Bronx Community Health Dashboard HIV and AIDS Created
Bronx Community Health Dashboard: HIV and AIDS Created: 5/4/2017 Last Updated: 10/23/2017 See last slide for more information about this project. 1
Overview of HIV/AIDS in the Bronx 2 Disparities exist in early HIV/AIDS detection, but are declining Bronx residents are being diagnosed with HIV at a lower rate and are living with HIV longer Bronx residents with lower incomes and less education are more likely to have had an HIV/AIDS test Bronx residents have the highest likelihood of ever having an HIV/AIDS screening compared to other boroughs Newly diagnosed Bronx residents equally likely to initiate care, but somewhat less likely to have viral suppression, 2015 AIDS diagnoses are highest in the Bronx amongst non-Hispanic black and males
Fewer people are being newly diagnosed with HIV and AIDS in the Bronx HIV Diagnosis HIV AIDS Diagnosis AIDS Rate of HIV and AIDS Diagnoses per 100, 000 120 107. 2 100 60% decrease 80 60 HIV Diagnosis: positive Western blot 40 40 test in adults and positive PCR (polymerase chain reaction) test in infants <18 months 28. 1 AIDS Diagnosis: HIV-infected and 20 0 2001 3 80% decrease 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2013. Analysis by Montefiore OCPH. either 1+ AIDS-defining opportunistic illness or a lab test indicating suppressed CD 4+ cell counts (<200 cells/µL)
The percent of Bronx residents living with HIV has been steadily increasing over the last 15 years Bronx NYC Excluding Bronx Percent of Population Living with HIV/AIDS 2. 50 2. 00 1. 50 1. 38 1. 32 1. 00 0. 50 0. 00 2001 4 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2013. Analysis by Montefiore OCPH. 2014 2015
New HIV and AIDS diagnoses rates are falling 120 Bronx 120. 0 NYC Excluding Bronx 107. 2 100. 0 3 fold decrease in new HIV diagnoses 80 60 40 20 64. 25 34 28. 33 Rate of AIDS Diagnoses per 100, 000 Rate of HIV Diagnoses per 100, 000 100 5 fold decrease in new AIDS diagnoses 80. 0 61. 61 40. 0 19. 9 20. 0 14. 45 0. 0 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 5 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2013. Analysis by Montefiore OCPH.
The rate of new HIV/AIDS cases is falling but the rate of people living with HIV/AIDS is increasing People Living with HIV and AIDS HIV Diagnosis AIDS Diagnosis 120 107. 2 2. 00 100 1. 38 60 1. 00 34 19. 9 0. 50 0. 00 40 2001 6 100 80 1. 50 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. 2014 2015 Rate of HIV and AIDS Diagnoses per 100, 000 Percent of People Living with HIV and AIDS 2. 50 Note different axis scales
HIV Testing 7
89. 0 90 80 83. 2 80. 0 76. 6 70 85. 1 82. 5 78. 1 77. 0 73. 2 63. 4 60 73. 8 66. 9 65. 9 56. 9 55. 4 47. 2 50 42. 8 40 30 20 Never married Divorced, widowed or separated Married/ in-couple Hispanic Female Non-Hispanic white Data source: Community Health Survey, 2015. Analysis by Montefiore OCPH. Age results not age-adjusted. Male 65+ 45 -64 25 -44 18 -24 Staten Island Queens Manhattan 0 Brooklyn 10 Non-Hispanic black 8 Bronx only 100 Bronx Age-adjusted percent reporting ever getting HIV/AIDS test Bronx adult residents more likely to have ever had an HIV/AIDS test compared to other boroughs
Age-adjusted percent reporting ever getting HIV/AIDS test Residents with lower incomes and less education more likely to have ever had an HIV/AIDS test 90 82. 5 80. 2 78. 1 80 79. 8 79. 7 73. 5 70 66. 8 67. 4 Low poverty Lowest poverty 76. 0 79. 3 67. 2 56. 9 60 50 40 30 20 10 0 Hispanic 9 Non. Hispanic black Non. Hispanic white Highest poverty High poverty Medium poverty Data source: Community Health Survey, 2015. Analysis by Montefiore OCPH. <HS High school Some college College
Since 2004, the Bronx has had the highest percentage of people ever getting an HIV/AIDS test Age-adjusted percent reporting ever getting HIV/AIDS test 90 Bronx Brooklyn Manhattan Queens Staten Island 76. 6 80 70 60 54. 3 50 40 30 20 10 0 2004 10 2005 2006 2007 2008 2009 2010 2011 Data source: Community Health Survey, 2004 -2015. Analysis by Montefiore OCPH. Comparable data not collected in 2006. 2012 2013 2014 2015
208 202 Hunts Point & Longwood 203 Morrisania & Crotona 204 Highbridge & Concourse 205 Fordham & University Heights 206 Belmont & East Tremont 207 Kingsbridge Heights & Bedford 208 Riverdale & Fieldston 207 205 206 204 203 201 202 211 209 210 80 70 60 Bronx 75 NYC 62 50 40 30 20 10 0 209 Parkchester & Soundview 90 80 70 60 50 40 30 20 10 0 210 Throgs Neck & Co-op City 211 Morris Park & Bronxdale er iv Ki R M or Th ro gs N ec k & 212 Williamsbridge & Baychester 11 Data source: NYC Community Health Profiles. 82 83 Percent of Adults Ever Tested C da o-o le p ng r sb is P & F City a rid ie ( ge rk & lds 210 W t illi ) am Hei Bro on ( g n 2 ht sb xd 08 s al ) Pa ridg & e Be e (2 rk & ch 11 d Ba for es ) d H yc un ter ( 20 he & ts Po So ste 7) r u in M t & ndv (21 ot 2) ie t w Be Ha Lon ( gw ve 2 lm n oo 09) on & d t& M Ea elr (20 M 2) o os st e H rris T (2 an r Fo igh ia emo 01 br rd ) & id nt ha ge C ( m 2 ro 0 & & to C na 6) U o ni (2 ve nco 03 rs ur ) ity se H (2 ei gh 04) ts (2 05 ) 201 Mott Haven & Melrose Percent of Adults Ever Tested 7 of 10 community districts with highest HIV testing are in the Bronx 90 63 65 70 71 75 77 80 80 81 81
HIV Diagnoses in the Bronx 12
HIV diagnosis rate disparities amongst race/ethnicities in the Bronx have fallen 30% over last 14 years 180. 0 160. 0 Hispanic NHB NHW Asian 161. 5 Non-Hispanic black population’s HIV diagnosis rate has fallen 3 fold since 2001 but remains highest of all race/ethnicities in the Bronx HIV Diagnosis Rate per 100, 000 140. 0 120. 0 100. 0 88. 0 80. 0 8 fold difference 60. 0 55. 0 40. 0 24. 7 29. 8 13. 4 14. 3 9. 4 20. 0 2001 13 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. 2002 -2004 data for Asian population is statistically unstable. 2014 2015 5. 8 fold difference
Males in the Bronx have higher rates of HIV diagnoses 100 Male Female 0 -19 87. 3 90 30 -39 40 -49 50 -59 60+ 140 127. 8 70 60 50. 9 47 50 40 30 20 HIV Diagnosis Rate per 100, 000 80 HIV Diagnosis Rate per 100, 000 20 -29 120 100 122. 7 103. 8 89. 6 80 76. 1 61 60 40 36. 5 19. 5 20 10 17. 4 13. 9 6. 9 11. 2 0 0 2006 14 2007 2008 2009 2010 2011 2012 2013 2014 2015 2006 2007 2008 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2006 -2015. Analysis by Montefiore OCPH. Age results not age-adjusted. 2009 2010 2011 2012 2013
208 201 Mott Haven & Melrose 202 Hunts Point & Longwood 203 Morrisania & Crotona 204 Highbridge & Concourse 205 Fordham & University Heights 206 Belmont & East Tremont 212 207 205 206 211 204 203 209 210 HIV Diagnosis Rate Per 100, 000 3 of 10 community districts with highest rates of HIV diagnoses are in the Bronx Highest: Clinton and Chelsea, Central Harlem 120 100 80 60 40 20 Bronx 39. 8 NYC 30. 4 201 202 0 207 Kingsbridge Heights & Bedford 208 Riverdale & Fieldston HIV Diagnosis Rate per 100, 000 C da o-o p le W r C illi is P & ity Fi am ar (2 el k sb d 10 rid & B sto ) n H r g on e un (2 Ki & xd 08 ng ts al ) sb Po Ba e y rid in ch (2 t ge 1 e & Lo ste 1) H Pa e r n i (2 rk ch ghts gw oo 12) es & d t M er & Bed (20 ot 2) t H So for d H u a (2 ig nd hb ven 07 vi rid e ) & Be ge M w (2 e lm 09 on & C lros ) on e t& (2 c Fo Ea ou M 01 o rd ) ha rris st T rse (2 an m re 0 m ia & on 4) U & ni t( ve Cro 20 rs to ity na 6) H (2 ei gh 03) ts (2 05 ) 70. 0 209 Parkchester & Soundview 60. 0 210 Throgs Neck & Co-op City 50. 0 211 Morris Park & Bronxdale 212 Williamsbridge & Baychester 35. 7 40. 0 30. 0 20. 0 15 Data source: NYC Community Health Profiles. er iv R M or Th ro gs N ec k & 0. 0 14. 7 19. 3 23. 4 42. 4 38. 8 39. 7 41. 1 45. 8 50. 5 52. 6 57. 7
HIV Diagnoses rate in the Bronx is highest and increasing for men who have sex with men 800 MSM IDU MSM-IDU Heterosexual Transgender Unknown Male HIV Diagnosis 764 Number of HIV Diagnoses 700 600 27% MSM IDU 500 MSM-IDU 400 350 Heterosexual Transgender Unknown 1% 300 2% 200 100 0 2001 16 9% 60% 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. Combined MSM-IDU category was not created until 2009. *numbers from 2015 data
HIV diagnosis rate is highest for females with heterosexual contact in the Bronx 600 582 IDU Heterosexual Transgender Unknown HIV Diagnosis 500 Number of HIV Diagnoses 1% 16% 400 IDU 7% Heterosexual Transgender 300 Unknown 76% *numbers from 2015 data 200 150 100 0 2001 17 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. Data values falling below 10 are not displayed on chart.
AIDS Diagnoses in the Bronx AIDS Diagnosis is defined as: 1). Those diagnosed concurrent with HIV 2). Those who transitioned from HIV to AIDS 18
The proportion of new HIV-only diagnoses that progressed to AIDS within 2 years decreased 50% in the Bronx between 2006 and 2013 Percentage Progressed to AIDS within 2 Years 25% People are classified as having AIDS if they either have one or more AIDSdefining opportunistic illnesses (based on 1993 CDC case definition) or a laboratory test indicating suppressed CD 4+ cell counts (<200 cells/µL) 21% 20% 18% 16% 15% 14% 15% 11% 9% 10% 5% 0% 2006 19 2007 2008 2009 2010 2011 2012 2013 Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016.
AIDS diagnoses rates are highest amongst non-Hispanic blacks in the Bronx NHB Hispanic NHW Asian 180. 0 AIDS Diagnosis Rate per 100, 000 160. 0 AIDS Diagnosis: HIV-infected and either 1+ AIDS-defining opportunistic illness or a lab test indicating suppressed CD 4+ cell counts (<200 cells/µL) 157. 2 140. 0 120. 0 103. 4 80. 0 60. 0 40. 0 36. 0 35. 0 20. 0 15. 8 5. 4 0. 0 2001 20 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. 2001 -2004 data for Asian population unstable. 2015
Males in the Bronx have higher rates of AIDS diagnoses 90 Male 85. 6 0 -19 140 Female 30 -39 40 -49 50 -59 60+ 127. 8 80 70 60 50. 5 50 40 28. 1 30 20 12. 6 AIDS Diagnosis Rate per 100, 000 120 AIDS Diagnosis Rate per 100, 000 20 -29 100 122. 7 103. 8 89. 6 80 61 60 40 20 10 0 2006 21 2007 2008 2009 2010 2011 2012 2013 2014 2015 0 2006 2007 2008 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. HIV diagnosis rates pre-2006 are unavailable 2009 2010 2011 2012 2013
In the Bronx, AIDS diagnoses are highest for men who have sex with men MSM 900 IDU MSM-IDU Heterosexual Transgender Unknown AIDS Diagnosis 875 800 Number of AIDS Diagnoses 700 600 MSM 36% 39% 500 IDU MSM-IDU Heterosexual 400 Transgender Unknown 8% 14% 300 *numbers from 2015 data 193 200 100 0 2001 22 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. MSM-IDU category was not created until 2009; 2002 values for Transgender are not statistically significant. 3%
In the Bronx, AIDS diagnoses are highest for females with heterosexual contact IDU 600 Heterosexual Transgender Unknown AIDS Diagnosis 573 Number of AIDS Diagnoses 500 7% 20% 400 IDU Heterosexual 6% Transgender 300 Unknown 66% 200 97 100 0 2001 23 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: New York City HIV/AIDS Annual Surveillance Statistics, 2001 -2015. Analysis by Montefiore OCPH. MSM-IDU category was not created until 2009; 2002 values for Transgender are not statistically significant. *numbers from 2015 data
HIV/AIDS Related Care in the Bronx 24
Timely initiation of care among newly diagnosed people with HIV remained steady in the Bronx between 2011 and 2015 80% Timely initiation of Care (%) 73% 72% 73% 70% 71% 60% Timely initiation of care is defined as first CD 4 or VL drawn within 3 months (91 days) of HIV diagnosis, following a 7 -day lag 40% 20% 0% 2011 25 2012 2013 2014 2015 Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016.
Among Bronx residents newly diagnosed with HIV in 2015, Whites were most likely to have timely initiation of care Timely initiation of care is defined as first CD 4 or VL drawn within 3 months (91 days) of HIV diagnosis, following a 7 -day lag Percent of Newly Diagnosed Bronx Residents with Timely Initiation of Care 100% 80% 79% 75% 73% 60% 40% 20% 0% Black 26 Latino/Hispanic White Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016. Asian
Percent of Newly Diagnosed Bronx Residents with Timely Initiation of Care Among Bronx residents newly diagnosed with HIV in 2015, MSM were most likely to have timely initiation of care 80% 78% 74% 70% 60% 40% 20% 0% MSM 27 IDU Heterosexual Contact Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016. Timely initiation of care is defined as first CD 4 or VL drawn within 3 months (91 days) of HIV diagnosis, following a 7 -day lag
Newly diagnosed Bronx residents equally likely to initiate care, but somewhat less likely to have viral suppression, 2015 Timely Initiation of Care Among Newly Diagnosed, 2015 100 Viral Suppression* within 12 Months of HIV Diagnosis, 2015 Viral Suppression* Among PLWHA, 2015 90 83 80 74 74 73 72 74 69 70 75 74 74 M Q SI 76 76 BX BK 79 77 67 60 % 50 40 30 20 10 0 BX BK M Q SI Timely initiation: First CD 4 or viral load drawn within 91 days of diagnosis, following a 7 -day lag 28 BX BK M Q Viral suppression: Viral load ≤ 200 copies/m. L; PLWHA: People Living with HIV/AIDS Data source: Care and Clinical Status of People Newly Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. New York City Department of Health & Mental Hygiene, 2016. SI
HIV/AIDS related care by risk category for all of New York City, 2015 Timely Initiation of Care Among Newly Diagnosed, 2015 100 90 Viral Suppression* within 12 Months of HIV Diagnosis, 2015 Viral Suppression* Among PLWHA, 2015 82 76 80 77 74 70 65 77 75 71 66 65 63 60 76 73 61 55 50 40 30 20 10 Timely initiation: First CD 4 or viral load drawn within 91 days of diagnosis, following a 7 -day lag 29 -S TG H et er os ex -ID SM M C ua l U U ID SM M C -S H et er os -ID SM M TG ex ua l U U ID SM 0 M % Viral suppression: Viral load ≤ 200 copies/m. L; PLWHA: People Living with HIV/AIDS Data source: Care and Clinical Status of People Newly Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. New York City Department of Health & Mental Hygiene, 2016. MSM = men who have sex with men, IDU = injection drug users, TG-SC = transgender-sexual contact
Among those newly diagnosed with HIV in the Bronx in 2015, 58% achieved viral suppression within 6 months and 69% within 12 months of diagnosis Percent of Newly Diagnosed Achieving Viral Suppression in the Bronx 80% 69% 70% 60% 58% 50% 40% 30% 20% 10% 0% 6 Months 30 12 Months Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016. Viral suppression is defined as viral load ≤ 200 copies/m. L
Among people newly diagnosed with HIV in the Bronx in 2015, Whites were the least likely to have achieved viral suppression within 12 months of diagnosis Percent of Newly Diagnosed Achieving Viral Suppression in the Bronx 100% 88% 90% 80% 70% 69% 64% 60% 50% 40% 30% 20% 10% 0% Black 31 Latino/Hispanic White Asian Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016. Viral suppression is defined as viral load ≤ 200 copies/m. L
Among people newly diagnosed with HIV in the Bronx in 2015, MSM were most likely to have achieved viral suppression within 12 months of diagnosis Percent of Newly Diagnosed Achieving Viral Suppression in the Bronx 80% 74% 71% 70% 60% 50% 40% 30% 20% 10% 0% MSM 32 IDU Heterosexual Contact Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016. Viral suppression is defined as viral load ≤ 200 copies/m. L
Among diagnosed PLWHA in the Bronx, Whites had the highest viral suppression proportion among all racial/ethnic groups. 90% Viral suppression is defined as viral load ≤ 200 copies/m. L Percent of Newly Diagnosed Achieving Viral Suppression in the Bronx 82% 80% 78% 75% 73% 74% 70% 66% 60% 50% 40% 30% 20% 10% 0% Black 33 Latino/Hispanic White Asian Native American Other Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016.
Among diagnosed PLWHA in NYC, MSM had the highest viral suppression proportion, and people with perinatal transmission risk had the lowest Viral suppression is defined as viral load ≤ 200 copies/m. L Viral Suppression Among Diagnosed PLWHA by Transmission Risk in the Bronx, 2015 90% 80% 77% 75% 74% 77% 76% 68% 70% 59% 60% 50% 40% 30% 20% 10% 0% MSM 34 IDU MSM-IDU Heterosexual Contact TG-SC Perinatal Other/Unknown Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016. TG-SC = Transgender people with sexual contact
Of approximately 24, 100 PLWHA in the Bronx in 2015, 71% had a suppressed viral load Viral Suppression Among Diagnosed in the Bronx, 2015 100% 94% 87% 90% PLWHA categories are not mutually exclusive 83% 80% 71% 70% 60% 50% 40% 30% 20% 10% 0% HIV-diagnosed 35 Retained in Care Prescribed ART Virally Suppressed Data source: Care and Clinical Status of People Diagnosed with HIV and People Living with HIV/AIDS in NYC, 2015. As reported to the New York City Department of Health and Mental Hygiene by June 30, 2016.
HIV/AIDS Mortality in the Bronx 36
HIV Mortality rates have fallen nearly 4 -fold since 2000 Bronx -- 2000: 3 rd leading cause of death | 2014: 9 th leading cause of death Rest of NYC Bronx NYC Excluding Bronx 35 30 74% decrease 25 20 79% decrease 16. 8 15 11. 2 10 3. 5 5 70 Age-adjusted HIV/AIDS mortality rate per 100, 000 Bronx 40 Bronx Miami-Dade County DC Baltimore City 60 52. 5 50 44. 6 40 These areas chosen for comparison due to similar demographics and high HIV/AIDS burden 42. 6 30 21. 4 20 14. 1 10 11. 2 6. 1 37 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09 20 10 20 11 20 12 20 13 20 14 20 15 20 03 02 20 20 20 01 0 00 0 20 Age-adjusted HIV/AIDS mortality rate per 100, 000 45 42. 6 Data source: Underlying Cause of Death 2000 -2015. Analysis by Montefiore OCPH.
Males and 45 -64 year olds have highest rates of HIV mortality in the Bronx Female 140 Male 60 35 -44 45 -54 55 -64 120 50 40 30 27. 8 20 25 -34 128. 4 61 16 HIV/AIDS Mortality Rate per 100, 000 Age-Adjusted HIV Mortality Rate per 100, 000 70 100 89. 4 80 60 50. 8 40 30. 5 28. 2 20 10 Data Suppressed 7. 4 11. 3 0 0 2000200120022003200420052006200720082009201020112012201320142015 38 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: Underlying Cause of Death, 2000 -2015. Analysis by Montefiore OCPH. Age-specific rates are not age-adjusted. 25 -34 year data unstable after 2006. 65+ data unstable for all years.
Bronx 45 -54 year old male and females with HIV have the highest mortality rates 189. 6 Male HIV Mortality Rate per 100, 000 45 -54 90 55 -64 80 180 Bronx males 45 -54 had highest HIV mortality rates until 2010 when the 55 -64 age group surpassed 160 140 120 35 -44 122. 3 100 88 80 60 41. 9 40 37. 3 35 -44 55 -64 78. 3 Bronx females 45 -54 have the highest mortality rates 70 60 45 -54 61. 2 50 40 30 Data Suppressed 20 20. 3 10 20 0 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 39 Female HIV Mortality Rate per 100, 000 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Data source: Underlying Cause of Death, 2000 -2015. Analysis by Montefiore OCPH. Age-specific rates are not age-adjusted. 25 -34 and 65+ year data for male and female unstable for all years.
HIV/AIDS mortality rates are highest for non-Hispanic blacks in the Bronx Hispanic NHB NHW Age-Adjusted HIV/AIDS Mortality Rate per 100, 000 60 55. 6 50 40 37. 7 30 20 16. 9 Data Suppressed 10 8. 2 0 2000 40 2001 2002 2003 2004 2005 2006 2007 2008 2009 Data source: Underlying Cause of Death, 2000 -2015. Analysis by Montefiore OCPH. Non-Hispanic White data 2008 -2015 statistically unstable 2010 2011 2012 2013 2014 2015
Morrisania has had the highest rate of HIV/AIDS Mortality but in 2014, East Tremont surpassed Morrisania Hunts Point (202) Concourse, Highbridge (204) East Tremont (206) Riverdale (208) 88. 3 80 60 22. 7 21. 5 20. 6 20 14. 214. 9 12. 2 10. 6 15 10 7. 9 5 Data unstable 0 20. 6 0 2000 41 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Data source: New York City HIV/AIDS Mortality Data, 2000 -2014. Analysis by Montefiore OCPH. Hunts Point, Riverdale, Throngs Neck, Pelham Parkway are statistically unstable le da ro R iv er Pe 20 Th 22. 7 un ts Po in t( 20 40 H Age-Adjusted Death Rate per 100, 000 100 25 2) lh gs ( 2 am Ne 0 ck 8) P U ar ni kw (21 on ay 0) F po o (2 rd rt, So ha 11) m C on Wi und (2 l U cou liam view 07) ni ve rse sb (2 r , rs 0 ity Hig idge 9) /M h or bri (21 2) ris dg e H ( e 2 M ight 04) or s (2 ri M san 05 ot ) ia Ea t Ha (20 v 3) st Tr en ( em 20 on 1) t( 20 6) Mott Haven (201) Morrisania (203) University/Morris Heights (205) Fordham (207) 118. 3 2014 Age-Adjusted Death Rate per 100, 000 120
There are dramatic disparities in all-cause mortality among people living HIV/AIDS in the Bronx Note: Different analysis approach from previous slides. Males, including transgender men 40 34. 6 Estimated deaths among people with HIV/AIDS per 1, 000 PLWHA 35 42 Female, including transgender women 30 28. 4 27. 4 25 20 10 14. 4 13. 6 15 8. 9 5 0 MSM IDU MSM-IDU Heterosexual IDU Data source: Calculated from NYC HIV/AIDS Annual Surveillance Statistics, 2014 -15. Analysis by OCPH. MSM = men who have sex with men, IDU = injection drug users. Not age-adjusted. Heterosexual
Technical notes – NYC HIV Care Continuum TECHNICAL “HIV-infected”: calculated as “HIV-diagnosed” divided by the estimated proportion of people living with HIV/AIDS (PLWHA) who had been diagnosed (94. 2%), based on a back-calculation method. Source: NYC HIV Surveillance Registry. Method: Hall HI, et al. Prevalence of Diagnosed and Undiagnosed HIV Infection — United States, 2008 -2012. MMWR 2015; 64(24): 657 -662. “HIV-diagnosed”: calculated as PLWHA “retained in care” plus the estimated number of PLWHA who were out of care, based on a statistical weighting method. This estimated number aims to account for out-migration from NYC, and therefore is different from the number of PLWHA published elsewhere. Source: NYC HIV Surveillance Registry. Method: Xia Q, et al. Proportions of Patients With HIV Retained in Care and Virally Suppressed in New York City and the United States. JAIDS 2015; 68(3): 351 -358. “Retained in care”: PLWHA with ≥ 1 VL or CD 4 count or CD 4 percent drawn in 2015, and reported to NYC HIV surveillance. Source: NYC HIV Surveillance Registry. “Prescribed ART”: calculated as PLWHA “retained in care” multiplied by the estimated proportion of PLWHA prescribed ART in the previous 12 months (95. 5%), based on the weighted proportion of NYC Medical Monitoring Project participants whose medical record included documentation of ART prescription. Source: NYC HIV Surveillance Registry and NYC Medical Monitoring Project, 2014. “Virally suppressed”: calculated as PLWHA in care with a most recent viral load measurement in 2015 of ≤ 200 copies/m. L, plus the estimated number of out-of-care 2015 PLWHA with a viral load ≤ 200 copies/m. L, based on a statistical weighting method. Source: NYC HIV Surveillance Registry. Method: Xia Q, et al. Proportions of Patients With HIV Retained in Care and Virally Suppressed in New York City and the United States. JAIDS 2015; 68(3): 351 -358. 43
About the Community Health Dashboard Project § The goal of the project is to provide Bronx-specific data on risk factors and health outcomes with an emphasis on presenting data on trends, socio-demographic differences (e. g. , by age, sex, race/ethnicity, etc. ) and sub-county/neighborhood level data § Data will be periodically updated as new data becomes available. § Produced by Montefiore’s Office of Community & Population Health using publicly-available data sources § For more information please contact Colin Rehm, Ph. D, Manager of Research & Evaluation (crehm@montefiore. org). 44
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