Metro St. Louis HIV Epidemiological Profile

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

2 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 2

3 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 3

4 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 4

5 Introduction: Sources Mandatory Reporting of HIV & AIDS Cases o Missouri Department of Health and Senior Services (MDHSS) o Illinois Department of Public Health (IDPH) HIV/AIDS Reporting System (ehars) o All positive test results o Demographic information 5

6 Introduction: Commonly used terms 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 HIV Disease Categorization that includes those with HIV infection and AIDS disease (HIV/AIDS) 6

7 Introduction: Context WHO o o o People living with HIV (PLWH) People living with AIDS (PLWA) People living with HIV Disease (PLWH/A) WHAT o o Prevalence WHERE o St. Louis TGA 7

8 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV Disease Prevalence HIV/AIDS Unmet Need Summary 8

9 9

10 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 10

11 HIV/AIDS Prevalence Those currently living with HIV or AIDS, this includes all cases that have been diagnosed as of 12/31/2012 (IL), or 12/31/2013 (MO)

12 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

13 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

14 HIV/AIDS Prevalence: County Total Living HIV Disease Rates County FRANKLIN CO JEFFERSON CO LINCOLN CO ST CHARLES CO ST LOUIS CITY ST LOUIS CO WARREN CO MO-TGA Total CLINTON JERSEY MADISON MONROE ST. CLAIR IL-TGA Total St. Louis TGA Rates *Rates are per 100,000 persons 14

15 Rate per 100,000 population HIV/AIDS Prevalence: County St. Louis TGA Rates of HIV Disease from Years MO-TGA Total IL-TGA Total 15

16 Rate per 100,000 persons HIV/AIDS Prevalence: County St. Louis TGA Rates of HIV Disease from , by County FRANKLIN CO. JEFFERSON CO. LINCOLN CO. ST CHARLES CO. ST LOUIS CITY ST LOUIS CO. WARREN CO. CLINTON JERSEY MADISON MONROE ST. CLAIR Years 16

17 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

18 HIV/AIDS Prevalence: Race Hispanic 3% Population By Race, St. Louis TGA, 2013 Black 19% Other 4% Hispanic 2% (n=153) PLWH/A by Race, St. Louis- TGA, 2012, 2013 (n=6688) Other 2% (n=160) White 74% White 41% (n=2664) Black 55% (n=3610) Black White Hispanic Other Black White Hispanic Other 18

19 HIV/AIDS Prevalence: Race Hispanic 3% Population By Race, St. Louis PLWH/A by Race, St. Louis- TGA, 2013 TGA, 2012, 2013 Other Disproportionate Impact: (n=6688) White 74% Black 19% Other 4% 2% (n=160) Blacks have the highest rate of HIV Disease prevalence Hispanic (Among blacks, the prevalence was 2% (n=153) cases per 100,000 persons in the TGA). White 41% (n=2664) Black 55% (n=3610) Black White Hispanic Other Black White Hispanic Other 19

20 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

21 HIV/AIDS Prevalence: Gender Population by Gender, St. Louis TGA, 2013 PLWH/A by Gender, St. Louis TGA; 2012, 2013 (n=6688) Female 19% (n=1259) Female 52% Male 48% Male 81% (n=5391) Male Female Male Female 21

22 HIV/AIDS Prevalence: Gender Population by Gender, St. Louis TGA, 2013 PLWH/A by Gender, St. Louis TGA; 2012, 2013 (n=6688) Female 52% Disproportionate Impact: Male 48% Males have the highest rate of HIV disease prevalence in the TGA (410.2 per 100,000 males), which is more than FOUR AND A HALF times the rate of prevalence for females (89.7 per 100,000 females) Female 19% (n=1259) Male 81% (n=5391) Male Female Male Female 22

23 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

HIV/AIDS Prevalence: Age Population by Age, St.

13-24 7% (n=434) 45-64 25% 13-25 19% 45-64 49%

24 HIV/AIDS Prevalence: Age Population by Age, St. Louis TGA, & Older 12% Under 13 20% PLWH/A by Age, St. Louis TGA; 2012, 2013 (n=6688) 65 & Older 4% (n=294) % (n=434) % % % (n=3255) % (n=2683) % Under & Older Under & Older 24

25 HIV/AIDS Prevalence: Age Population by Age, St. Louis TGA, % 65 & Older 12% Disproportionate Under 13 20% Impact: year olds make up 89% of the PLWH/A population % PLWH/A by Age, St. Louis TGA; 2012, 2013 (n=6688) 65 & Older 4% (n=294) % (n=3255) % (n=2683) % (n=434) % Under & Older Under & Older 25

26 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

27 HIV/AIDS Prevalence: MOT PLWH/A by MOT, St. Louis TGA; 2012, 2013 (n=6688) Other/Unk/NR 17% (n=1113) Heterosexual 15% (n=1027) MSM 61% (n=4051) MSM & IDU 3% (n=203) IDU 4% (n=294) MSM IDU MSM & IDU Heterosexual Other/Unk/NR 27

28 HIV/AIDS Prevalence: MOT Trend 70% PLWH/A by MOT in St. Louis TGA, % 50% 40% 30% 20% 10% 0% , 2013 MSM IDU MSM & IDU Heterosexual Other/Unk/NR 28

29 HIV/AIDS Prevalence: MOT Trend 70% PLWH/A by MOT in St. Louis TGA, % 50% 40% 30% Continuing Trend: MSM exposure accounts for the majority of living HIV Disease cases; this trend has not changed since % 10% 0% , 2013 MSM IDU MSM & IDU Heterosexual Other/Unk/NR 29

30 HIV/AIDS Prevalence COUNTY RACE GENDER AGE GROUP MOT Subpopulations

31 Number of Cases HIV/AIDS Prevalence Subpopulation: Males, by Race HIV Disease Among Males by Race, St. Louis TGA; 2012, 2013 (n=5425) 60.0% 50.0% 49.8% 44.5% 40.0% 30.0% 20.0% 10.0% 0.0% 2.7% 2.9% Black White Hispanic Other/Unknown Race Missouri (as of 12/31/13) & Illinois (as of 12/31/12) 31

32 Percentage of Males HIV/AIDS Prevalence Subpopulation: Males by MOT & Race* 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% HIV Disease Among Males by MOT & Race, St. Louis TGA; 2012, 2013 (n=5252) 69.6% 4.7% 82.5% 70.5% 14.2% 7.7% 9.4% 3.8% 5.5% 1.9% 3.8% 2.4% 3.4% 4.1% % % % Race, by Mode of Transmission MSM IDU MSM & IDU Heterosexual Other/Unk/NR 16.4% *Race category Other/Unknown was not stratified by Gender in this report 32

33 Number of Cases HIV/AIDS Prevalence Subpopulation: Females, by Race HIV Disease Among Females by Race, St. Louis TGA; 2012, 2013 (n=1263) 80.0% 70.0% 72.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 20.7% 2.8% 4.6% Black White Hispanic Other/Unknown Race Missouri (as of 12/31/13) & Illinois (as of 12/31/12) 33

34 Percentage of Females HIV/AIDS Prevalence Subpopulation: Females, by MOT & Race HIV Disease Among Females by MOT & Race, St. Louis TGA; 2012, 2013 (n=1205) 70.0% 60.0% 60.3% 60.5% 54.3% 50.0% 42.9% 40.0% 33.0% 30.0% 23.0% 20.0% 16.5% 10.0% 0.0% 6.7% 2.9% % % % Race, by MOT IDU Heterosexual Other/Unk/NR 34

35 Percentage of Males HIV/AIDS Prevalence 70.0% Subpopulation: Age & Race (MO) HIV Disease by Age & Race, St. Louis TGA; 2012, 2013 (n=6688) 60.0% 50.0% 40.0% 30.0% 45.1% 41.5% 31.6% 59.8% 53.6% 38.7% 50.5% 40.4% 20.0% 10.0% 0.0% 10.2% 7.0% 5.5% 6.4% 2.7% 0.5% 0.1% 1.6% 0.6% 1.7% 2.8% 0.0% % % % % Race, by Age Group Under & Older 35

36 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 36

37 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 37

38 HIV & AIDS is the number of newly diagnosed cases within a specific time period.

39 HIV & AIDS COUNTY RACE GENDER AGE GROUP MOT

40 HIV & AIDS COUNTY RACE GENDER AGE GROUP MOT

41 HIV/AIDS by County Overall Population HIV Disease HIV Disease HIV Disease in 2011 in 2012 in 2013 Cases Rate Cases Rate Cases Rate County (2010 Census) FRANKLIN CO JEFFERSON CO LINCOLN CO ST CHARLES CO ST LOUIS CITY ST LOUIS CO WARREN CO MO-TGA CLINTON JERSEY MADISON MONROE ST. CLAIR IL-TGA St. Louis TGA *2013 data is unavailable until July 2014 Significant rate change from 2012? 41

42 Persons per 100,000 HIV/AIDS by County 16.0 St. Louis TGA HIV Disease ( ) Years MO-TGA IL-TGA 42

43 HIV & AIDS COUNTY RACE GENDER AGE GROUP MOT

44 HIV/AIDS in the TGA - Race Missouri 2011 (n=164) 2012 (n=226) 2013 (n=180) 2011 (n=70) 2012 (n=60) 2013 (n=61) HIV (n=164) % HIV (n=226) % HIV (n=180) % AIDS (n=70) % AIDS (n=60) % AIDS (n=61) % Race/Ethnicity White % % % % % % Black % % % % % % Hispanic 2 1.2% 8 3.5% 7 3.9% 3 4.3% 3 5.0% 1 1.6% Other 2 1.2% 2 0.9% 4 2.2% 1 1.4% 0 0.0% 2 3.3% Unknown 1 0.6% 1 0.4% 1 0.6% 0 0.0% 0 0.0% 0 0.0% Total HIV (n=240) % HIV (n=146) % AIDS (n=122) % AIDS (n=127) % White % % % % Black % % % % Hispanic 6 2.5% 2 1.4% 4 3.3% 6 4.7% Other % 8 5.5% % % Unknown % % 5 4.1% 0 0.0% Total *2013 data is unavailable until July 2014 Illinois*

45 Percentage of Newly Diagnosed Cases HIV/AIDS Race -MO 80.0% HIV & AIDS Comparison, by Race - Missouri- TGA; % 60.0% 67.8% 62.3% 50.0% 40.0% 30.0% 20.0% 25.6% 32.8% 10.0% 0.0% 3.9% 1.6% 2.2% 3.3% 0.6% 0.0% White Black Hispanic Other Unknown Race HIV (n=180) AIDS (n=61) 45

46 Percentage of Newly Diagnosed Cases HIV/AIDS Race -MO 80.0% HIV & AIDS Comparison, by Race - Missouri- TGA; % 60.0% 50.0% 40.0% 32.8% 67.8% 62.3% Disproportionate impact: In Missouri-TGA, out of all the newly diagnosed cases of HIV or AIDS, the majority were Black. 30.0% 25.6% 20.0% 10.0% 0.0% 3.9% 1.6% 2.2% 3.3% 0.6% 0.0% White Black Hispanic Other Unknown Race HIV (n=180) AIDS (n=61) 46

47 Percentage of Newly Diagnosed Cases HIV/AIDS Race -IL HIV & AIDS Comparison, by Race - Illinois- TGA; % 50.0% 54.1% 54.3% 40.0% 30.0% 25.3% 26.8% 20.0% 14.2% 13.7% 10.0% 0.0% 4.7% 5.5% 1.4% 0.0% White Black Hispanic Other Unknown Race HIV (n=146) AIDS (n=127) 47

48 Percentage of Newly Diagnosed Cases HIV/AIDS Race -IL HIV & AIDS Comparison, by Race - Illinois- TGA; % 50.0% 40.0% 30.0% 25.3% 26.8% 54.1% 54.3% Disproportionate impact: In Illinois-TGA, out of all the newly diagnosed cases of HIV or AIDS, the majority were Black. 20.0% 14.2% 13.7% 10.0% 0.0% 4.7% 5.5% 1.4% 0.0% White Black Hispanic Other Unknown Race HIV (n=146) AIDS (n=127) 48

49 Percentage of Newly Diagnosed Cases HIV Comparison, Race - MO 80.0% 70.0% 60.0% HIV Comparison from , by Race - Missouri-TGA 66.8% 67.8% 64.0% 50.0% 40.0% 30.0% 20.0% 32.9% 28.3% 25.6% 10.0% 0.0% 1.2% 3.5% 3.9% 1.2% 0.9% 2.2% 0.6% 0.4% 0.6% White Black Hispanic Other Unknown Race 2011 (n=164) 2012 (n=226) 2013 (n=180) 49

50 Percentage of Newly Diagnosed Cases AIDS Comparison, Race - MO 70.0% 60.0% 50.0% 40.0% 30.0% AIDS Comparison from , by Race - Missouri-TGA 37.1% 41.7% 32.8% 57.1% 53.3% 62.3% 20.0% 10.0% 0.0% 4.3% 5.0% 3.3% 1.6% 1.4% 0.0% 0.0% 0.0% 0.0% White Black Hispanic Other Unknown Race 2011 (n=70) 2012 (n=60) 2013 (n=61) 50

51 HIV & AIDS COUNTY RACE GENDER AGE GROUP MOT

52 HIV/AIDS by Gender Missouri 2010 (n=229) 2011 (n=164) 2012 (n=226) 2013 (n=180) 2012 (n=71) 2013 (n=70) 2012 (n=60) 2013 (n=61) HIV (n=229) % HIV (n=164) % HIV (n=226) % HIV (n=180) % AIDS (n=71) % AIDS (n=70) % AIDS (n=60) % AIDS (n=61) % Age Male % % % % % % % % Female % % % % % % % % Illinois* Male % % Female % % Total

53 HIV/AIDS by Gender - Missouri HIV by Gender - Missouri-TGA, 2013 AIDS by Gender - Missouri-TGA, 2013 Female 16% Female 15% Male 84% Male 85% Male Female Male Female 53

54 HIV/AIDS by Gender - Illinois HIV by Gender - Illinois- TGA, 2012 AIDS by Gender - Illinois-TGA, 2012 Female 23% Female 32% Male 77% Male 68% Male Female Male Female 54

55 HIV & AIDS COUNTY RACE GENDER AGE GROUP MOT

56 HIV/AIDS in the TGA - Age Missouri 2010 (n=229) 2011 (n=164) 2012 (n=226) 2013 (n=180) 2010 (n=71) 2011 (n=70) 2012 (n=60) 2013 (n=61) HIV (n=229) % HIV (n=164) % HIV (n=226) % HIV (n=180) % AIDS (n=71) % AIDS (n=70) % AIDS (n=60) % AIDS (n=61) % Age Under % 1 0.6% 2 0.9% 1 0.6% 0 0.0% 0 0.0% 0 0.0% 0 0.0% % % % % % % % % % % % % % % % % % % % % % % % % 65 & Older 1 0.4% 3 1.8% 1 0.4% 0 0.0% 1 1.4% 2 2.9% 1 1.7% 2 3.3% Total HIV (n=56) % AIDS (n=47) % Under % 3 6.4% % % % % 65 & Older 0 0.0% 0 0.0% Total *2013 data is unavailable until July 2014 Illinois*

57 Percentage of Newly Diagnosed Cases HIV/AIDS, Age - MO HIV & AIDS Comparison, by Age - Missouri-TGA, % 45.0% 42.8% 41.7% 45.9% 40.0% 35.0% 32.8% 30.0% 25.0% 20.0% 15.0% 10.0% 18.0% 15.0% 5.0% 0.0% 3.3% 0.6% 0.0% 0.0% Under & Older Age Groups HIV (n=180) AIDS (n=61) 57

Percentage of Newly Diagnosed Cases HIV/AIDS, Age - MO HIV & AIDS Comparison, by Age - Missouri-TGA, 2013 50.0% 45.0% 40.0% 35.0% 30.0% 42.

58 Percentage of Newly Diagnosed Cases HIV/AIDS, Age - MO HIV & AIDS Comparison, by Age - Missouri-TGA, % 45.0% 40.0% 35.0% 30.0% 42.8% Key point: The majority of newly diagnosed AIDS cases are in the older age groups. 41.7% 45.9% 32.8% 25.0% 20.0% 15.0% 10.0% 18.0% 15.0% 5.0% 0.0% 3.3% 0.6% 0.0% 0.0% Under & Older Age Groups HIV (n=180) AIDS (n=61) 58

Percentage of Newly Diagnosed Cases HIV/AIDS, Age - MO 50.0% 45.0% 40.0% 35.0% 30.0% 25.0% HIV & AIDS Comparison, by Age - Missouri-TGA, 2013 42.8% 41.7% 45.

59 Percentage of Newly Diagnosed Cases HIV/AIDS, Age - MO 50.0% 45.0% 40.0% 35.0% 30.0% 25.0% HIV & AIDS Comparison, by Age - Missouri-TGA, % 41.7% 45.9% Disproportionate impact: Over 80% of newly diagnosed 32.8% HIV cases are in the & age group. 20.0% 15.0% 10.0% 18.0% 15.0% 5.0% 0.0% 3.3% 0.6% 0.0% 0.0% Under & Older Age Groups HIV (n=180) AIDS (n=61) 59

Percentage of Newly Diagnosed Cases HIV/AIDS, Age - IL HIV & AIDS Comparison, by Age - Illinois-TGA, 2012 70.0% 63.8% 60.0% 50.0% 40.

60 Percentage of Newly Diagnosed Cases HIV/AIDS, Age - IL HIV & AIDS Comparison, by Age - Illinois-TGA, % 63.8% 60.0% 50.0% 40.0% 37.5% 35.7% 30.0% 26.8% 29.8% 20.0% 10.0% 0.0% 6.4% 0.0% 0.0% Under & Older Age Groups HIV (n=56) AIDS (n=47) 60

61 Percentage of Newly Diagnosed Cases HIV Comparison, Age - MO 60.0% HIV Comparison from , by Age - Missouri-TGA 50.0% 40.0% 30.0% 42.8% 37.2% 34.9% 34.1% 51.8% 47.2% 43.8% 41.7% 20.0% 10.0% 0.0% 16.6% 17.7% 15.0% 11.6% 0.9% 0.6% 0.9% 0.6% 1.8% 0.4% 0.4% 0.0% Under & Older Age Groups 2010 (n=229) 2011 (n=164) 2012 (n=226) 2013 (n=180) 61

62 Percentage of Newly Diagnosed Cases HIV Comparison, Age - MO 60.0% HIV Comparison from , by Age - Missouri-TGA 50.0% 40.0% 30.0% 20.0% 10.0% 42.8% 37.2% 34.9% 34.1% 47.2% 51.8% 43.8% 41.7% Disproportionate impact: From 2010 to 2013, this age group saw an increase in the number of newly diagnosed HIV cases. 16.6% 17.7% 15.0% 11.6% 0.0% 0.9% 0.6% 0.9% 0.6% 1.8% 0.4% 0.4% 0.0% Under & Older Age Groups 2010 (n=229) 2011 (n=164) 2012 (n=226) 2013 (n=180) 62

63 Percentage of Newly Diagnosed Cases AIDS Comparison, Age MO 60.0% AIDS Comparison from 2012 to 2013, by Age - Missouri-TGA 50.0% 40.0% 30.0% 51.7% 45.9% 40.8% 41.4% 38.0% 37.1% 35.0% 32.8% 20.0% 19.7% 18.6% 18.0% 10.0% 0.0% 11.7% 2.9% 3.3% 1.4% 1.7% 0.0% 0.0% 0.0% 0.0% Under & Older Age Groups 2010 (n=71) 2011 (n=70) 2012 (n=60) 2013 (n=61) 63

64 HIV & AIDS COUNTY RACE GENDER AGE GROUP MOT

65 HIV/AIDS in the TGA - MOT Missouri 2010 (n=164) 2011 (n=164) 2012 (n=226) 2013 (n=180) 2010 (n=71) 2011 (n=70) 2012 (n=60) 2013 (n=61) HIV (n=164) % HIV (n=164) % HIV (n=226) % HIV (n=180) % AIDS (n=71) % AIDS (n=70) % AIDS (n=60) % AIDS (n=61) % MOT MSM % % % % % % % % IDU 6 2.6% 4 2.4% 6 2.7% 3 1.7% 0 0.0% 2 2.9% 0 0.0% 0 0.0% MSM & IDU 2 0.9% 0 0.0% 4 1.8% 3 1.7% 1 1.4% 0 0.0% 0 0.0% 0 0.0% Heterosexual % % % % 4 5.6% % % % Other/NIR % % % % % % % % Total HIV (n=240) % HIV (n=146) % % AIDS (n=127) % MSM % % 39.3% % IDU % 7 4.8% 6.6% % MSM & IDU 1 0.4% 1 0.7% 1.6% 5 3.9% Heterosexual % % 20.5% % Other/NIR % % 32.0% % Total *2013 data is unavailable until July 2014 Illinois*

66 Percentage of Newly Diagnosed Cases HIV/AIDS, MOT - MO 70.0% 60.0% HIV & AIDS Comparison, by MOT - Missouri- TGA, % 55.7% 50.0% 40.0% 30.0% 31.1% 20.0% 16.1% 13.1% 18.9% 10.0% 0.0% 1.7% 0.0% 1.7% 0.0% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission HIV (n=180) AIDS (n=61) 66

67 Percentage of Newly Diagnosed Cases HIV/AIDS, MOT - IL 50.0% HIV & AIDS Comparison, by MOT - Illinois-TGA, % 43.2% 40.0% 35.0% 38.6% 34.9% 30.0% 25.0% 26.8% 22.0% 20.0% 15.0% 10.0% 5.0% 0.0% 16.4% 8.7% 4.8% 3.9% 0.7% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission HIV (n=146) AIDS (n=127) 67

68 Percentage of Newly Diagnosed Cases HIV Comparison, MOT - MO 70.0% 60.0% HIV Comparison from , MOT - Missouri-TGA 64.0% 62.4% 61.7% 59.0% 50.0% 40.0% 30.0% 20.0% 16.1% 30.1% 26.5% 23.2% 18.9% 10.0% 0.0% 10.4% 7.4% 6.6% 2.6% 2.4% 2.7% 1.7% 0.9% 1.8% 1.7% 0.0% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission 2010 (n=164) 2011 (n=164) 2012 (n=226) 2013 (n=180) 68

69 Percentage of Newly Diagnosed Cases AIDS Comparison, MOT - MO 80.0% 70.0% AIDS Comparison from , MOT - Missouri-TGA 71.4% 60.0% 50.0% 40.0% 30.0% 50.7% 48.3% 55.7% 42.3% 41.7% 31.1% 20.0% 10.0% 0.0% 15.7% 13.1% 10.0% 10.0% 5.6% 2.9% 0.0% 0.0% 0.0% 1.4% 0.0% 0.0% 0.0% MSM IDU MSM & IDU Heterosexual Other/NIR Mode of Transmission 2010 (n=71) 2011 (n=70) 2012 (n=60) 2013 (n=61) 69

70 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 70

71 Unmet Need Unmet Need is defined as the proportion of people living with HIV/AIDS in our region who do not have evidence of HIV medical care In 2013, the St. Louis TGA (Missouri) reported 2,861 people living with HIV and 2,777 people living with AIDS That same year, 23% of people living with AIDS and 43% living with HIV in our region did not have evidence of care. Therefore, unmet need among PLWH/A in 2013 was 35% *Missouri Data is for cases tested for CD4 or viral load 71

72 Unmet Need Missouri-TGA Race Trend line Black/African American Male 43.5% 34.6% 32.5% Black/African American Female 41.2% 28.9% 27.0% White Male 46.8% 37.2% 35.4% White Female 45.5% 25.5% 26.9% Hispanic 51.5% 42.8% 39.9% Other / UNKNOWN 43.2% 34.7% 31.3% Gender Male 45.3% 36.0% 34.1% Female 42.1% 28.7% 27.0% Mode of Exposure MSM 44.4% 35.8% 34.0% IDU 39.9% 34.1% 32.7% MSM/IDU 44.7% 32.3% 30.1% HRH 44.5% 31.2% 29.0% Pediatric Exposure 48.7% 41.5% 41.9% Other 57.7% 37.5% 36.0% Not Reported 47.4% 34.1% 31.9% Current Age 0-12 yrs 66.7% 57.9% 52.6% % 28.2% 28.6% % 34.9% 32.5% % 34.3% 32.7% 65 & older 58.1% 45.4% 42.3% Total 44.8% 34.8% 32.9% *Missouri Data is for cases tested for CD4 or viral load 72

73 Unmet Need Missouri-TGA Race Trend line Black/African American Male 43.5% 34.6% 32.5% Black/African American Female 41.2% 28.9% 27.0% White Male 46.8% 37.2% 35.4% White Female 45.5% 25.5% 26.9% Hispanic 51.5% 42.8% 39.9% Other / UNKNOWN 43.2% 34.7% 31.3% Gender Male 45.3% 36.0% 34.1% Female 42.1% 28.7% 27.0% Mode of Exposure MSM 44.4% 35.8% 34.0% IDU 39.9% 34.1% 32.7% MSM/IDU 44.7% 32.3% 30.1% HRH 44.5% 31.2% 29.0% Pediatric Exposure 48.7% 41.5% 41.9% Other 57.7% 37.5% 36.0% Not Reported 47.4% 34.1% 31.9% Current Age 0-12 yrs 66.7% 57.9% 52.6% % 28.2% 28.6% % 34.9% 32.5% % 34.3% 32.7% 65 & older 58.1% 45.4% 42.3% Total 44.8% 34.8% 32.9% *Missouri Data is for cases tested for CD4 or viral load 73

74 Table of Contents Introduction St. Louis Transitional Grant Area Map HIV/AIDS Prevalence HIV/AIDS Unmet Need Summary 74

75 HIV/AIDS Trends 5638 cases of HIV/AIDS in the MO-TGA as of 2013, an increase of 2.8% from 2012 (n=5482, 2012) 180 new cases of HIV in the MO-TGA in 2013, a decrease of 20.4% from 2012 (n=226, 2012) 61 new cases of AIDS in the MO-TGA in 2013, a increase of 1.7% from 2012 (n=60, 2012) 75

76 HIV/AIDS Trends COUNTY o The City of St. Louis has the highest rates of HIV Disease prevalence RACE o Blacks have the highest rate of HIV Disease prevalence (Among blacks, the prevalence was cases per 100,000 persons in the TGA) o Blacks make up the majority of newly diagnosed cases of HIV or AIDS GENDER o Males have the highest rate of HIV disease prevalence in the TGA (410.2 per 100,000 males), which is more than FOUR AND A HALF times the rate of prevalence for females (89.7 per 100,000 females) 76

77 HIV/AIDS Trends AGE GROUP o year olds make up 89% of the PLWH/A population o Over 80% of newly diagnosed HIV cases are in the & age group o From 2010 to 2013, the age group saw an increase in the number of newly diagnosed HIV cases MOT o MSM exposure accounts for the majority of living HIV Disease cases; this trend has not changed since 2009 Subpopulations: o The majority of males with HIV Disease are Black(50%), 45% are White o The majority of females with HIV Disease are Black (72.0%) o Blacks, Hispanics, and Other Races have higher prevalence rates of HIV Disease in the age group than the age group 77

78 Metro St. Louis HIV Epidemiological Profile Saint Louis TGA Part A Planning Council Prepared by the City of St. Louis Department of Health s Center for Health Information, Research, and Planning 05/14/2014

Missouri St. Louis TGA 2016 HIV Epidemiological Profile

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