Georgia HIV/AIDS

Surveillance Summary

Data Through

December 31, 2009

HIV Epidemiology Unit

Division of Health Protection

Georgia Department of Public Health

HIV/AIDS Surveillance Summary, Georgia, 2009

Acknowledgements

GeorgiaDepartment of Community Health.

David A. Cook, Commissioner

Division of Public Health

Brenda Fitzgerald, MD, Director & State Health Officer

Epidemiology Branch

Anil T. Mangla, MS., PhD., MPH., FRIPH, Acting Director

HIV Epidemiology Section

Jianglan White, MD, MPH, Director

Deepali Rane, MBBS, MPH, Epidemiologist

Terry Easton, PhD, Ethnographer

GraceWariua, MPH

Visit https://dph.georgia.gov/georgias-hivaids-epidemiology-surveillance-section

for more information about HIV/AIDS in Georgia.

INTRODUCTION TO TABLES

Georgia statutesand regulations require physicians and laboratories to report all cases of HIV (Human Immunodeficiency Virus) infection and AIDS (Acquired Immunodeficiency Syndrome) to the Georgia Department of Community Health, Division of Public Health (PH)[1]. The information is used to monitor the HIV/AIDS epidemic in Georgiaand to help guide program planning and evaluation. The data presented in the accompanying tables are based on confidential case reports collected through the PH HIV/AIDS Reporting System. Cases are counted if they meet the Centers for Disease Control and Prevention (CDC) surveillance case definitions for HIV and/or AIDS.[2]

This report includes surveillance datathrough December 31, 2009 by diagnostic category for persons living with HIV (not AIDS) and AIDS, newly diagnosed cases, and cumulative cases. The data are displayed by date of diagnosis and are not adjusted for age, sex, reporting delays or incomplete reporting.Persons residing in correctional facilities are included in this report and may inflate rates in certain geographic regions where there are large concentrations of HIV-positive inmates. Tables depicting “Persons Living with HIV (not AIDS) and AIDS” comprise persons with a current address in Georgia regardless of where the persons were diagnosed. Persons represented in the “Newly Diagnosed” and “Cumulative” tables were diagnosed in Georgia. Because of the difference in residency criteria and the influx of cases to Georgia, the number of persons living with HIV (not AIDS)may sometimes be higher than cumulative HIV (not AIDS) cases.

Unlike name-based AIDS reporting which began in the early 1980s, name-based HIV (not AIDS) reporting began on December 31, 2003. Since the HIV (not AIDS) surveillance system is still rather young, and there are known delays with case reporting, numbers will continue to increase as additional case reports are received. Concentrated case reporting efforts by PH staff in 2009likely contributed to the rise in reported cases and consequently led to a more accurate representation of the epidemic in Georgiathan previously described; however, this should not necessarily be interpreted as an indication of increased HIV transmission. Additionally, not everyone is aware of his or her infection, so this reportunderestimatesthe true number of personsinfected with HIV/AIDS in Georgia.

Note on HIV Transmission Categories: The transmission categories presented in this report follow the standards created by the CDC and have been used for many years. According to the CDC, “Transmission category is the term for the classification of cases that summarizes a person’s possible HIV risk factors; the summary classification results from selecting, from the presumed hierarchical order of probability, the onerisk factor most likely to have been responsible for transmission. For surveillance purposes, cases of HIV/AIDS, HIV infection (not AIDS), and AIDS cases are counted only once in the hierarchy of transmission categories. Persons with more than one reported risk factor for HIV infection are classified in the transmission category listed first in the hierarchy. The exception is men who report sexual contact with other men and injection drug use; this group makes up a separate transmission category. Persons whose transmission category is classified as high-risk heterosexual contact are persons who report specific heterosexual contact with a person known to have, or be at high risk for, HIV infection (e.g., an injection drug user). Cases in persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as either ‘no risk factor reported or identified’[3]. These cases are categorized as NIR (no identified risk) or NRR (no reported risk).

TABLE HIGHLIGHTS

Tables 1 to 3. Persons Newly Diagnosed with HIV Infection (notAIDS) and AIDS,Georgia,2009

Persons Newly Diagnosed with HIV Infection (notAIDS)[4], Georgia, 2009

  • There were 1,366 persons newly diagnosed with HIV (not AIDS) in Georgia in 2009.
  • The majority (74%) of persons newly diagnosed with HIV (not AIDS) were male. Females accounted for a higher percentage of new HIV(not AIDS) diagnoses (26%) than new (AIDS) diagnoses (23%).
  • Persons newly diagnosed with HIV (not AIDS) in 2009 were most frequently in the30-39age category at the time of diagnosis.New HIV (not AIDS) cases showed a younger age distribution than new AIDS cases.
  • The majority of new HIV (not AIDS) and AIDS diagnoses among all ethnicities/races in Georgia were Blacks. In 2009:
  • Blacks accounted for 74% of new HIV (not AIDS) diagnoses and 30% of Georgia’s population[5];
  • Whites accounted for 21% of new HIV (not AIDS) diagnosesand 57% of Georgia’s population2, and;
  • Hispanics/Latinos of all races accounted for 5% of new HIV (not AIDS) diagnosesand 8% of Georgia’s population2.
  • Among males newly diagnosed with HIV (not AIDS) in 2009, 49% of cases were due to male-to-male sexual contact. The second most commontransmission category(46%) was missing risk information or did not meet a CDC-defined transmission category.
  • Among females newly diagnosed with HIV (not AIDS) in 2009,81% of cases were missing risk information or did not meet a CDC-defined transmission category. The second most common transmission category (16%) was high-risk heterosexual contact[6].
  • By Public Health District, the highest rate of new HIV (not AIDS) diagnoses in 2009occurred among residents of the DeKalb Health District (33.5 per 100,000 population). Several other health districts had new HIV diagnosis rates higher than the overall state rateof 14.1cases per 100,000 population. In descending order, they are:Clayton (27.9), Fulton(25.1), South (18.9), Southwest (18.5) West Central (16.6),and North Central (15.5).

Persons Newly Diagnosed with AIDS[7],Georgia, 2009

  • There were884persons newly diagnosed with AIDS in Georgia in 2009.
  • In 2009, the majority (77%) of persons newly diagnosed with AIDS in Georgiawere male.
  • Persons newly diagnosed with AIDS in 2009 were most frequently in the 30-39 years of age category at the time of diagnosis. New AIDS cases showed an older age distribution than new HIV (not AIDS) cases.
  • The majority of persons newly diagnosed with AIDS among all ethnicities/races in Georgia were Blacks. In 2009:
  • Blacks accounted for 75% of new AIDS diagnosesand 30% of Georgia’s population[8];
  • Whites accounted for 16% of new AIDS diagnoses and 57% of Georgia’s population2; and
  • Hispanics/Latinos of all races accounted for 8% of new AIDS diagnoses and 8% of Georgia’s population2.
  • Among males,47% ofnew AIDS cases were reported in the transmission category male-to-male sexual contact. The second most commonly reported transmission category (44%) was missing risk information or did not meet one of the CDC-defined transmission categories
  • Among females, the majority of new AIDS cases (77%) was missing risk information or did not meet one of the CDC-defined transmission categories. The secondmost commonly reported transmission category (18%)was high-risk heterosexual contact[9].
  • By Public Health District, the highest rate of new AIDS diagnoses occurred among residents of Clayton Health District (30.1 per 100,000 populations). Several other health districts had new AIDS diagnosis rates higher than the overall state rate of 9.1 cases per 100,000 population. In descending order, they were: DeKalb (29.8) and Fulton (20.3).

Tables 4 to 6. Persons Living with HIV(not AIDS) and AIDS,2009, Georgia

Persons Living with HIV (not AIDS)[10], 2009, Georgia

  • There were17,368persons living with HIV (not AIDS) in Georgia as of December 31, 2009.
  • The majority (71%) of persons living with HIV (not AIDS) were male.
  • Among persons living with HIV (not AIDS) in Georgia in 2009, the most frequent age category was40-49 years.
  • Blacks accounted for the largest percentage of persons living with HIV (not AIDS) among all ethnicities/races in Georgia. In 2009:
  • Blacks accounted for 71% of persons living with HIV (not AIDS) and 30% of Georgia’s population[11];
  • Whites accounted for 23% of persons living with HIV (not AIDS) and 57% of Georgia’spopulation2; and
  • Hispanics/Latinos of all races accounted for 4% of persons living with HIV (not AIDS) and 8% of Georgia’s population2.
  • Among males living with HIV (not AIDS), male-to-male sexual contact was the most commonly reported transmission category(51%). The second most common transmission category (37%) wasmissing risk information or did not meet one of the CDC-defined transmission categories.
  • Among females living with HIV (not AIDS), 68% were missing risk information or did not meet one of the CDC-defined transmission categories. The second most common transmission category (22%) washigh-risk heterosexual contact[12].
  • The DeKalb Health District had the highest HIV (not AIDS) prevalence rate in 2009 (435.9 cases per 100,000). In 2009, the health districts with HIV (not AIDS) prevalence rates above the overall state prevalence rate of 176.7cases per 100,000 population were (in descending order): Fulton (407.5), Clayton (307.1),South Central (230), East Central (187.1), and South (182.1).

Persons Living withAIDS[13],2009, Georgia

  • There were22,960 persons living with AIDS in Georgia as of December 31, 2009
  • Among persons living with AIDS in Georgia, the majority (77%) were male
  • Among persons living with AIDS in Georgia in 2009, the most frequent age category was40-49 years.
  • Blacks accounted for the largest percentage of persons living with AIDS among all ethnicities/races in Georgia. In 2009:
  • Blacks accounted for 69% of persons living with AIDSand comprised 30% of Georgia’s population[14].
  • Whites accounted for 25% of persons living with AIDS and comprised 57% of Georgia’s population2.
  • Hispanics/Latinos of all races accounted for 5% of persons living with AIDS and comprised 8% of Georgia’s population2.
  • Among males living with AIDS,male-to-male sexual contact was the most commonly reported transmission category(55%). The second most common transmission category(23%) was missing risk information or did not meet one of the CDC-defined transmission categories.
  • Among females living with AIDS, 47% were missing risk information or did not meet one of the CDC-defined transmission categories. The second most common transmission category (37%) washigh-risk heterosexual contact[15].
  • The Fulton Health District had the highest AIDS prevalence rate in Georgiain 2009(710.1 cases per 100,000 population). In 2009, the health districts above the overall state prevalence rate of 233.7cases per 100,000 population were (in descending order): DeKalb (533), Clayton (341.9), East Central (241.4), Coastal (224.9) and Southwest (201.2).

Tables 7 to 9. CumulativeHIV Infection(not AIDS) and AIDSCases, 2009, Georgia

Cumulative HIV Infection (not AIDS) Cases[16], 2009, Georgia

  • There were 15,485cumulative HIV (not AIDS)casesdiagnosed in Georgia as of December 31, 2009.
  • The majority (70%) of cumulative HIV (not AIDS) cases were male.
  • Among cumulative HIV (not AIDS) cases, the most frequent age category was 30-39 years.
  • Blacks accounted for the largest percentage of cumulative HIV cases (not AIDS) among all ethnicities/races in Georgia. As of 2009:
  • Blacks accounted for 72% of cumulative HIV (not AIDS) cases and comprised 30% of Georgia’s population[17];
  • Whites accounted for 22% were of cumulative HIV (not AIDS) cases and comprised57% of Georgia’s population2;
  • Hispanics/Latinos of all races accounted for 4% of all HIV (not AIDS) cases and comprised 8% of Georgia’s population2.
  • Among males, 48% of cumulative HIV (not AIDS) cases were male-to-male sexual contact. The second most commonly reported transmission category (40%) wasmissing risk information or did not meet one of the CDC-defined transmission categories.
  • Among females, 70% of cumulative HIV (not AIDS) cases were missing risk information or did not meet one of the CDC-defined transmission categories. The second most commonly reported transmission category (21%) was high-risk heterosexual contact[18].
  • The Fultonand DeKalb Health Districts had the two highest cumulative numbers of persons diagnosed with HIV (not AIDS) in Georgia (3,974 2,712 respectively).

Cumulative AIDS Cases,2009Georgia

  • There were35,299cumulative AIDS cases[19]diagnosed in Georgia as of December 31, 2009.
  • The majority (79%) of cumulative AIDS cases were male.
  • Among cumulative AIDS cases, the most frequent age category was 30-39 years.
  • Blacks accounted for the largest percentage of cumulative AIDS cases among all ethnicities/races in Georgia. As of 2009:
  • Blacks accounted for 66% of cumulative AIDS cases and comprised 30% of Georgia’s population[20];
  • Whites accounted for 27% of cumulative AIDS cases and comprised 57% of Georgia’s population2;
  • Hispanics/Latinos of all races accounted for 3% of cumulative AIDS cases and comprised 8% of Georgia’s population2.
  • Among males, male-to-male sexual contact was the most commonly reported transmission category(55%) among cumulative AIDS cases. The second most common transmission category (18%) wasmissing risk information or did not meet one of the CDC-defined transmission categories.
  • Among females, missing risk information or did not meet one of the CDC-defined transmission categorieswas the most commonly reported transmission category (41%) among cumulative AIDS cases. The second most common transmission category (38%) was high-risk heterosexual contact[21].
  • The Fulton and DeKalb Health Districts had the two highest cumulative numbers of persons diagnosed with AIDS in Georgia (13,971 & 5,532respectively).

Table 1: Newly Diagnosed HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, 2009
HIV (not AIDS)1 / AIDS2 / Total
Gender / Count / Percent 3 / Count / Percent / Count / Percent
Male / 1007 / 74 / 684 / 77 / 1691 / 75
Female / 359 / 26 / 200 / 23 / 559 / 25
Age at Diagnosis (yr) / Count / Percent 3 / Count / Percent / Count / Percent
<13 / <5 / <1 / 1 / <1 / 2 to 5 / <1
13-19 / 64 / 5 / 26 / 3 / 90 / 4
20 -24 / 260 / 19 / 100 / 11 / 360 / 16
25 -29 / 234 / 17 / 119 / 30 / 353 / 16
30 -39 / 328 / 24 / 260 / 29 / 588 / 26
40 -49 / 308 / 23 / 228 / 26 / 536 / 24
50 -59 / 133 / 10 / 116 / 13 / 249 / 11
60 + / 35 / 1 / 34 / 2 / 69 / 2
Race/Ethnicity / Count / Percent 3 / Count / Percent / Count / Percent
White, Non-Hispanic / 282 / 21 / 141 / 16 / 423 / 19
Black, Non-Hispanic / 1009 / 74 / 665 / 75 / 1674 / 75
Hispanic/Latino, Any Race / 62 / 5 / 67 / 8 / 129 / 6
American Indian/Alaskan Native, Non-Hispanic / <5 / <1 / <5 / <1 / 2 to 8 / <1
Asian/ Hawaiian/Pacific Islander, Non-Hispanic / <5 / <1 / <5 / <1 / 2 to 8 / <1
Multiracial/Unknown/Others, Non-Hispanic / 6 / <1 / 8 / <1 / 14 / <1
Total / 1359 / 884 / 2243
1 ‘Persons newly diagnosed with HIV infection (not AIDS)’ refers to reported cases that meet the CDC surveillance case definition fro HIV (not AIDS) and were diagnosed in Georgia in 2009. Numbers are based on data reported through June 30, 2010, and are not adjusted for reporting delays.
2 ‘Persons newly diagnosed with AIDS’ refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in 2009. Numbers are based on data reported through June 30, 2010, and are not adjusted for reporting delays.
3 Total Percentages may not add up to 100% due to rounding.
Table 2: Newly Diagnosed HIV (not AIDS) and AIDS by Gender Transmission Category, Georgia, 2009
HIV (not AIDS)1 / AIDS2 / Total
Males / Count / Percent / Count / Percent / Count / Percent
MSM / 494 / 49 / 319 / 47 / 813 / 48
IDU / 10 / 1 / 14 / 2 / 24 / 1
MSM and IDU / 15 / 1 / 20 / 3 / 35 / 2
HRH3 / 26 / 3 / 28 / 4 / 54 / 3
Perinatal / 0 / 0 / <5 / <1 / <5 / <1
NIR/NRR4 / 462 / 46 / 302 / 44 / 764 / 45
Subtotal / 1007 / 684 / 1690
Females / Count / Percent / Count / Percent / Count / Percent
IDU / 9 / 2 / 9 / 4 / 18 / 3
HRH / 59 / 16 / 36 / 18 / 95 / 17
Other5 / 0 / 0 / 0 / 0 / 0 / 0
Perinatal / <5 / <1 / 0 / 0 / <5 / <1
NIR/NRR / 289 / 81 / 155 / 77 / 444 / 79
Subtotal / 359 / 200 / 559
Total / 1366 / 884 / 2250
1 ‘Persons Newly Diagnosed with HIV infection (not AIDS)’ refers to reported cases that meet the CDC surveillance case definition for HIV (not AIDS) and were diagnosed in Georgia in 2009. Numbers are based on data reported through June 30, 2010, and are not adjusted for reporting delays.
2 ‘Persons Newly Diagnosed with AIDS’ refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in 2009. Numbers are based on data reported through June 30, 2010, and are not adjusted for reporting delays.
3 Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, person with AIDS or documented HIV.
4No Identified Risk or No Reported Risk
5Other includes hemophilia, blood transfusion, transplant and pediatric.
Table 3: Newly Diagnosed HIV (not AIDS) and AIDS by Public Health District of Residence at Diagnosis, Georgia, 2009
Public Health District / HIV (not AIDS)1 / AIDS2 / Total
Count / Rate / Count / Rate / Count / Rate
1-1 / Northwest (Rome) / 17 / 2.7 / 10 / 1.6 / 27 / 4.3
1-2 / North Georgia (Dalton) / 15 / 3.5 / 14 / 3.2 / 29 / 6.7
2 / North (Gainesville) / 9 / 1.5 / 12 / 1.9 / 21 / 3.4
3-1 / Cobb-Douglas / 76 / 9.0 / 55 / 6.5 / 131 / 15.5
3-2 / Fulton / 259 / 25.1 / 210 / 20.3 / 469 / 45.4
3-3 / Clayton (Jonesboro) / 77 / 27.9 / 83 / 30.1 / 160 / 58.0
3-4 / East Metro (Lawrenceville) / 58 / 5.8 / 36 / 3.6 / 94 / 9.5
3-5 / DeKalb / 250 / 33.5 / 223 / 29.8 / 473 / 63.3
4 / La Grange / 72 / 9.1 / 43 / 5.4 / 115 / 14.5
5-1 / South Central (Dublin) / 19 / 13.1 / 6 / 4.1 / 25 / 17.3
5-2 / North Central (Macon) / 80 / 15.5 / 17 / 3.3 / 97 / 18.8
6 / East Central (Augusta) / 58 / 12.9 / 35 / 7.8 / 93 / 20.7
7 / West Central (Columbus) / 60 / 16.6 / 23 / 6.4 / 83 / 23.0
8-1 / South (Valdosta) / 47 / 18.9 / 16 / 6.4 / 63 / 25.3
8-2 / Southwest (Albany) / 68 / 18.5 / 23 / 6.2 / 91 / 24.7
9-1 / Coastal (Savannah) / 60 / 10.8 / 33 / 6.0 / 93 / 16.8
9-2 / Southeast (Waycross) / 22 / 6.2 / 19 / 5.4 / 41 / 11.6
10 / Northeast (Athens) / 22 / 4.7 / 19 / 4.0 / 41 / 8.7
GA Cases with Unknown Health District / 97 / 7 / 104
Total / 1366 / 14.1 / 884 / 9.1 / 2250 / 23.2
Note: case count includes incarcerated persons and may inflate rates in certain geographic regions where there are large concentrations of HIV-positive inmates.
1 ‘Persons Newly Diagnosed with HIV infection (not AIDS)’ refers to reported cases that meet the CDC surveillance case definition for HIV (not AIDS) and were diagnosed in Georgia in 2009. Numbers are based on data reported through June 30, 2010, and are not adjusted for reporting delays.
2 ‘Persons Newly Diagnosed with AIDS’ refers to reported cases that meet the CDC surveillance case definition for AIDS and were diagnosed in Georgia in 2009. Numbers are based on data reported through June 30, 2010, and are not adjusted for reporting delays.
3Georgia 2009 population estimates obtained from GDPH’s Online Analytical Statistical Information System (OASIS). Rates are per 100,000 population.
Table 4: Persons Living with HIV (not AIDS) and AIDS by Gender, Age and Race/Ethnicity, Georgia, 2009
HIV (not AIDS)1 / AIDS2 / Total
Gender / Count / Percent 3 / Count / Percent / Count / Percent
Male / 12,291 / 71 / 17,628 / 77 / 29,919 / 74
Female / 5,077 / 29 / 5,332 / 23 / 10,409 / 26
Age as of December 31, 2009 (years)4 / Count / Percent 3 / Count / Percent / Count / Percent
<13 / 167 / 1 / 35 / <1 / 202 / 1
13-19 / 352 / 2 / 138 / 1 / 490 / 1
20 -24 / 1,352 / 8 / 409 / 2 / 1,761 / 4