HIV/AIDS Prevalence and Mortality Report, 2018

HIV/AIDS Prevalence and Mortality Report, 2018

HIV/AIDS Prevalence and Mortality Report, 2018 HIV/AIDS Surveillance System http://www.health.state.mn.us/diseases/hiv/stats/index.html Introduction (I) These three introduction slides provide a general context for the data used to create this slide set. If you have questions about any of the slides, please

refer to the HIV/AIDS Surveillance Technical Notes on our website. This slide set displays estimates of the number of persons living with HIV/AIDS (prevalence) and mortality in Minnesota by person, place, and time. The slides rely on data from HIV/AIDS cases diagnosed through 2018 and reported to the Minnesota Department of Health (MDH) HIV/AIDS Surveillance System, which is a part of the National HIV/AIDS Surveillance System (NHSS).

2 Introduction (II) Data analyses exclude persons diagnosed in federal or private correctional facilities, but include state prisoners (number of state prisoners believed to be living with HIV/AIDS = 30). Data analyses for new infections exclude persons arriving to Minnesota through the HIV+ Refugee Resettlement Program (number of primary HIV+ refugees in this program living in Minnesota as of December 31, 2018 = 169), as well as other refugees/immigrants reporting a positive test prior to their arrival in Minnesota (n = 164).

Some limitations of surveillance data: Do not include people living with HIV who have not been tested for HIV Do not include persons whose positive test results have not been reported to MDH Do not include people living with HIV who have only tested anonymously Case numbers for the most recent years may be undercounted due to delays in reporting Reporting of living cases that were not initially diagnosed in Minnesota is known to be incomplete, as well as transfer of living cases that have moved to other states from Minnesota 3

Introduction (III) Persons are assumed to be alive unless MDH has knowledge of their death. Persons whose most recently reported state of residence was Minnesota are assumed to be currently residing in Minnesota unless MDH has knowledge of their relocation. Our ability to track changes of residence, including within the state, is limited and subject to reporting delays. Vital status and current residence are updated through one or more of the following methods: Standard case reporting

Correspondence with other health departments Active surveillance Death certificate reviews (annually) Birth certificate reviews (annually, pregnant persons only) 4 National Context

Rates of Adults and Adolescents with Diagnosed HIV Infection, by Area of Residence, Year-end 2016 U.S. and 6 Dependent Areas N = 1,006,691 Total Rate: 367.6 Data are based on address of residence as of December 31, 2016 (i.e., most recent known address). Rates of Adults and Adolescents with HIV Infection Ever Classified as Stage 3 (AIDS), by Area of Residence, Year-end 2016 U.S. and 6 Dependent Areas

N = 534,515 Data are based on address of residence as of December 31, 2016 (i.e., most recent known address). Total Rate: 195.2 Stage 3 (AIDS) Classifications and Deaths of Persons with Diagnosed HIV Infection Ever Classified as Stage 3 (AIDS) 19852016, U.S. and 6 Dependent Areas

Deaths of persons with HIV infection, stage 3 (AIDS) may be due to any cause. 8 Overview of HIV/AIDS in Minnesota New HIV Diagnoses, HIV (non-AIDS) and AIDS Cases by Year

of HIV Diagnosis, 1990-2018 *Includes all new cases of HIV infection (both HIV (non-AIDS) and AIDS at first diagnosis diagnosed within a given calendar year. ^Includes all cases diagnosed with HIV in that year who subsequently progressed to AIDS diagnosis status, including those diagnosed with AIDS when they were first diagnosed with HIV^^ and those who were diagnosed with AIDS in subsequent years^^^ This includes refugees in the HIV+ Resettlement Program, as well as, other refugee/immigrants diagnosed with AIDS subsequent to their arrival in the United States. 10

Persons Living with HIV/AIDS in Minnesota Estimated Number of Persons Living with HIV/AIDS in Minnesota As of December 31, 2018 8,981* persons are assumed alive and living in Minnesota with HIV/AIDS. This includes: 4,937 (55%) living with HIV infection (non-AIDS)

4,044 (45%) living with AIDS This number includes 2,331 persons who were first reported with HIV or AIDS elsewhere and subsequently moved to Minnesota This number excludes 1,560 persons who were first reported with HIV or AIDS in Minnesota and subsequently moved out of the state *This number includes persons with Minnesota reported as their current state of residence, regardless of residence at time of diagnosis. It also includes state prisoners and refugees arriving through the HIV+ Refugee Resettlement Program, as well as HIV+ refugees/immigrants arriving through other programs. 12

Place Minnesota Patients Living with HIV# by County of Current Residence, 2018 City of Minneapolis City of St. Paul

Suburban* Greater Minnesota Total 3,190 cases (833.8 per 100,000) 1,149 cases (403.1 per 100,000) 3,105 cases (142.3 per 100,000) 1522 cases (62.0 per 100,000)

8,966 cases (169.0 per 100,000) HIV or AIDS at last appointment *7-county metro area, excluding the cities of Minneapolis and St. Paul # 14

2018 Minnesota Patients Living with HIV by Metro County City of Minneapolis City of St. Paul Suburban* Greater Minnesota Total

3,190 cases (833.8 per 100,000) 1,149 cases (403.1 per 100,000) 3,105 cases (142.3 per 100,000) 1522 cases (52.0 per 100,000) 8,966 cases (169.0 per 100,000) *7-county metro area, excluding the cities of Minneapolis and St. Paul 15

Persons Living with HIV/AIDS in Minnesota by Current Residence, 2018 *66 persons missing residence information Suburban includes the seven-county metro area of Anoka, Carver, Dakota, Hennepin (except Minneapolis), Ramsey (except Saint Paul), Scott, and Washington counties. Greater Minnesota includes all other counties outside of the seven-county metro area.

16 Sex Assigned at Birth and Race/Ethnicity Persons Living with HIV/AIDS in Minnesota by Sex Assigned at Birth, 2018 18

Persons Living with HIV/AIDS in Minnesota by Sex Assigned at Birth and Race/Ethnicity, 2018 *Other includes multi-racial persons and persons with unknown race. Race information missing for 15 PLWH. 19

Number of Cases and Rates (per 100,000 persons) of Persons Living with HIV/AIDS by Race/Ethnicity in Minnesota, 2018 ^2010 United States Census Data used for rate calculations, except where otherwise specified. *African-born refers to Blacks who reported an African country of birth. Non African-born refers to all other Blacks. Rates for black, non African-born and black, African-born are not comparable to previous years due to a decrease in the estimate for black, African-born population. Other includes multi-racial persons and persons with unknown race

Estimate of 104,828 Source: 2014-2016 American Community Survey with additional calculations by the Minnesota State Demographic Center. 20 Number of Cases and Rates (per 100,000 persons) of Adults and Adolescents* Living with HIV/AIDS by Sex Assigned at Birth and Risk in Minnesota, 2018

*HIV or AIDS at first diagnosis ages 13 and older. ^2010 United States Census Data used for rate calculations, except where otherwise specified. MSM refers to both MSM and MSM/IDU risk identified at time of reported HIV diagnosis. It includes all PLWH assigned the sex of male at birth who report a male sexual partner. Therefore, some Trans Women are included in both the total number of cases and the population estimate. Estimate of 90,663 Source: http://www.emorycamp.org/item.php?i=92

21 Number of Cases of Adults and Adolescents* Living with HIV/ AIDS by Gender Identity in Minnesota, 2018 *HIV or AIDS at first diagnosis ages 13 and older. Current gender was not reportable until 2009, so may be incomplete for HIV infections reported before that time. Because current gender is incomplete

for a large number of cases, there may be misclassification of transgender Minnesotans in either of the cisgender groups. 22 Age Persons Living with HIV/AIDS in Minnesota by Age Group*, 2018

*Age missing for 7 persons living with HIV/AIDS 24 Persons Living with HIV/AIDS in Minnesota by Age* and Sex Assigned at Birth, 2018 *Age missing for 7 persons living with HIV/AIDS

25 Foreign Born Populations Foreign Born Persons Living with HIV/AIDS in Minnesota by Region of Birth, 2008-2018 *This number includes persons who reported Minnesota as their current state of residence, regardless of residence at time of diagnosis. It also includes state prisoners

and refugees arriving through the HIV+ Refugee Resettlement Program, as well as HIV+ refugees/immigrants arriving through other programs. 27 African-Born* Persons Living with HIV/AIDS Compared to Other Minnesota Cases by Sex Assigned at Birth, 2018 *Includes persons arriving to Minnesota through the HIV+ Refugee Resettlement Program and other refugee/immigrant programs. Also includes 4

Hispanic, 4 White, and 15 Multi-Race identifying African-born persons. Three African-born persons had missing race information. 28 Latin American/Caribbean* Persons Living with HIV/AIDS Compared to Other Minnesota Cases by Sex Assigned at Birth, 2018 *Includes Mexico and all Central/South American and Caribbean countries.

29 Countries of Birth Among Foreign Born Persons* Living with HIV/AIDS in Minnesota, 2018 *Includes over 100 additional countries

30 Mortality Reported Deaths Among Persons living with HIV/AIDS in Minnesota, 1984-2018 *Number of deaths known to have occurred among all people living with HIV infection in Minnesota, regardless of location of diagnosis or cause of death

^Number of deaths known to have occurred among people living with AIDS in Minnesota in a given calendar year, regardless of location of diagnosis or cause of death **Number of deaths known to have occurred among people living with HIV (non-AIDS) in Minnesota in a given calendar year, regardless of location of diagnosis or 32 cause of death

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