5% 45.3% 50% 40% 32.5% 30% 20% 28.9% 30% 20% 30% 20% 21.3% 24.6% 10% 10% 10% 0% % %

50 HIV/AIDS Incidence: MSM Group MO, St. Louis TGA, HIV/AIDS MSM Group Incidence Comparison by Race Under 25 MO, St. Louis TGA Black White 100% 100% 90% 90% 80% 82.6% 79.0% 80% 70% 70% 60% 60% 50% 50% 40% 40% 30% 30% 20% 10% 20% 10% 10.1% 9.7% 0% %

51 HIV/AIDS Incidence: Female Heterosexual Cases MO, St. Louis TGA, HIV/AIDS Females Heterosexual Incidence Comparison by Race MO, St. Louis TGA White Black 100% 90% 80% 70% 60% 50% 42.9% 40% 30% 21.4% 20% 10% 0% % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 57.1% 71.4%

52 Unmet Need Unmet need is defined as the proportion of people leaving with HIV/AIDS in on our region who do not have evidence of HIV medical care (tested for CD4 or Viral load) during a specific year. 52

53 Unmet Need MO St. Louis TGA, 2016 Unmet Needs Characteristics Race Trend line Unmet Need Black/African American Ma 34.6% 32.5% 30.6% 29.6% 30.3% Black/African American Fe 28.9% 27.0% 25.3% 25.7% 28.4% White Male 37.2% 35.4% 33.9% 33.2% 34.9% White Female 25.5% 26.9% 24.6% 25.1% 24.4% Hispanic 42.8% 39.9% 40.8% 42.9% 42.0% Other / UNKNOWN 34.7% 31.3% 31.3% 28.6% 26.1% Gender Male 36.0% 34.1% 32.4% 31.5% 32.6% 1,649 1,535 1,545 1,590 1,633 Female 28.7% 27.0% 25.5% 26.2% 27.6% Mode of Exposure MSM 35.8% 34.0% 31.9% 30.8% 31.9% ,172 1,184 1,228 1,258 IDU 34.1% 32.7% 29.2% 16.6% 30.0% MSM/IDU 32.3% 30.1% 32.0% 42.3% 36.2% HRH 31.2% 29.0% 28.9% 28.3% 30.0% Pediatric Exposure 41.5% 41.9% 32.7% 39.2% 46.3% Other 37.5% 36.0% 33.3% 33.3% 37.5% Not Reported 34.1% 31.9% 30.6% 31.9% 31.6% Current Age 0-12 yrs 57.9% 52.6% 26.7% 21.4% 25.0% % 28.6% 24.6% 28.3% 30.3% % 32.5% 28.7% 29.9% 31.3% % 32.7% 31.4% 30.7% 31.7% & older 45.4% 42.3% 31.5% 36.8% 36.7% Total 34.8% 32.9% 31.3% 30.6% 31.7% 1,951 1,809 1,803 1,854 1,905 53

54 Who were less likely to receive medical care? oin 2016, the St. Louis TGA reported 3104 people living with HIV o38.7% (1203) living with HIV in our region did not have evidence of care othat same year there was 3041 people living with AIDS o24.5% (748) of people living with AIDS did not have evidence of care otherefore, unmet need among PLWH/A in 2016 was 31.7% (1951) 54

55 National Strategy and Indicators Goal 2. Access to care Early diagnosis Viral suppression Survival HIV + HIV - HIV + Diagnosed Care & Treatment Health Outcome Goal 1. New infections Linkage to care Retention in care Goal 3. Health disparities 55

56 Percentage of People Living with Diagnosed HIV HIV Continuum of Care Among Cases 13 +, % 80% 70% 77% 60% 50% 40% 30% 54% 48% 20% 10% 0% Linked to Care Retained in Care Retained in Care, virally suppressed Stages 11% Not retained in care, virally suppressed Linked to Care - Derived from adults and adolescents newly diagnosed with HIV disease in the St. Louis TGA MO in 2015 with a CD4 or viral load lab result within three months of diagnosis. Retained in Care - Derived from number of adults and adolescents diagnosed with HIV through 2014 and living in 2015 who resided in the St. Louis TGA MO at the time of their most recent diagnosis of HIV or stage 3 (AIDS) who had at least two CD4 or viral load lab results in 2014 which were collected at least 3 months apart. Virally Suppressed, Retained in Care Derived from number of adults and adolescents diagnosed with HIV through 2014 and living in 2015 who resided in the St. Louis HIV Care Region at the time of their most recent diagnosis of HIV or stage 3 (AIDS) who were considered to be retained in care and whose most recent viral load lab result in 2014 was 200 copies/ml or less. 56

57 OTHER SEXUALLY TRANSMITTED DISEASES 57

58 Number of cases Rate per 100,000 people Chlamydia Case Counts & Rates Chlamydia Case Counts and Rates MO, St. Louis TGA, ,800 11, , ,500 11,400 11,300 11,200 11, , ,100 11,000 11,215 11,288 11, , Case counts Rates 58

59 Number of cases Rate per 100,000 people Gonorrhea Case Counts & Rates 4,500 Gonorrhea Case Counts and Rates MO, St. Louis TGA, ,000 3,500 3,000 2, ,000 1,500 3,962 3,894 3,745 3,475 4, , Case counts Rates 0 59

60 Gonorrhea Case Counts & Rates by Sex Gonorrhea Case Rates by Sex MO, St. Louis TGA, Males Females 60

61 Number of cases Rate per 100,000 people P&S Syphilis Case Counts & Rates P&S syphilis Case Counts and Rates, MO, St. Louis TGA Case counts Rates 0 61

62 Summary o Continue increase in HIV/AIDS new diagnosis among males under 25 in the St. Louis TGA, Region, Particularly among black MSM, and Latino o Among people newly diagnosed with HIV disease: o Despite the decreasing trend in late diagnosis approximately one quarter were diagnosed late o Nearly 1 in 4 were not linked to care within 3 month of diagnosis o Among people living with HIV o Nearly 30% did not have evidence of receiving care o Nearly 46% were not retained in care o About 41% were not virally suppressed 62

63 Thanks for your Consideration Questions Or Comments 63