New Mexico Annual HIV Surveillance Report, 2010
0
NEW MEXICO DEPARTMENT OF HEALTH Catherine D. Torres, M.D. Secretary of Health New Mexico Department of Health C. Mack Sewell, Dr. P.H., M.S. State Epidemiologist and Division Director Epidemiology and Response Division Michael Landen, M.D., M.P.H. Deputy State Epidemiologist Epidemiology and Response Division Joan Baumbach, M.D., M.P.H., M.S. Bureau Chief Infectious Disease Epidemiology Bureau Chad Smelser, M.D. Medical Epidemiologist Infectious Disease Epidemiology Bureau
HIV & HEPATITIS EPIDEMIOLOGY PROGRAM Terry Bryant, M.S. HIV & Hepatitis Program Manager (505) 476-3654 terry.bryant@state.nm.us Heidi Purcell, M.P.H. HIV/AIDS Surveillance Coordinator (505) 476-1643 heidi.purcell@state.nm.us Kelly Gallagher, Ph.D. HIV/AIDS Epidemiologist (505) 476-3509 kelly.gallagher@state.nm.us Monica Brackney, M.S. Hepatitis C Epidemiologist (505) 827-0074 monica.brackney@state.nm.us Monica Roybal Management Analyst (505) 476-3035 monica.roybal@state.nm.us
HIV & Hepatitis Epidemiology Program
Infectious Disease Epidemiology Bureau Epidemiology and Response Division New Mexico Department of Health 1190 St. Francis Dr., N1350 Santa Fe, NM 87502-6110 Phone: (505) 476-3515 Fax: (505) 476-3544 http://nmhealth.org/ERD/HealthData/hiv_aids.html
To report cases of HIV: New Mexico Department of Health 1190 St Francis Dr., N1350 P.O. Box 26110 Santa Fe, NM 87502-6110 Attention: Surveillance Coordinator Phone: (505) 476-3515 Secure fax: (505) 476-3544
ACKNOWLEDGEMENTS The HIV & Hepatitis Epidemiology Program (the Program) would like to thank the many dedicated individuals who have been involved in HIV surveillance in New Mexico. These providers, laboratories, and surveillance staff support the collection of data upon which this report is based. The Program also thanks its partners within the New Mexico Department of Health, including the Public Health Division’s HIV Prevention Program and HIV Services Program. We also recognize the feedback and support of the New Mexico HIV Prevention Community Planning and Action Group (CPAG), HIV Health Management Alliance Agencies, and Governor’s HIV and AIDS Policy Commission. The Program acknowledges the U.S. Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP), for the financial and technical support without which this report would not be possible. Thanks also to the organizations and individuals who contributed photographs and granted us permission to include them in this report.
Annual retreat of the HIV Prevention Community Planning and Action Group (CPAG) in Taos, N.M., 2010.
T A B L E OF C O N T E N T S Table of Contents Introduction Program Highlights A Special Note about Terminology Report Highlights SECTION 1: New Diagnoses of HIV infection and AIDS (Incidence) SECTION 2: Persons Living with a Diagnosis of HIV Infection or AIDS (Prevalence) SECTION 3: Incidence and Prevalence of HIV or AIDS by Regions in New Mexico SECTION 4: Incidence and Prevalence of HIV or AIDS by Transmission Risk Category SECTION 5: Survival and Mortality Tables and Figures Data Sources Strengths & Limitations Technical Notes Definitions Used in This Report NMDOH Resources References
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Annual HIV Surveillance Report
4 5 6 7 8 8 10 11 12 12 14 38 39 40 43 44 45
INTRODUCTION The New Mexico Department of Health (NMDOH) administers statewide programs to prevent human immunodeficiency virus (HIV) infection and/or acquired immunodeficiency syndrome (AIDS), ensure the availability of quality medical and social services for persons infected with HIV, and monitor the impact of HIV in New Mexico. As part of this effort, the HIV & Hepatitis Epidemiology Program is responsible for tracking the epidemic to describe the burden of HIV in the state, characterize the population(s) most affected, and assist in the planning and allocation of resources for HIV prevention, treatment, and supportive services. To provide a comprehensive update of HIV infection and AIDS in New Mexico, the Program is pleased to share with you our 2010 HIV Surveillance Report. The 2010 HIV Surveillance Report is organized into five sections: 1. New diagnoses of HIV Infection and AIDS during 2009 (Incidence) 2. Persons Living with a Diagnosis of HIV Infection or AIDS (Prevalence) 3. Incidence and Prevalence of HIV or AIDS by Regions in New Mexico 4. Incidence and Prevalence of HIV or AIDS by Transmission Risk Category 5. Survival and Mortality For each section in the report, the Program has included an overview of significant findings, as well as detailed tables and graphs, to illustrate the current state of the HIV epidemic in New Mexico. In addition, the report highlights recent changes and improvements the Program has implemented to enhance the information available to our partners throughout the state. Staff from the HIV & Hepatitis Epidemiology Program are available to assist with interpretation of these data as well as to provide additional analyses. With your assistance, surveillance data will continue to guide HIV prevention strategies and resource allocation for care services in New Mexico. For questions or comments, please call (505) 476-3515.
Annual HIV Surveillance Report
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PROGRAM HIGHLIGHTS Since our last annual report, New Mexico HIV/AIDS Annual Surveillance Report: 2008, NMDOH and its partners in HIV prevention, care, and treatment have achieved many exciting successes in the fight against HIV. Included in these successes are:
Partner Services The New Mexico State Legislature passed Senate Bill 12, amending the HIV Test Act to allow the Program to share information with NMDOH’s Disease Prevention Teams concerning individuals newly diagnosed with HIV infection for the purposes of offering HIV Partner Services. Partner services are confidential, voluntary services in which the sexual or needle-sharing partners of a person diagnosed with HIV or an STD are informed of their exposure to infection and offered free testing, counseling, and referrals to medical treatment.
Adult Case Report Forms The need to collect high quality information regarding HIV cases remains a priority in order to accurately reflect the current HIV epidemic. The Program uses a case reporting protocol that includes follow-up of new cases using detailed case report forms. To further clarify the exposure risk information we collect, this year we added transgender categories to our Confidential HIV Case Report form.
Community Collaborative Care Program NMDOH has designated five regional HIV specialty care agencies called Health Management Alliances (HMAs). Each HMA brings all area HIV-related services under an administrative ‘umbrella’ to create an integrated, comprehensive continuum of care. In 2009, the Community Collaborative Care Program, administered by the NMDOH Public Health Division in Region 5, assumed responsibility as the HMA for southwestern New Mexico.
Cases of Public Health Importance Cases of public health importance (COPHI) are cases initially reported with a rare or unusual risk factor for HIV infection. Although CDC provides specific guidance for conducting COPHI investigations, the particular circumstances regarding a COPHI can change at the local, county, or state level; therefore, this past year, the Program developed a protocol specific to COPHI investigations in New Mexico. The New Mexico protocol features a team approach that requires the involvement of the patient’s HIV medical and/or social services provider, an Infectious Disease Epidemiology Bureau (IDEB) Medical Epidemiologist, and a member of the Public Health Division’s Disease Prevention Team.
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Annual HIV Surveillance Report
For HIV infected persons who are also infected with syphilis, the Program is now collecting the date of syphilis infection. These data will be useful to identify comorbidity patterns as well as to understand the effectiveness of Partner Services implementation to prevent communicable spread of STDs, especially among those individuals already infected with either HIV or syphilis.
Risk Ascertainment and No Identified Risk Determining the most likely source of HIV infection is important to monitor trends in transmission routes, target risk reduction interventions to the most affected populations, and allocate prevention resources. Since 1994, however, the percentage of newly reported persons in New Mexico with no identified risk has increased from 10% to 30%. To call attention to this increasing concern, the Program published a special report entitled “Risk Ascertainment and No Identified Risk.” The report describes barriers to risk ascertainment and proposes several strategies to improve collection of this information.
PROGRAM HIGHLIGHTS
Syphilis Co-morbidity
A SPECIAL NOTE ABOUT TERMINOLOGY Reflecting new developments in understanding and describing HIV and AIDS, and in accord with changes implemented by the CDC, this report emphasizes the diagnosis of HIV infection or AIDS. The term HIV/AIDS, which was used previously to refer to a diagnosis of HIV infection regardless of the person’s AIDS status at the time of diagnosis, has been replaced with the term “diagnosis of HIV infection.” This change acknowledges the 2008 revisions to the HIV infection classification system and the surveillance case definitions for HIV infection and AIDS; these case definitions have been revised and combined into a single case definition for HIV infection.1
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REPORT HIGHLIGHTS Section 1: New Diagnoses of HIV Infection and AIDS (Incidence) At the end of 2009, a cumulative total of 6,118 persons had been reported with human HIV and/or AIDS in New Mexico. Of these cases 1,281 were known to still be living with HIV and 2,009 were known to still be living with AIDS in New Mexico, for a total of 3,290 HIV positive individuals. With fewer than 200 new cases reported each year since 1999, New Mexico continues to be a low morbidity state for HIV. However, during 2009, 168 new HIV cases were documented, an increase of 8% over 2008 numbers and a 20% increase over 2005 numbers (Table 1.1). In 2009, the incidence rate of new HIV diagnoses in New Mexico was 8.0 per 100,000 population. Though this rate is well below the national rate of 19.4 per 100,000 population,2 the national incidence rate has been stable, whereas New Mexico’s rate has increased by 14% since 2005. Additionally, between 2005 and 2009: •
More males were diagnosed with HIV than females, averaging 84% of the new diagnoses each year.
•
Among American Indian/Alaska Natives, the incidence rate of new HIV diagnoses increased from 4.6 to 11.7 per 100,000, and among African Americans, the incidence rate of new HIV diagnoses increased from 9.5 to 23.2 per 100,000.
•
Rates among those 20-29 years have seen some fluctuation, but remained steady overall, while rates among those 30-49 have been increasing over the last few years. The greatest rate increase was seen among those ages 50 or older.
•
Men who have sex with other men (MSM) were the predominant transmission risk category each year, followed by injection drug users (IDU), including those identifying as MSM. The proportion of new HIV diagnoses reporting a high-risk heterosexual (HRH) transmission risk category decreased from 17 to 7% while the proportion of those with no identified transmission risk category more than doubled, rising from 16 to 34%.
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Annual HIV Surveillance Report
diagnosed with AIDS has declined. The number of persons diagnosed with AIDS in New Mexico decreased 6%, while the incidence rate of AIDS decreased 11% (Table 1.2). More males were diagnosed with AIDS than females, averaging 85% of AIDS diagnoses each year. Additionally, between 2005 and 2009: •
Hispanics and American Indian/Alaska Natives accounted for a disproportionate number of AIDS diagnoses; in 2009, Hispanics accounted for 50% of AIDS diagnoses, and American Indian/Alaska Natives accounted for 19% of AIDS diagnoses. These race/ethnicity groups accounted for only 43% and 11% of the state’s population, respectively.
•
AIDS diagnosis rates increased with increasing age until age 50, when rates declined.
•
MSM was the predominant transmission risk category, followed by IDU, including those identifying as MSM. The proportion of HRH decreased, while the proportion of individuals with no identified transmission risk category increased.
The occurrence of concurrent diagnoses in NM, defined as individuals who progressed to AIDS less than one year after initial HIV diagnosis, has declined and is now comparable to the national rate. Though 44% of all individuals diagnosed with HIV in New Mexico between 1999 and 2008 received a concurrent diagnosis of AIDS – compared to 38% in a similar period
SECTION 1 HIGHLIGHTS
In contrast to the rising incidence rate of diagnosis of HIV infection, the number of persons
of time at the national level3 – only 37% of new HIV cases were concurrently diagnosed with AIDS in 2008 (Table 1.3). Additionally, between 2004 and 2008: •
The proportion of men concurrently diagnosed remained stable at approximately 40%, whereas the proportion of women concurrently diagnosed ranged from a low of 21% (2008) to a high of 54% (2006).
•
Though the annual proportion of American Indian/Alaska Natives and African Americans concurrently diagnosed varied widely, it appears that the decline in concurrent diagnoses is occurring among persons of all race/ethnic groups.
•
The proportion of individuals receiving concurrent diagnoses increased with increasing age at initial HIV diagnosis.
•
High-risk heterosexuals had the greatest average proportion of concurrent diagnoses (47%) followed by MSM/IDU (43%).
Annual HIV Surveillance Report
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Section 2: Persons Living with a Diagnosis of HIV Infection or AIDS (Prevalence) At the end of 2009 there were 3,290 people with HIV known to be living in New Mexico, 2,009 of whom had progressed to AIDS (Table 2.1). The prevalence rate of HIV (not AIDS) was 61.1 per 100,000 population, and the AIDS prevalence rate was 95.7 per 100,000 population. Combined, the 2009 HIV or AIDS prevalence rate was 156.8 per 100,000 population. In 2007, the last year for which national data are available, the U.S. combined prevalence rate was 275.4 per 100,000 population.4 Other than age at time of initial HIV diagnosis, the distribution of persons living with a diagnosis of HIV infection who had progressed to AIDS did not differ greatly from those who had not progressed to AIDS (persons who had progressed to AIDS tended to be older than those who had not). Additionally, at year-end 2009: •
While 26% of new diagnoses of HIV occurred among non-Hispanic Whites, most individuals living with HIV or AIDS in New Mexico were non-Hispanic White (46%).
•
Seventy-five percent of persons living with a diagnosis of HIV infection or AIDS were aged 40 years or older.
•
African Americans accounted for 7% of persons living with a diagnosis of HIV infection or AIDS in New Mexico, and had the highest prevalence rate at 401.8 per 100,000.
•
The majority of people living with HIV infection in New Mexico identified as MSM, followed by MSM/IDU.
•
Four percent of HIV positive persons living in New Mexico reported being co-infected with Hepatitis B; 16% reported being co-infected with Hepatitis C.
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Annual HIV Surveillance Report
Section 3: Incidence and Prevalence of HIV or AIDS by Region in New Mexico New Mexico is a large, rural state bordered by five other states as well as Mexico. The state’s residents are widely distributed, with only five of its 33 counties having more than 100,000 residents. Albuquerque, located in Bernalillo county, is the state’s largest city, having just over a halfmillion residents. The geographic distribution of HIV in New Mexico mirrors the state’s population distribution. Additionally, from 2005 through 2009: •
Thirty-nine percent of all new HIV diagnoses occurred in Bernalillo County. Forty-three percent of all persons known to be living with HIV or AIDS in New Mexico resided in Bernalillo County at the end of 2009.
•
Northwestern New Mexico continued to report the largest proportion of new HIV diagnoses among American Indian/Alaska Natives (50%), while the northeastern and southwestern parts of the state reported the largest proportions of new diagnoses among Hispanics (comprising 71% and 69% of new diagnoses respectively).
•
The largest proportion of new diagnoses in the southeast and southwest portions of the state were between the ages of 30-39 years, whereas in the northeast, northwest, and in Bernalillo county, the largest proportion of new diagnoses occurred between the ages of 40-49 years.
•
Northeast and Northwest New Mexico reported the highest proportions of new diagnoses without any identified risk (50% and 42% of their cases respectively).
•
HIV incidence continued to be the lowest in southeastern New Mexico. The rate of new diagnoses decreased in Bernalillo County and the southeast, but increased in the northwest, northeast, and southwestern New Mexico. The number of new HIV infections diagnosed in the northwest increased 39% from 2008 to 2009.
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Section 4: Incidence and Prevalence of HIV or AIDS by Transmission Risk Category Transmission risk categories are used to summarize a person’s most likely HIV risk factors. The category assigned to each case is determined by selecting the risk factor presumed to most likely have been responsible for transmission. Notable differences in the incidence and prevalence of HIV or AIDS exist between transmission risk categories. From 2006 to 2009: •
Approximately one-half of new diagnoses of HIV infection occurred among MSM; these persons tended to be Hispanic (43%), and of younger age at the time of diagnosis than individuals from other transmission risk categories.
•
The number of heterosexual IDU diagnosed with HIV in New Mexico was greater than that of MSM/IDU. These persons were predominantly male (69%), non-Hispanic White (49%), and between the ages of 30-39 at time of diagnosis (33%). After HRH, IDU represents the second major transmission risk category among women.
•
As compared to MSM or IDU alone, a smaller number of MSM/IDU were diagnosed with HIV in New Mexico. These men were predominantly Hispanic (59%) and between the ages of 30-39 years of age (45%).
•
The majority of HRH diagnosed with HIV were women (62%). New diagnoses among HRH were predominantly Hispanic (45%). The number of HIV diagnoses was approximately equally distributed among all age groups, beginning with those aged 20 years or older.
•
The number of individuals diagnosed with HIV with no identified risk more than doubled. The majority of these individuals were male (75%), Hispanic (56%), and were between the ages of 30-49 years at the time of diagnosis (60%).
Section 5: Survival and Mortality Eighty-seven percent of persons with HIV infection were still alive three years after their initial diagnosis, and 83% were still alive five years after their diagnosis (Table 5.1). Similarly, 80% of persons were still alive three years after AIDS diagnosis, and 75% were still alive after five years (Table 5.2). Little differences existed between the survival rates after HIV infection or AIDS diagnosis of males and females, nor were differences in survival evident among persons of different racial/ ethnic groups. Additionally, among persons diagnosed with HIV or AIDS between 2000-2004: •
IDU had the lowest survival percentages, regardless whether the survival time was estimated following the initial HIV diagnosis (73%) or from the diagnosis of AIDS (67%). Lower survival among persons in this transmission risk category may be due to the high hepatitis C co-infection rates among IDU (50%) and MSM/IDU (39%, Table 2.2).
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Annual HIV Surveillance Report
•
Persons diagnosed with either HIV infection or AIDS in 2003 and 2004 appear to have increased survival relative to persons diagnosed in 2000-2002. Though persons diagnosed with HIV infection had better survival than those who were diagnosed with AIDS, the proportion of persons surviving five or more years after diagnosis increased for both groups.
From 2006-2009, there were 141 HIV-related deaths in New Mexico (Table 5.1). among New Mexico residents aged 20 to 59 years, HIV ranked among the 15 leading causes of death. Among persons aged 30-39 years, HIV was the 8th leading cause of death in New Mexico. Additionally, between 2006 and 2009: •
Nearly 90% of HIV-related deaths occurred among men, reflecting the greater HIV burden in the male population.
•
HIV-related deaths were distributed among racial/ethnic groups in proportion with the HIV burden in those groups; approximately half of deaths occurred among non-Hispanic Whites, and one-third occurred among Hispanics.
NMDOH staff and partners conduct outreach at Gay Pride in Gallup, N.M., Summer 2010.
Annual HIV Surveillance Report
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TABLES & FIGURES
SECTION 1
Table 1.1. Incidence of HIV Infection by Year of Diagnosis and Selected Characteristics, New Mexico, 2005-2009 2005
2006
2007
2008
2009
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
Male
113
11.7
82%
131
13.2
85%
126
12.5
86%
136
13.3
88%
137
13.3
82%
Female
25
2.5
18%
24
2.3
15%
21
2.0
14%
19
1.8
12%
31
2.9
18%
SEX
RACE/ETHNICITY African-Am.
5
9.5
4%
10
18.7
6%
9
16.5
6%
12
21.7
8%
13
23.2
8%
AI/AN
10
4.6
7%
13
5.8
8%
14
6.2
10%
19
8.3
12%
27
11.7
16%
Asian/PI
0
0.0
0%
2
5.9
1%
3
8.6
2%
0
0.0
0%
1
2.8
1%
Hispanic
74
9.1
54%
79
9.5
51%
71
8.4
48%
75
8.7
48%
82
9.0
49%
Multi-Race
0
-
0%
4
-
3%
3
-
2%
1
-
1%
1
-
1%
White
49
5.8
36%
47
5.4
30%
47
5.3
32%
48
5.3
31%
44
5.1
26%
< 13 years
0
0.0
0%
2
0.6
1%
1
0.3
1%
1
0.3
1%
1
0.3
1%
13-19 years
5
2.4
4%
6
2.9
4%
8
3.4
5%
4
1.7
3%
5
2.1
3%
20-29 years
34
12.3
25%
36
12.5
23%
43
15.7
29%
42
15.2
27%
36
12.9
21%
30-39 years
38
15.8
28%
51
21.1
33%
39
15.3
27%
43
16.6
28%
46
17.6
27%
40-49 years
42
14.3
30%
35
11.8
23%
28
8.7
19%
40
12.2
26%
52
15.8
31%
50+ years
19
3.2
14%
25
4.0
16%
28
4.4
19%
25
3.9
16%
28
4.4
17%
AGE
RISK TRANSMISSION CATEGORY MSM
77
-
56%
84
-
54%
83
-
56%
82
-
53%
77
-
46%
IDU
9
-
7%
14
-
9%
8
-
5%
10
-
6%
13
-
8%
MSM/IDU
7
-
5%
5
-
3%
7
-
5%
8
-
5%
9
-
5%
HRH
23
-
17%
21
-
14%
11
-
7%
15
-
10%
11
-
7%
Pediatric
0
-
0%
2
-
1%
2
-
1%
0
-
0%
1
-
1%
Other
0
-
0%
2
-
1%
0
-
0%
0
-
0%
0
-
0%
NIR
22
-
16%
27
-
17%
36
-
24%
40
-
26%
57
-
34%
138
7.0
100%
155
7.7
7.5
100%
168
8.0
100%
TOTAL
Due to rounding, percentages may not total to 100%.
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Annual HIV Surveillance Report
100% 147
7.2
100% 155
Table 1.2. Incidence of AIDS Diagnoses by Year of Diagnosis and Selected Characteristics, New Mexico, 2005-2009 2005
2006
2007
2008
2009
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
Male
113
11.7
82%
131
13.2
85%
126
12.5
86%
136
13.3
88%
137
13.3
82%
Female
25
2.5
18%
24
2.3
15%
21
2.0
14%
19
1.8
12%
31
2.9
18%
RACE ETHNICITY African-Am. 5
9.5
4%
10
18.7
6%
9
16.5
6%
12
21.7
8%
13
23.2
8%
AI/AN
10
4.6
7%
13
5.8
8%
14
6.2
10%
19
8.3
12%
27
11.7
16%
Asian/PI
0
0.0
0%
2
5.9
1%
3
8.6
2%
0
0.0
0%
1
2.8
1%
Hispanic
74
9.1
54%
79
9.5
51%
71
8.4
48%
75
8.7
48%
82
9.0
49%
Multi-Race
0
-
0%
4
-
3%
3
-
2%
1
-
1%
1
-
1%
White
49
5.8
36%
47
5.4
30%
47
5.3
32%
48
5.3
31%
44
5.1
26%
< 13 years
0
0.0
0%
2
0.6
1%
1
0.3
1%
1
0.3
1%
1
0.3
1%
13-19 years
5
2.4
4%
6
2.9
4%
8
3.4
5%
4
1.7
3%
5
2.1
3%
20-29 years
34
12.3
25%
36
12.5
23%
43
15.7
29%
42
15.2
27%
36
12.9
21%
30-39 years
38
15.8
28%
51
21.1
33%
39
15.3
27%
43
16.6
28%
46
17.6
27%
40-49 years
42
14.3
30%
35
11.8
23%
28
8.7
19%
40
12.2
26%
52
15.8
31%
50+ years
19
3.2
14%
25
4.0
16%
28
4.4
19%
25
3.9
16%
28
4.4
17%
56%
84
-
54%
83
-
56%
82
-
53%
77
-
46%
SEX
AGE
RISK TRANSMISSION CATEGORY MSM
77
-
IDU
9
-
7%
14
-
9%
8
-
5%
10
-
6%
13
-
8%
MSM/IDU
7
-
5%
5
-
3%
7
-
5%
8
-
5%
9
-
5%
HRH
23
-
17%
21
-
14%
11
-
7%
15
-
10%
11
-
7%
Pediatric
0
-
0%
2
-
1%
2
-
1%
0
-
0%
1
-
1%
Other
0
-
0%
2
-
1%
0
-
0%
0
-
0%
0
-
0%
NIR
22
-
16%
27
-
17%
36
-
24%
40
-
26%
57
-
34%
138
7.0
100%
155
7.7
100%
147
7.2
100%
155
7.5
100%
168
8.0
100%
Annual HIV Surveillance Report
15
TOTAL
Due to rounding, percentages may not total to 100%.
16
26
Female
Annual HIV Surveillance Report
13
0
84
0
54
AI/AN
Asian/PI
Hispanic
Asian/PI
White
6
41
48
41
22
13-19 years
20-29 years
30-39 years
40-49 years
50+ years
17
30
19
7
0
0
26
0
34
0
8
5
11
62
66
21
10
24
0
0
37
158
MSM
IDU
MSM/IDU
HRH
Pediatric
Other
NIR
TOTAL
73
14
0
0
14
2
11
32
RISK TRANSMISSION CATEGORY
0
< 13 years
AGE
7
African-Am.
RACE/ETHNICITY
132
Male
SEX
46%
38%
0%
0%
58%
20%
52%
48%
77%
73%
40%
17%
0%
0%
48%
0%
40%
0%
62%
71%
42%
47%
# of # of % new Concurrent within HIV dx dx group
2004
2006
138
22
0
0
23
7
9
77
19
42
38
34
5
0
49
0
74
0
10
5
25
113
57
5
0
0
12
4
4
32
11
18
21
6
1
0
17
0
34
0
5
1
10
47
41%
23%
0%
0%
52%
57%
44%
42%
58%
43%
55%
18%
20%
0%
35%
0%
46%
0%
50%
20%
40%
42%
155
27
2
2
21
5
14
84
25
35
51
36
6
2
47
2
79
2
13
10
24
131
60
13
2
1
9
3
6
26
16
17
19
7
0
1
23
0
28
0
5
4
13
47
39%
48%
100%
50%
43%
60%
43%
31%
64%
49%
37%
19%
0%
50%
49%
0%
35%
0%
38%
40%
54%
36%
# of % # of % # of new # of new Concurrent within Concurrent within HIV dx HIV dx dx group dx group
2005 2008
147
36
0
2
11
7
8
83
28
28
39
43
8
1
47
3
71
3
14
9
21
126
60
16
0
1
4
1
4
34
16
13
17
12
1
1
19
2
29
2
3
4
8
52
41%
44%
0%
50%
36%
14%
50%
41%
57%
46%
44%
28%
13%
100%
40%
67%
41%
67%
21%
44%
38%
41%
155
40
0
0
15
8
10
82
25
40
43
42
4
1
48
0
75
0
19
12
19
136
58
18
0
0
5
3
5
27
15
21
14
8
0
0
20
0
27
0
10
1
4
54
37%
45%
0%
0%
33%
38%
50%
33%
60%
53%
33%
19%
0%
0%
42%
0%
36%
0%
53%
8%
21%
40%
# of # of # of # of % within % within new Concurrent new Concurrent group group HIV dx dx HIV dx dx
2007
Table 1.3. Incidence of HIV infection and Number of Concurrent HIV/AIDS Diagnoses by Year of Diagnosis and Selected Characteristics, New Mexico, 2004-2008
Number of HIV Diagnoses
180 160 140 120 100 80 60 40 20 0
Males Females Total
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Number of HIV diagnoses
Figure 1.2 Incidence of HIV Infection by Year of Diagnosis and Race/Ethnicity, New Mexico, 2000-2009 100 90 80 70 60 50 40 30 20 10 0
African Am. AI/AN Asian/PI Hispanic White 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
T A B L E S & F I G U R E S: S E C T I O N 1
Figure 1.1 Incidence of HIV Infection by Year of Diagnosis and Sex, New Mexico, 2000-2009
Excludes 11 cases that reported Multi-Race.
Figure 1.3 Incidence of HIV Infections by Year of Diagnosis and Age at Diagnosis, New Mexico, 2000-2009
Number of HIV Diagnoses
60 50
<13
40
13-19
30
20-29
20
30-39
10
40-49 50+
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Annual HIV Surveillance Report
17
Number of HIV Diagnoses
100 90 80 70 60 50 40 30 20 10 0
MSM IDU MSM/IDU HRH Pediatric Other NIR 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Figure 1.5 AIDS Diagnoses by Year of Diagnosis and Sex, New Mexico, 2000-2009
Number of AIDS Diagnoses
140 120 100 80
Males
60
Females
40
Total
20 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Figure 1.6 AIDS Diagnoses by Year of Diagnosis and Race/Ethnicity, New Mexico, 2000-2009 Number of AIDS Diagnoses
70 60 50
African Am.
40
AI/AN
30
Asian/PI
20
Hispanic
10
White
0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Excludes 7 cases that reported Multi-Race.
18
Annual HIV Surveillance Report
TABLES & FIGURES: Section 1
Figure 1.4 Incidence of HIV Infection by Year of Diagnosis and Transmission Category, New Mexico, 2000-2009
AIDS Diagnoses by Year of Diagnosis and Age at Diagnosis, New Mexico, 2000-2009 Number of AIDS Diagnoses
60 50
< 13
40
13-19
30
20-29
20
30-39
10
40-49 50+
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Figure 1.8 AIDS Diagnoses by Year of Diagnosis and Transmission Category, New Mexico, 2000-2009
Number of AIDS Diagnoses
80 70
MSM
60 50
IDU
40
MSM/IDU
30
HRH
20
Pediatric
10
Other
0
NIR
TABLES & FIGURES: Section 1
Figure 1.7
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Figure 1.9 Incidence of HIV Infection and Number of Concurrent HIV/AIDS Diagnoses by Year of Diagnosis, New Mexico, 1999-2008 180
Number of Diagnoses
160 140 120 100
Infections
Incident HIV Diagnoses Concurrent HIV/AIDS Diagnoses
80 60 40 20 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Annual HIV Surveillance Report
19
TABLES & FIGURES
SECTION 2
Table 2.1. Prevalence of HIV or AIDS by Selected Characteristics, New Mexico, Year-End 2009 HIV
AIDS
Total
N
Rate
% of total
N
Rate
% of total
N
Rate
% of total
Male
1076
104.2
84%
1795
173.9
89%
2871
278.1
87%
Female
205
19.2
16%
214
20.1
11%
419
39.3
13%
African-Am.
106
189.3
8%
119
212.5
6%
225
401.8
7%
AI/AN
96
41.6
7%
133
57.6
7%
229
99.2
7%
Asian/PI
10
28.0
1%
13
36.4
1%
23
64.4
1%
Hispanic
510
56.1
40%
766
84.2
38%
1276
140.2
39%
5
-
<1%
15
-
1%
20
-
1%
554
64.0
43%
963
111.2
48%
1517
175.2
46%
< 13 years
3
0.9
<1%
3
0.9
<1%
6
1.7
<1%
13-19 years
6
2.5
<1%
5
2.1
<1%
11
4.6
<1%
20-29 years
184
65.7
14%
51
18.2
3%
235
83.9
7%
30-39 years
313
120.0
24%
290
111.2
14%
603
231.2
18%
40-49 years
438
132.9
34%
859
260.6
43%
1297
393.4
39%
50+ years
337
52.4
26%
801
124.7
40%
1138
177.1
35%
SEX
RACE/ETHNICITY
Multi-Race White
AGE
RISK TRANSMISSION CATEGORY MSM
720
-
56%
1249
-
62%
1969
-
60%
IDU
109
-
9%
184
-
9%
293
-
9%
MSM/IDU
97
-
8%
243
-
12%
340
-
10%
HRH
141
-
11%
179
-
9%
320
-
10%
Pediatric
8
-
1%
17
-
1%
25
-
1%
Other
2
-
<1%
10
-
<1%
12
-
<1%
204
-
16%
127
-
6%
331
-
10%
1281
61.1
100%
2009
95.7
100%
3290
156.8
100%
NIR TOTAL
Due to rounding, percentages may not total to 100%.
20
Annual HIV Surveillance Report
Total HIV/AIDS
Hepatitis B Co-infection % within N group
Hepatitis C Co-infection % within N group
SEX Male Female
2871 419
137 11
5% 3%
440 84
15% 20%
RACE/ETHNICITY African-Am. AI/AN Asian/PI Hispanic Multi-Race White
225 229 23 1276 20 1517
7 6 1 62 2 70
3% 3% 4% 5% 10% 5%
34 46 4 214 4 222
15% 20% 17% 17% 20% 15%
AGE < 13 years 13-19 years 20-29 years 30-39 years 40-49 years 50+ years
6 11 235 603 1297 1138
0 0 3 25 62 58
0% 0% 1% 4% 5% 5%
0 0 7 79 223 215
0% 0% 3% 13% 17% 19%
RISK TRANSMISSION CATEGORY MSM 1969 IDU 293 MSM/IDU 340 HRH 320 Pediatric 25 Other 12 NIR 331
98 16 19 4 1 3 7
5% 5% 6% 1% 4% 25% 2%
185 147 131 34 3 4 20
9% 50% 39% 11% 12% 33% 6%
TOTAL
148
4%
524
16%
3290
TABLES & FIGURES: Section 2
Table 2.2. Number and Percent of Persons Living with HIV or AIDS who are Co-Infected with Hepatitis B and/or Hepatitis C by Selected Characteristics, New Mexico, Year-End 2009
Due to rounding, percentages may not total to 100%.
Annual HIV Surveillance Report
21
TABLES & FIGURES
SECTION 3
Table 3.1. Incidence of HIV Infection by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS, Year-End 2009, by Region in New Mexico 2006 HIV Incidence
2007 HIV Incidence
2008 HIV Incidence
2009 HIV Incidence
N
Rate
N
Rate
N
Rate
N
Northwest
24
5.7
26
5.9
27
6.1
Northeast
22
7.3
19
6.3
18
Bernalillo County
71
11.3
74
11.5
Southeast
13
5.1
8
Southwest
25
6.1
New Mexico
155
7.7
Prevalence of HIV/AIDS HIV
AIDS
Total
Rate
N
N
N
Rate
38
8.4
199
272
471
104.5
5.9
24
7.8
205
400
605
196.5
69
10.6
65
9.9
551
879
1430
217.8
3.1
9
3.5
6
2.3
75
131
206
79.8
20
4.8
32
7.6
35
8.2
245
316
561
132.0
147
7.2
155
7.5
168
8.0
1281
2009
3290
156.8
Current regional totals may not sum to state total due to missing current residence information.
Figure 3.1 Incidence of HIV Infection by Year of Diagnosis and Region, New Mexico, 2000-2009.
Number of HIV Diagnoses
80
70 60
NW
50
NE
40
Bernalillo Co.
30 20
SE
10
SW
0 2000
22
2001
2002
2003
2004
Annual HIV Surveillance Report
2005
2006
2007
2008
2009
Figure 3.3 HIV or AIDS Prevelance Rate by Region in New Mexico, Year-End 2009
Annual HIV Surveillance Report
TABLES & FIGURES: Section 3
Figure 3.2 HIV Incidence Rate by Region in New Mexico, 2009
23
2006 HIV Incidence
2007 HIV Incidence
2008 HIV Incidence
2009 HIV Incidence
Prevalence of HIV/AIDS HIV
AIDS
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Male
21
88%
21
81%
25
93%
27
71%
161
81%
235
86%
Female
3
13%
5
19%
2
7%
11
29%
38
19%
37
14%
SEX
RACE/ETHNICITY African-Am.
1
4%
1
4%
3
11%
2
5%
15
8%
15
6%
AI/AN
7
29%
8
31%
10
37%
19
50%
48
24%
74
27%
Asian/PI
0
0%
1
4%
0
0%
1
3%
2
1%
2
1%
Hispanic
10
42%
7
27%
9
33%
12
32%
66
33%
78
29%
Multi-Race
0
0%
2
8%
1
4%
0
0%
1
1%
0
0%
White
6
25%
7
27%
4
15%
4
11%
67
34%
103
38%
< 13 years
0
0%
0
0%
1
4%
0
0%
1
1%
0
0%
13-19 years
1
4%
2
8%
1
4%
0
0%
1
1%
0
0%
20-29 years
7
29%
6
23%
8
30%
7
18%
30
15%
11
4%
30-39 years
12
50%
6
23%
8
30%
11
29%
44
22%
60
22%
40-49 years
2
8%
6
23%
6
22%
14
37%
72
36%
99
36%
50+ years
2
8%
6
23%
3
11%
6
16%
51
26%
102
38%
AGE
RISK TRANSMISSION CATEGORY MSM
8
33%
11
42%
14
52%
14
37%
86
43%
150
55%
IDU
4
17%
2
8%
2
7%
2
5%
22
11%
36
13%
MSM/IDU
2
8%
0
0%
1
4%
1
3%
18
9%
26
10%
HRH
4
17%
2
8%
1
4%
5
13%
27
14%
33
12%
Pediatric
0
0%
1
4%
0
0%
0
0%
2
1%
2
1%
Other
1
0%
0
0%
0
0%
0
0%
0
0%
2
1%
NIR
5
21%
10
38%
9
33%
16
42%
44
22%
23
8%
TOTAL
24
100
26
100
27
100
38
100
199
100
272
100
Due to rounding, percentages may not total to 100%.
24
Annual HIV Surveillance Report
TABLES & FIGURES: Section 3
Table 3.2. Incidence of HIV infection by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS, Year-End 2009, by Selected Characteristics, Northwest New Mexico
2006 HIV Incidence
2007 HIV Incidence
2008 HIV Incidence
2009 HIV Incidence
Prevalence of HIV/AIDS
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Male
19
86%
17
89%
17
94%
16
67%
178
87%
364
91%
Female
3
14%
2
11%
1
6%
8
33%
27
13%
36
9%
HIV
AIDS
SEX
RACE/ETHNICITY African-Am.
1
5%
0
0%
1
6%
2
8%
11
5%
10
3%
AI/AN
2
9%
1
5%
0
0%
1
4%
9
4%
11
3%
Asian/PI
0
0%
0
0%
0
0%
0
0%
3
1%
2
1%
Hispanic
9
41%
13
68%
11
61%
17
71%
77
38%
146
37%
Multi-Race
0
0%
0
0%
0
0%
0
0%
0
0%
0
0%
White
10
45%
5
26%
6
33%
4
17%
105
51%
231
58%
< 13 years
0
0%
0
0%
0
0%
1
4%
1
<1%
0
0%
13-19 years
1
5%
0
0%
0
0%
0
0%
1
<1%
0
0%
20-29 years
4
18%
7
37%
5
28%
8
33%
22
11%
7
2%
30-39 years
5
23%
8
42%
4
22%
2
8%
41
20%
31
8%
40-49 years
8
36%
4
21%
5
28%
9
38%
67
33%
167
42%
50+ years
4
18%
0
0%
4
22%
4
17%
73
36%
195
49%
63%
15
83%
7
29%
135
66%
280
70%
AGE
TABLES & FIGURES: Section 3
Table 3.3. Incidence of HIV Infection by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS, Year-End 2009, by Selected Characteristics, Northeast New Mexico.
RISK TRANSMISSION CATEGORY MSM
12
55%
12
IDU
3
14%
0
0%
0
0%
2
8%
14
7%
21
5%
MSM/IDU
1
5%
3
16%
0
0%
1
4%
20
10%
45
11%
HRH
1
5%
2
11%
2
11%
1
4%
18
9%
28
7%
Pediatric
0
0%
0
0%
0
0%
1
4%
2
1%
2
1%
Other
0
0%
0
0%
0
0%
0
0%
1
<1%
2
1%
NIR
5
23%
2
11%
1
6%
12
50%
15
7%
22
6%
TOTAL
22
100%
19
100%
18
100%
24
100%
205
100%
400
100%
Due to rounding, percentages may not total to 100%.
Annual HIV Surveillance Report
25
2006 HIV Incidence
2007 HIV Incidence
2008 HIV Incidence
2009 HIV Incidence
Prevalence of HIV/AIDS HIV
AIDS
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Male
61
86%
65
88%
58
84%
60
92%
487
88%
793
90%
Female
10
14%
9
12%
11
16%
5
8%
64
12%
86
10%
SEX
RACE/ETHNICITY African-Am.
8
11%
5
7%
6
9%
7
11%
47
9%
61
7%
AI/AN
3
4%
4
5%
5
7%
7
11%
35
6%
42
5%
Asian/PI
2
3%
1
1%
0
0%
0
0%
4
1%
7
1%
Hispanic
35
49%
38
51%
32
46%
28
43%
209
38%
330
38%
Multi-Race
4
6%
1
1%
0
0%
1
2%
3
1%
11
1%
White
19
27%
25
34%
26
38%
22
34%
253
46%
428
49%
< 13 years
2
3%
0
0%
0
0%
0
0%
0
0%
1
<1%
13-19 years
3
4%
4
5%
1
1%
4
6%
2
<1%
2
<1%
20-29 years
17
24%
23
31%
16
23%
12
18%
77
14%
17
2%
30-39 years
22
31%
17
23%
22
32%
18
28%
127
23%
115
13%
40-49 years
17
24%
14
19%
19
28%
21
32%
199
36%
411
47%
50+ years
10
14%
16
22%
11
16%
10
15%
146
26%
333
38%
AGE
RISK TRANSMISSION CATEGORY MSM
47
66%
45
61%
36
52%
37
57%
368
67%
581
66%
IDU
4
6%
3
4%
3
4%
4
6%
29
5%
63
7%
MSM/IDU
0
0%
4
5%
6
9%
5
8%
44
8%
110
13%
HRH
9
13%
6
8%
6
9%
1
2%
51
9%
70
8%
Pediatric
2
3%
0
0%
0
0%
0
0%
0
0%
6
1%
Other
1
<1%
0
0%
0
0%
0
0%
0
0%
3
<1%
NIR
8
11%
16
22%
18
26%
18
28%
59
11%
46
5%
TOTAL
71
100%
74
100%
69
100%
65
100%
551
100%
879
100%
Due to rounding, percentages may not total to 100%.
26
Annual HIV Surveillance Report
TABLES & FIGURES: Section 3
Table 3.4. Incidence of HIV Infection by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS, Year-End 2009, by Selected Characteristics, Bernalillo County New Mexico
2006 HIV Incidence
2007 HIV Incidence
2008 HIV Incidence
2009 HIV Incidence
Prevalence of HIV/AIDS HIV
AIDS
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Male
9
69%
6
75%
7
78%
5
83%
53
71%
116
89%
Female
4
31%
2
25%
2
22%
1
17%
22
29%
15
11%
SEX
RACE/ETHNICITY African-Am.
0
0%
2
25%
2
22%
0
0%
13
17%
14
11%
AI/AN
0
0%
0
0%
0
0%
0
0%
0
0%
2
2%
Asian/PI
0
0%
0
0%
0
0%
0
0%
0
0%
0
0%
Hispanic
8
62%
2
25%
3
33%
1
17%
25
33%
46
35%
Multi-Race
0
0%
0
0%
0
0%
0
0%
1
1%
2
2%
White
5
38%
4
50%
4
44%
5
83%
36
48%
67
51%
< 13 years
0
0%
0
0%
0
0%
0
0%
1
1%
0
0%
13-19 years
0
0%
0
0%
1
11%
0
0%
0
0%
0
0%
20-29 years
4
31%
4
50%
4
44%
1
17%
13
17%
4
3%
30-39 years
2
15%
1
13%
0
0%
3
50%
21
28%
24
18%
40-49 years
4
31%
0
0%
2
22%
2
33%
25
33%
50
38%
50+ years
3
23%
3
38%
2
22%
0
0%
15
20%
53
40%
AGE
TABLES & FIGURES: Section 3
Table 3.5. Incidence of HIV Infection by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS, Year-End 2009, by Selected Characteristics, Southeast New Mexico
RISK TRANSMISSION CATEGORY MSM
6
46%
4
50%
4
44%
4
67%
37
49%
65
50%
IDU
2
15%
1
13%
2
22%
1
17%
11
15%
20
15%
MSM/IDU
0
0%
0
0%
0
0%
0
0%
5
7%
24
18%
HRH
2
15%
1
13%
1
11%
0
0%
13
17%
14
11%
Pediatric
0
0%
0
0%
0
0%
0
0%
2
3%
0
0%
Other
0
0%
0
0%
0
0%
0
0%
1
1%
1
1%
NIR
3
23%
2
25%
2
22%
1
17%
6
8%
7
5%
TOTAL
13
100%
8
100%
9
100%
6
100%
131
100%
75 100%
Due to rounding, percentages may not total to 100%.
Annual HIV Surveillance Report
27
2006 HIV Incidence
2007 HIV Incidence
2008 HIV Incidence
2009 HIV Incidence
Prevalence of HIV/AIDS HIV
AIDS
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Male
21
84%
17
85%
29
91%
29
83%
192
78%
276
87%
Female
4
16%
3
15%
3
9%
6
17%
53
22%
40
13%
SEX
RACE/ETHNICITY African-Am
0
0%
1
5%
0
0%
2
6%
19
8%
18
6%
AI/AN
1
4%
1
5%
4
13%
0
0%
4
2%
4
1%
Asian/PI
0
0%
1
5%
0
0%
0
0%
1
<1%
2
1%
Hispanic
17
68%
11
55%
20
63%
24
69%
131
53%
163
52%
Multi-Race
0
0%
0
0%
0
0%
0
0%
0
0%
2
1%
White
7
28%
6
30%
8
25%
9
26%
90
37%
127
40%
< 13 years
0
0%
1
5%
0
0%
0
0%
0
0%
2
1%
13-19 years
1
4%
2
10%
1
3%
1
3%
2
1%
3
1%
20-29 years
4
16%
3
15%
9
28%
8
23%
42
17%
12
4%
30-39 years
10
40%
7
35%
9
28%
12
34%
78
32%
60
19%
40-49 years
4
16%
4
20%
8
25%
6
17%
73
30%
127
40%
50+ years
6
24%
3
15%
5
16%
8
23%
50
20%
112
35%
AGE
RISK TRANSMISSION CATEGORY MSM
11
44%
11
55%
13
41%
15
43%
92
38%
166
53%
IDU
1
4%
2
10%
3
9%
4
11%
33
13%
42
13%
MSM/IDU
2
8%
0
0%
1
3%
2
6%
9
4%
36
11%
HRH
5
20%
0
0%
5
16%
4
11%
32
13%
34
11%
Pediatric
0
0%
1
5%
0
0%
0
0%
2
1%
7
2%
Other
0
0%
0
0%
0
0%
0
0%
0
0%
2
1%
NIR
6
24%
6
30%
10
31%
10
29%
77
31%
29
9%
TOTAL
25
100%
20
100%
32
100%
35
100%
245
100%
316
100%
Due to rounding, percentages may not total to 100%.
28
Annual HIV Surveillance Report
TABLES & FIGURES: Section 3
Table 3.6. Incidence of HIV infection by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS, Year-End 2009, by Selected Characteristics, Southwest New Mexico
TABLES & FIGURES
SECTION 4
Table 4.1. Incidence of HIV Infection among MSM by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS among MSM, Year-End 2009, by Selected Characteristics, New Mexico 2006 Incidence
2007 Incidence
2008 Incidence
2009 Incidence
Prevalence
RACE/ ETHNICITY
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
African-Am.
4
5%
5
6%
3
4%
7
9%
95
5%
AI/AN
9
11%
4
5%
13
16%
13
17%
120
6%
Asian/PI
1
1%
2
2%
0
0%
0
0%
15
1%
Hispanic
36
43%
41
49%
44
54%
33
43%
729
37%
Multi-Race
3
4%
1
1%
0
0%
1
1%
12
1%
White
31
37%
30
36%
22
27%
23
30%
998
51%
< 13 years
0
0%
0
0%
0
0%
0
0%
0
0%
13-19 years
2
2%
2
2%
4
5%
2
3%
1
0%
20-29 years
26
31%
29
35%
24
29%
22
29%
123
6%
30-39 years
26
31%
21
25%
21
26%
20
26%
320
16%
40-49 years
19
23%
17
20%
21
26%
22
29%
812
41%
50+ years
11
13%
14
17%
12
15%
11
14%
713
36%
TOTAL
84
100%
83
100%
82
100%
77
100%
1969
100%
AGE
Due to rounding, percentages may not total to 100%.
Figure 4.2 Prevalence of HIV or AIDS Among MSM by Race/Ethnicity, New Mexico, 2009
Figure 4.1 Incidence of HIV Infection Among MSM by Race/Ethnicity, New Mexico, 2000-2009 5%
35%
10%
African Am. 1%
5% 6% 1%
AI/AN Asian
Hispanic Excludes 5 Multi-Race
51%
White
49%
Figure 4.3 Incidence of HIV Infection Among MSM by Age at Diagnosis, New Mexico, 2000-2009 13%
3%
25%
33%
26%
37%
Excludes 12 Multi-Race
African Am. AI/AN Asian Hispanic White
Figure 4.4 Prevalence of HIV or AIDS among MSM by Current Age, New Mexico, 2009
13-19 20-29 30-39 40-49 50+
36%
6%
17%
20-29
30-39 40-49 41%
Annual HIV Surveillance Report
50+
29
2006 Incidence
2007 Incidence
2008 Incidence
2009 Incidence
Prevalence
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
9
64%
5
63%
8
80%
9
69%
194
66%
Females 5 RACE/ETHNICITY
36%
3
38%
2
20%
4
31%
99
34%
African-Am.
1
7%
0
0%
0
0%
1
8%
29
10%
AI/AN
2
14%
1
13%
0
0%
1
8%
16
5%
Asian/PI
0
0%
0
0%
0
0%
0
0%
1
0%
Hispanic
5
36%
1
13%
6
60%
5
38%
115
39%
Multi-Race
0
0%
0
0%
0
0%
0
0%
3
1%
White
6
43%
6
75%
4
40%
6
46%
129
44%
< 13 years
0
0%
0
0%
0
0%
0
0%
0
0%
13-19 years
0
0%
0
0%
0
0%
0
0%
0
0%
20-29 years
4
29%
1
13%
5
50%
3
23%
11
4%
30-39 years
6
43%
2
25%
1
10%
6
46%
53
18%
40-49 years
1
7%
1
13%
1
10%
3
23%
120
41%
50+ years
3
21%
4
50%
3
30%
1
8%
109
37%
TOTAL
14
100%
8
100%
10
100%
13
100%
293
100%
SEX Males
AGE
Due to rounding, percentages may not total to 100%.
Figure 4.5 Incidence of HIV Infection among IDU by Race/Ethnicity, New Mexico, 2000-2009 6%
37%
6%
African Am.
Figure 4.6 Prevalence of HIV or AIDS among IDU by Race/Ethnicity, New Mexico, 2009 44%
10%
6%
AI/AN
<1%
Hispanic White
51%
Figure 4.7 Incidence of HIV Infection among IDU by Age at Diagnosis, New Mexico, 2000-2009 14%
36%
30
23%
27%
20-29 30-39 40-49 50+
Annual HIV Surveillance Report
Excludes 3 Multi-Race
40%
African Am. AI/AN Asian Hispanic White
Figure 4.8 Prevalence of HIV or AIDS among IDU by Current Age, New Mexico, 2009 37%
4%
41%
18%
20-29 30-39 40-49 50+
TABLES & FIGURES: Section 4
Table 4.2. Incidence of HIV Infection among IDU by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS among IDU, Year-End 2009, by Selected Characteristics, New Mexico
2006 Incidence
2007 Incidence
2008 Incidence
2009 Incidence
Prevalence
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Afri-Amer
0
0%
0
0%
0
0%
0
0%
17
5%
AI/AN
1
20%
1
14%
1
13%
0
0%
25
7%
Asian/PI
0
0%
0
0%
0
0%
0
0%
0
0%
Hispanic
2
40%
4
57%
4
50%
7
78%
112
33%
Multi-Race
0
0%
0
0%
0
0%
0
0%
2
1%
White
2
40%
2
29%
3
38%
2
22%
184
54%
< 13 years
0
0%
0
0%
0
0%
0
0%
0
0%
13-19 years
0
0%
0
0%
0
0%
1
11%
0
0%
20-29 years
1
20%
1
14%
2
25%
2
22%
12
4%
30-39 years
3
60%
3
43%
4
50%
3
33%
64
19%
40-49 years
0
0%
3
43%
2
25%
2
22%
149
44%
50+ years
1
20%
0
0%
0
0%
1
11%
115
34%
TOTAL
5
100%
7
100%
8
100%
9
100%
340
100%
RACE/ ETHNICITY
AGE
Due to rounding, percentages may not total to 100%.
Figure 4.9 Incidence of HIV Infection among MSM/ IDU by Race/Ethnicity, New Mexico, 2000-2009 38%
3%
12%
6%
39%
African Am. AI/AN
Hispanic
Hispanic
White
26%
7%
AI/AN
Figure 4.11 Incidence of HIV Infection among MSM/ IDU by Age at Diagnosis, New Mexico, 2000-2009 7%
5%
African Am.
47%
22%
Figure 4.10 Prevalence of HIV or AIDS among MSM/IDU by Race/Ethnicity, New Mexico, 2009
13-19 20-29 30-39 40-49 50+
33%
55%
TABLES & FIGURES: Section 4
Table 4.3. Incidence of HIV Infection among MSM/IDU by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS among MSM/IDU, Year-End 2009, by Selected Characteristics, New Mexico
White
Figure 4.12 Prevalence of HIV or AIDS among MSM/IDU by Current Age, New Mexico, 2009 34%
3%
19%
20-29 30-39 40-49 50+
44%
Annual HIV Surveillance Report
31
2006 Incidence
2007 Incidence
2008 Incidence
2009 Incidence
Prevalence
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Males
8
38%
3
27%
6
40%
5
45%
110
34%
Females
13
62%
8
73%
9
60%
6
55%
210
66%
African-Am.
3
14%
2
18%
2
13%
1
9%
42
13%
AI/AN
1
5%
1
9%
3
20%
4
36%
35
11%
Asian/PI
0
0%
0
0%
0
0%
0
0%
1
0%
Hispanic
13
62%
6
55%
4
27%
3
27%
133
42%
Multi-Race
1
5%
0
0%
0
0%
0
0%
2
1%
White
3
14%
2
18%
6
40%
3
27%
107
33%
< 13 years
0
0%
0
0%
0
0%
0
0%
0
0%
13-19 years
3
14%
1
9%
0
0%
1
9%
2
1%
20-29 years
3
14%
5
45%
5
33%
0
0%
26
8%
30-39 years
7
33%
3
27%
2
13%
4
36%
69
22%
40-49 years
4
19%
0
0%
4
27%
5
45%
108
34%
50+ years
4
19%
2
18%
4
27%
1
9%
115
36%
TOTAL
21
100%
11
100%
15
100%
11
100%
320
100%
SEX
RACE/ETHNICITY
AGE
Due to rounding, percentages may not total to 100%.
Figure 4.13 Incidence of HIV infection among HRH by Race/Ethnicity, New Mexico, 2000-2009 10%
27%
11% 1%
Excludes 2 Multi-Race
51%
African Am. AI/AN Asian Hispanic White
Figure 4.15 Incidence of HIV Infection among HRH by Age at Diagnosis, New Mexico, 2000-2009
21%
31%
32
4%
17%
27%
13-19 20-29 30-39 40-49 50+
Annual HIV Surveillance Report
Figure 4.14 Prevalence of HIV or AIDS among HRH by Race/Ethnicity, New Mexico, 2009 13%
34%
Excludes 2 Multi-Race
11% <1%
42%
African Am. AI/AN Asian Hispanic White
Figure 4.16 Prevalence of HIV or AIDS among HRH by Current Age, New Mexico, 2009 36%
1% 8%
34%
21%
13-19 20-29 30-39 40-49 50+
TABLES & FIGURES: Section 4
Table 4.4. Incidence of HIV Infection among HRH by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS among HRH, Year-End 2009, by Selected Characteristics, New Mexico
2006 Incidence
2007 Incidence
2008 Incidence
2009 Incidence
Prevalence
N
% of total
N
% of total
N
% of total
N
% of total
N
% of total
Males
24
89%
26
72%
32
80%
37
65%
239
72%
Females
3
11%
10
28%
8
20%
20
35%
92
28%
African-Am.
0
0%
1
3%
7
18%
4
7%
35
11%
AI/AN
0
0%
7
19%
2
5%
9
16%
30
9%
Asian/PI
1
4%
1
3%
0
0%
1
2%
5
2%
Hispanic
21
78%
19
53%
17
43%
33
58%
172
52%
Multi-Race
0
0%
2
6%
1
3%
0
0%
1
0%
White
5
19%
6
17%
13
33%
10
18%
88
27%
< 13 years
0
0%
0
0%
1
3%
0
0%
1
0%
13-19 years
1
4%
4
11%
0
0%
1
2%
1
0%
20-29 years
2
7%
7
19%
6
15%
9
16%
52
16%
30-39 years
8
30%
10
28%
15
38%
13
23%
94
28%
40-49 years
11
41%
7
19%
12
30%
20
35%
104
31%
50+ years
5
19%
8
22%
6
15%
14
25%
79
24%
100%
331
100%
SEX
RACE/ETHNICITY
AGE
TOTAL
27
100%
36
100%
40
100%
57
Due to rounding, percentages may not total to 100%.
Figure 4.17 Incidence of HIV Infection among NIR by Race/Ethnicity, New Mexico, 2000-2009 25%
25%
Excludes 4 Multi-Race
7%
57%
10% 7%
10% 1%
57%
1%
A frica n Am. A m. African A I/A N AI/AN A sia n Asian H isp a n ic Hispanic W h ite White
Figure 4.19 Incidence of HIV Infection among NIR by Age at Diagnosis, New Mexico, 2000-2009 19%
27%
<1% 5%
27%
22%
< 13 13-19 20-29 30-39 40-49 50+
Figure 4.18 Prevalence of HIV or AIDS among NIR by Race/Ethnicity, New Mexico, 2009 27%
Excludes 1 Multi-Race
11%
9%
1%
52%
TABLES & FIGURES: Section 4
Table 4.5. Incidence of HIV Infection among NIR, by Year of Diagnosis, 2006-2009, and Prevalence of HIV or AIDS among NIR, Year-End 2009, by Selected Characteristics, New Mexico
African Am. AI/AN Asian Hispanic White
Figure 4.20 Prevalence of HIV or AIDS among NIR by Current Age, New Mexico, 2009 24% <1% <1%
32%
16%
28%
< 13 13-19 20-29 30-39 40-49 50+
Annual HIV Surveillance Report
33
SECTION 5
TABLES & FIGURES Table 5.1. Survival for More than 12, 24, 36, and 60 Months after a Diagnosis of HIV During 2000-2004 by Selected Characteristics, New Mexico Proportion Survived (in months) > 12
> 24
> 36
> 60
No. of persons
N
%
N
%
N
%
N
%
Males
520
469
90%
453
87%
445
86%
425
82%
Females
106
99
93%
98
92%
97
92%
96
91%
African-Am.
36
32
89%
30
89%
30
83%
29
81%
AI/AN
55
51
93%
49
93%
48
87%
44
80%
Asian/PI
4
3
75%
3
75%
3
75%
3
75%
Hispanic
321
291
91%
285
89%
280
87%
269
84%
2
1
50%
1
50%
1
50%
1
50%
208
190
91%
183
88%
180
87%
175
84%
< 13 years
0
N/A
-
N/A
-
N/A
-
N/A
-
13-19 years
17
17
100%
17
100%
17
100%
16
94%
20-29 years
140
138
99%
136
97%
135
96%
132
94%
30-39 years
208
199
96%
195
94%
190
91%
187
90%
40-49 years
177
151
85%
145
82%
144
81%
135
76%
50+ years
84
63
75%
58
69%
56
67%
51
61%
SEX
RACE/ETHNICITY
Multi-Race White
AGE
TRANSMISSION RISK CATEGORY MSM
298
282
95%
271
91%
265
89%
258
87%
IDU
74
66
89%
63
85%
62
84%
54
73%
MSM/IDU
49
46
94%
45
92%
45
92%
42
86%
HRH
85
82
96%
81
95%
79
93%
78
92%
Pediatric
0
N/A
-
N/A
-
N/A
-
N/A
-
Other
4
3
75%
3
75%
3
75%
3
75%
116
89
77%
88
76%
88
76%
86
74%
NIR
YEAR OF HIV DIAGNOSIS 2000
138
123
89%
119
86%
118
86%
114
83%
2001
113
96
85%
93
82%
91
81%
86
76%
2002
99
90
91%
87
88%
86
87%
82
83%
2003
118
111
94%
109
92%
106
90%
104
88%
2004
158
148
94%
143
91%
141
89%
135
85%
TOTAL
626
568
91%
551
88%
542
87%
521
83%
Due to rounding, percentages may not total to 100%.
34
Annual HIV Surveillance Report
Proportion Survived (in months) > 12
> 24
> 36
> 60
No. of persons
N
%
N
%
N
%
N
%
Males
449
393
88%
372
83%
359
80%
338
75%
Females
67
60
90%
57
85%
54
81%
51
76%
African-Am.
30
26
87%
25
83%
24
80%
22
73%
AI/AN
48
44
92%
40
83%
37
77%
34
71%
SEX
RACE/ETHNICITY
Asian/PI
2
2
100%
2
100%
2
100%
2
100%
Hispanic
252
220
87%
212
84%
205
81%
194
77%
2
1
50%
1
50%
1
50%
1
50%
182
160
88%
149
82%
144
79%
136
75%
< 13
0
N/A
-
N/A
-
N/A
-
N/A
-
13-19
2
2
100%
2
100%
2
100%
2
100%
20-29
59
58
98%
56
95%
51
86%
50
85%
30-39
192
178
93%
169
88%
164
85%
154
80%
40-49
178
148
83%
142
80%
139
78%
131
74%
50+
85
67
79%
60
71%
57
67%
52
61%
Multi-Race White
AGE
TABLES & FIGURES: Section 5
Table 5.2. Survival for More than 12, 24, 36, and 60 Months after AIDS Diagnosis During 2000-2004 by Selected Characteristics, New Mexico
TRANSMISSION RISK CATEGORY MSM
276
255
92%
242
88%
232
84%
220
80%
IDU
64
54
84%
50
78%
50
78%
43
67%
MSM/IDU
58
54
93%
50
86%
49
84%
47
81%
HRH
57
54
95%
52
91%
48
84%
46
81%
Pediatric
4
3
75%
3
75%
2
50%
2
50%
Other
5
3
60%
3
60%
3
60%
3
60%
NIR
52
30
58%
29
56%
29
56%
28
54%
YEAR OF AIDS DIAGNOSIS 2000
103
89
86%
85
83%
83
81%
77
75%
2001
98
82
84%
74
76%
70
71%
64
65%
2002
94
79
84%
74
79%
73
78%
70
74%
2003
116
107
92%
103
89%
98
84%
94
81%
2004
105
96
91%
93
89%
89
85%
84
80%
TOTAL
516
453
88%
429
83%
413
80%
389
75%
Due to rounding, percentages may not total to 100%.
Annual HIV Surveillance Report
35
2006 Deaths
2007 Deaths
2008 Deaths
2009 Deaths
N
% of total
N
% of total
N
% of total
N
% of total
Males
30
86%
30
91%
38
88%
26
87%
Females
5
14%
3
9%
5
12%
4
13%
African-Am.
2
6%
2
6%
2
5%
2
7%
AI/AN
5
14%
7
21%
4
9%
2
7%
Asian/PI
0
0%
0
0%
1
2%
0
0%
Hispanic
13
37%
15
45%
24
56%
10
33%
Multi-Race
1
3%
2
6%
1
2%
0
0%
White
14
40%
9
27%
11
26%
14
47%
< 13 years
1
3%
0
0%
0
0%
0
0%
13-19 years
0
0%
0
0%
0
0%
0
0%
20-29 years
1
3%
1
3%
4
9%
0
0%
30-39 years
8
23%
9
27%
7
16%
5
17%
40-49 years
13
37%
9
27%
18
42%
10
33%
50-59 years
8
23%
9
27%
10
23%
8
27%
60+ years
4
11%
5
15%
7
16%
7
23%
TOTAL
35
100%
33
100%
43
100%
30
100%
SEX
RACE/ETHNICITY
AGE
Due to rounding, percentages may not total to 100%.
36
Annual HIV Surveillance Report
TABLES & FIGURES: Section 5
Table 5.3. HIV-Related Deaths by Selected Characteristics, New Mexico, 2006-2009
Annual HIV Surveillance Report Septicemia Nephritis Congenital Anomalies Viral hepatitis Congenital Anomalies
Pregnancy, 12 Childbirth, and puerperium
13 Cerebrovascular Diseases
14 Benign Neoplasm
15 HIV
Homicide
Benign Neoplasm
Suicide
Septicemia
Chronic Liver Disease
National Center for Health Statistics (NCHCS) leading causes of deaths of New Mexico residents from 2006-2009 Source: New Mexico’s Indicator-Based Information System (NM-IBIS), queried on October 11, 2010
Chronic Lower Respiratory Disease Hypertension Congenital HIV anomalies
Nephritis
Septicemia
Hypertension
Influenza and Pneumonia
HIV Septicemia
Parkinson’s Disease
Nephritis
Unintentional Injury Alzheimer’s Disease Influenza and Pneumonia
Diabetes mellitus
Nephritis
Cerebrovascular Diseases
Viral hepatitis
Chronic Lower Respiratory Disease
Diabetes mellitus
Suicide
Chronic Liver Disease
Unintentional Injury
Viral hepatitis
Influenza and Pneumonia Cerebrovascular Diseases
Homicide
Diabetes Mellitus HIV
Diabetes mellitus
Heart Disease
11 Septicemia
6
Influenza and Pneumonia Cerebrovascular Diseases
Suicide
Chronic Liver Disease
Heart Disease
5
Chronic Liver Disease and 7 Influenza Pneumonia 8 Congenital anomalies 9 Diabetes mellitus Legal 10 Injury, intervention
Chronic Liver Disease
Homicide
Malignant Neoplasm
4
Heart Disease
Malignant Neoplasm
Homicide
3
Malignant Neoplasm Chronic Lower Respiratory Disease Cerebrovascular Diseases
Heart Disease
Malignant Neoplasm
Suicide
60-69 years Heart Disease
50-59 years
Unintentional Injury Malignant Neoplasm
30-39 years Unintentional Injury
Suicide
20-29 years Unintentional Injury
2
1
Rank
CAUSE OF DEATH 40-49 years
TABLES & FIGURES: Section 5
Table 5.4. Leading Causes of Death by Selected Age Groups, New Mexico, 2006-2009
37
DATA SOURCES Core HIV/AIDS Surveillance Data All HIV and AIDS cases diagnosed or treated in New Mexico are reportable to the NMDOH HIV & Hepatitis Epidemiology Program. All laboratory confirmed positive HIV antibody tests, tests for HIV RNA or HIV cDNA (viral loads), tests to detect HIV proteins, any positive HIV culture, or any other tests or conditions indicative of HIV infection are reportable to the Program. AIDS-defining opportunistic infections, cancers, and CD4 lymphocyte counts and percents (<200 per ÂľL or <14% of total lymphocytes) are also reportable. Initially established in 1981 to track newly diagnosed AIDS cases, the surveillance system was expanded in 1998 to include HIV reporting. Standardized case report forms are used to collect sociodemographic information, transmission risk categories, laboratory and clinical information, perinatal exposure, vital status, and referrals for treatment or services. To allow for reporting delays, 2009 data are considered complete at the end of June 2010. In July 2008, legacy information from the HIV/AIDS Reporting System (HARS) was converted to the Enhanced HIV/AIDS Reporting System (eHARS), a standardized database developed by CDC; all subsequent case information is now entered in eHARS.
Hepatitis Co-infection Data Hepatitis B and C co-infection data are obtained through HIV case reports from HIV medical staff and case managers and via laboratory reporting to the HIV & Hepatitis Epidemiology Program. Hepatitis data are stored in the New Mexico Electronic Disease Surveillance System (NM-EDSS). Each year NM-EDSS data are matched to eHARS in an effort to determine or update co-infection status.
Mortality Data The NMDOH Bureau of Vital Records and Health Statistics collects information on all births and deaths that occur in New Mexico. Mortality data, including cause of death, are based on items reported on the death certificate. Medical and cause of death information are completed by the attending physician or the Office of the Medical Investigator. Mortality data used in this report are limited to New Mexico residents. Deaths resulting from HIV or whose underlying cause was HIV may be underreported on a death certificate.
Population Data The Bureau of Business and Economic Research (BBER), located at the University of New Mexico, conducts economic and demographic research and analysis related to New Mexico. Using a housing unit based methodology, BBER provides population estimates for New Mexico. Analysis by BBER indicates that the U.S. Bureau of the Census underestimates New Mexicoâ&#x20AC;&#x2122;s population, especially during intercensal years. New Mexico population data presented here represent revised estimates from BBER (http://www. unm.edu/~bber). Beginning with the population estimates for 2007, BBER updated its estimates of agespecific migration with new data, causing a break in continuity between the 2006 and 2007 estimates. This methodological change primarily affects older age groups, but all rates calculated from BBER population estimates are potentially affected. Thus, 2006 and earlier rates should be compared with any 2007 and later rates with caution, as differences may be partly attributable to the change in population estimates used in the rate denominators.
38
Annual HIV Surveillance Report
STRENGTHS & LIMITATIONS When using these data to make planning decisions, it is important to consider their strengths and limitations. Although the purpose of the 2009 Annual HIV Surveillance Report is to provide comprehensive analyses of HIV in New Mexico, some issues must be considered before the data are interpreted. Surveillance for HIV in New Mexico is population-based. The HIV & Hepatitis Epidemiology Program maintains an active surveillance system that combines the receipt of laboratory and provider reports with regular medical record reviews. Since the surveillance system does not systematically track migration in to and out of New Mexico, place-of-residence data may not be up to date for all cases. However, the methods used are consistent over time and are based upon guidelines set forth by CDC. Persons who have tested anonymously, tested elsewhere outside of New Mexico and are not seeking care in New Mexico, or who have not been tested, are not reported. Thus HIV data may not directly reflect disease transmission but rather testing behavior, treatment outcomes, and access to medical care or services that follow HIV infection. To monitor the epidemic in New Mexico, it is ideal to measure over time the number of persons who become newly infected. Laboratory methods for identifying newly infected persons (i.e., incident cases) are currently in use in a limited number of states, not including New Mexico. For the purposes of this report, diagnosis of HIV infection is defined as a report of newly diagnosed HIV infection; the actual date of infection for an individual is unknown and thus can not be used to define an incident case. Due to the dynamic nature of HIV data, readers may notice discrepancies in the statistics reported in the annual reports from year to year. This is the result of a variety of factors including regular data cleaning, the national interstate de-duplication process (also known as the Routine Interstate De-duplication Report, or RIDR), the conversion from HARS to eHARS and the resulting higher level of data scrutiny and quality adjustments, and most recently, changes in the way some terms have been defined and classified by the Program. Despite these limitations, HIV surveillance data are considered to be more than 85% complete.5 For this reason, the epidemiologic data are one of the major sources to inform both HIV prevention and HIV care planning. In some instances, analyses in this report were conducted using a small number of events (e.g., the number of diagnoses of HIV infection among a certain age group). A small number of events can lead to concerns about statistical reliability and validity. Over time, small numbers may fluctuate due to random variation, rather than as a result of true changes in the event under consideration. Readers are cautioned against drawing any formal conclusions from data included in this report that may be subject to reliability and validity concerns.
Annual HIV Surveillance Report
39
TECHNICAL NOTES HIV Surveillance This report includes data from case reports submitted to the Program by HIV service providers and clinical laboratories throughout the state prior to July 1, 2010. The 2008 revised HIV case definition was used to classify HIV infection among adults and adolescents and children.6 HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have been tested. Some persons infected with HIV may have been tested anonymously; these persons are not included in this report. The data presented in this report provide a minimum estimate of persons known to be infected with HIV.
Incidence Incidence data include persons diagnosed with HIV infection during a calendar year. This may include cases that meet the CDC surveillance definition for AIDS at the time they were initially diagnosed with HIV infection (AIDS at first diagnosis, or concurrent diagnosis). The number of new HIV infections in New Mexico includes only persons who were first reported with HIV infection while residents of New Mexico. Persons moving to New Mexico already infected with HIV were excluded if they were previously reported in another state. Age-group assignment was based on the personâ&#x20AC;&#x2122;s age at the time of diagnosis.
Prevalence Prevalence data include persons living with HIV infection or AIDS as of December 31, 2009. To be included in the prevalence analysis, persons living with HIV infection or AIDS must have been alive and living in New Mexico as of December 31, 2009; residence at time of HIV or AIDS diagnosis was not considered. The most recent known residential address was used to determine whether persons were included in the analysis. Age-group assignment was based on the personâ&#x20AC;&#x2122;s age as of December 31, 2009.
Cumulative Cumulative data include the total number of persons, both living and dead, reported to the Program since AIDS and HIV became reportable conditions in New Mexico in 1981 and 1998, respectively. Neither residence at diagnosis nor residence at year-end are considered in the cumulative analysis.
Concurrent HIV/AIDS Diagnosis Persons diagnosed with HIV infection who progress to AIDS within 12 months of their initial HIV diagnosis are considered to be concurrently diagnosed. In this report, persons diagnosed with HIV infection prior to January 1, 2009 were included in the concurrent diagnosis analysis. Concurrent status cannot be determined for persons infected with HIV in 2009 because 12 months had not passed at the time 2009 surveillance data were finalized.
40
Annual HIV Surveillance Report
Analysis of survival for persons diagnosed with HIV infection or AIDS was limited to persons diagnosed during 2000-2004 to allow at least five years of follow-up from the time of diagnosis. Persons were considered alive unless their death had been reported to the Program.
Mortality Persons reported to the Program are assumed alive unless/until their death is reported to the program. Cases reported to the Program are regularly linked to the New Mexico Vital Statistics Registry to update vital status and to determine cause of death. Mortality analyses described in this report rely on information provided by the New Mexico Bureau of Vital Records and Health Statistics.
Race and Ethnicity The Program collects race and ethnicity data according to the U.S. Department of Health and Human Services Office of Management and Budget standards. (Federal Register, Vol.62, No. 210, October 30, 19977) These standards provide five categories for data on race: American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White. Two categories for ethnicity, independent of race, are also provided: Hispanic or Latino, and Not Hispanic or Latino. In this report, race and ethnicity groups were calculated according to NMDOH guidelines. These guidelines combine race and ethnicity into a single construct. Persons designated as Black or African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander were grouped according to designated race without regard to ethnicity. Persons designated as White were grouped as White or Hispanic according to their ethnic designation. Persons of White race and Hispanic or Latino ethnicity were grouped as Hispanic. Persons of White race and Not Hispanic or Latino ethnicity were grouped as White. All persons with other designation(s) of race (including multiple-race) and Hispanic or Latino ethnic designation were grouped as Hispanic.
TECHNICAL NOTES
Survival
The Program recognizes that categories in this classification are social-political constructs and does not interpret them as being scientific or anthropological in nature; rather, the categories provide a common language for uniformity and comparability in the collection and use of data on race and ethnicity.
Transmission Risk Categories The Program summarizes a personâ&#x20AC;&#x2122;s possible HIV risk factors using a hierarchical order of possible risks for transmission. Persons whose transmission category is classified as MSM (male-to-male sexual contact) include men who report sexual contact with other men and men who report sexual contact with both men and women. Persons whose transmission
Annual HIV Surveillance Report
41
category is classified as High-Risk Heterosexual (HRH) include persons who report heterosexual contact with a person known to have, or to be at high risk for, HIV infection (e.g., heterosexual sexual contact with bi-sexual males, injection drug users, persons with hemophilia, HIV-infected transfusion recipient, or other HIV-infected persons with unknown risk). Persons whose transmission category is classified as IDU are persons who report injecting illicit or nonprescription drugs. Except for men who report sexual contact with other men and injection drug use, persons with more than one reported risk factor are classified according to the category listed first in the hierarchy. Men who report sexual contact with other men and injection drug use comprise a separate transmission risk category, MSM/IDU. Persons with no reported exposure to HIV through any of the categories in the hierarchy are classified as “no risk factor reported or identified” (NRR or NIR).
New Mexico Public Health Regions To ensure NMDOH’s effective delivery of public health services, New Mexico is divided into five distinct regions, each served by a regional public health office. The Northeast region (Region 1) is comprised of Cibola, McKinley, San Juan, Sandoval, and Valencia counties. The Northwest region (Region 2) is comprised of Colfax, Guadalupe, Mora, Los Alamos, Rio Arriba, San Miguel, Santa Fe, Taos, and Union counties. Bernalillo county, home to approximately one-half the state’s population, is designated as the Central region (Region 3). The Southeast region (Region 4) is comprised of Chaves, Curry, De Baca, Eddy, Harding, Lea, Quay, and Roosevelt counties. The Southwest region (Region 5) is comprised of Catron, Dona Ana, Grant, Hildago, Lincoln, Luna, Otero, Sierra, Socorro, and Torrence counties.
Rates Rates per 100,000 population were calculated using population denominators provided by The Bureau of Business and Economic Research (BBER), located at the University of New Mexico. Rates were calculated by dividing the total number of events (HIV infections, AIDS diagnoses, or deaths) for the calendar year by the population for that year, and multiplying by 100,000. Denominators for calculating age-, sex-, and race/ethnicity-specific rates were provided by BBER. Rates based on small numbers may be unstable and should be interpreted with caution.
Correctional Facilities and Other Institutions Persons imprisoned in a state or county correctional or detention facility, or who were housed in a residential facility (e.g., drug treatment facility), were included in the data presented unless otherwise noted.
42
Annual HIV Surveillance Report
TECHNICAL NOTES
Transmission Risk Categories (continued)
DEFINITIONS USED IN THIS REPORT AIDS (Acquired immune deficiency syndrome) Diagnosis with AIDS is defined by a confirmed HIV positive test along with either 1) a CD4 positive lymphocyte count < 200; 2) a CD4 positive lymphocyte count < 14% of total lymphocytes; or 3) any of 26 opportunistic infections indicative of AIDS. CDC U.S. Centers for Disease Control and Prevention. CDC/DHAP CDC’s Division of HIV/AIDS Prevention. eHARS (Enhanced HIV/AIDS Reporting System) A modernized version of HARS that uses web-based technology for expanded, document-based data collection. HRH (High-risk heterosexuals) Adults or adolescents ≥ 13 years who have a history of heterosexual sexual contact with bi-sexual males, injection drug users, persons with hemophilia, HIV-infected transfusion recipient, or other HIV-infected persons, with unknown risk. HIV (Human immunodeficiency virus) Diagnosis with HIV infection is defined by either 1) a confirmed positive result on a screening test for HIV antibody (e.g., reactive enzyme immunoassay), followed by a positive result on a confirmatory test for HIV antibody (e.g., Western blot or immunofluorescence antibody test); or 2) a positive result or a detectable quantity on a virologic test (e.g., polymerase chain reaction, neutralization assay, or culture). IDU (Injection drug user) Adults or adolescents ≥ 13 years who have a history of injecting illicit or nonprescription drugs. MSM (Men who have sex with men) Adults or adolescents ≥ 13 years who have a history of sexual contact with men or with both men and women. NIR (No identified risk) Adults or adolescents ≥ 13 years who have no reported history of exposure to HIV, as defined by CDC. NIR cases can be under investigation, have incomplete histories because they have died, have refused to divulge their history, or were lost to follow up. Cases under investigation may take up to a year to resolve. NMDOH New Mexico Department of Health. Other (Other risk) Adults or adolescents ≥ 13 years who have a history of hemophilia or coagulation disorder, receipt of blood transfusion, blood components or tissue. Pediatric (Pediatric risk) Children < 13 years who have a history of hemophilia or coagulation disorder, receipt of blood transfusion, blood components or tissue, or had a mother with injection drug use, heterosexual risk for HIV, or otherwise known to be HIV positive.
Annual HIV Surveillance Report
43
NMDOH RESOURCES HIV & Hepatitis Epidemiology Program, (505) 476-3515 Conducts state-wide surveillance and analysis of HIV/AIDS, hepatitis B and hepatitis C data. http://nmhealth.org/ERD/HealthData/hiv_aids.shtml HIV Prevention Program, (505) 476-3612 Supports community planning, HIV prevention and HIV testing activities across the state, including training, capacity building, funding and oversight. http://nmhealth.org/IDB/HIV.shtml HIV Services Program, (505) 476-3628 Supports a statewide array of providers in the Health Management Alliance (HMA) network that provide case management, medical care and support services for people with HIV/AIDS. New Mexico HIV, STD and Hepatitis Resource Guide www.nmhivguide.org
COMMUNITY PARTNERS New Mexico HIV Prevention Community Planning and Action Group (CPAG) This group is co-chaired by representatives from NMDOH, the community, and persons living with HIV/ AIDS. The CPAG collaborates with NMDOH to develop a statewide Comprehensive HIV Prevention Plan. www.nmcpag.org HIV/AIDS Health Management Alliance (HMA) The HMA is a non-profit health care system consisting of five partner organizations that offer comprehensive services including medical and case management, support, and prevention for HIV. New Mexico AIDS Services (NMAS) Based in Albuquerque and serves northwestern New Mexico. (888) 882-2437 www.nmas.net University of New Mexico Health Sciences Center, Truman Street Clinic Based in Albuquerque and serves northwestern New Mexico in collaboration with New Mexico AIDS Services. (505) 272-1312 http://hsc.unm.edu/unmmg/truman/ First Nations Community Health Source Based in Albuquerque and serves the American Indian/Alaska Native community. (505) 262-2481 www.fnch.org
44
Annual HIV Surveillance Report
RESOURCES
Southwest CARE Center Based in Santa Fe and serves northeastern New Mexico (888) 320-8200 www.southwestcare.org Alianza of New Mexico Based in Roswell and serves southeastern New Mexico (800) 957-1995 www.alianzanm.org Community Collaborative Care (CCC) Based in Las Cruces and serves southwestern New Mexico (575) 528-5001 www.health.state.nm.us/phd/dist3/HMA3.html
REFERENCES 1. CDC. MMWR 2008; 57(RR-10):1-8. 2. CDC. HIV Surveillance Report, 2008; vol. 20. Published June 2010. 3. CDC. Late HIV testing – 34 states, 1996-2005. MMWR Jun 26; 58(24): 661-5. 4. CDC. HIV Surveillance Report, 2008; vol. 20. Published June 2010. 5. CDC. HIV/AIDS Surveillance Report, 2003 (Vol. 15). US Department of Health and Human Services, CDC; 2004:1-46. 6. CDC. MMWR 2008; 57(RR-10):1-12. 7. Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity (Notice of Decision).” Federal Register 26:210 (October 30, 1997): 58782.
Will McLauchlin, Statewide Co-Chair of New Mexico Community Prevention and Action Group (CPAG)
Annual HIV Surveillance Report
45
www.NMHIVGUIDE.org