The scientific study of disease distribution and
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The scientific study of disease distribution and the factors that cause diseases to spread in communities. Analyze the facts Educate others Build partnership Lend their perspectives Raise critical questions Seek knowledge. The number of people living with HIV/AIDS during a given year. - PowerPoint PPT Presentation
Transcript of The scientific study of disease distribution and
The scientific study of disease distribution and the factors that cause diseases to spread in communities
• Analyze the facts• Educate others• Build partnership• Lend their perspectives• Raise critical questions• Seek knowledge
The number of people living with HIV/AIDS during a given year
In 2006, an estimated 1,106,400 individuals were living with HIV/AIDS in the United States
In 2006, an estimated 56,300 individuals became HIV infected in the U.S.
The annual number of people who become HIV infected in a given period of time, typically a year.
A rate measures a certain quantity or amount of one thing considered in relation to a unit of another thing.
In public health, rates help describe the number of events per population unit,
typically expressed as health events or disease per 100,000
people.
A rate consists of a numerator and a denominator.
525,600 / 56,300 = 9.33
Annual minutes (numerator) divided by annual infections (denominator) equals a rate of 9 ½ minutes per infection
Rates allow us to compare communities of different sizes.
The numerator is the number of health events or disease
and the denominator is the defined population at risk
(including those who experience the event/disease):
numerator ____________ x 100,000 = population rate denominator
Based on meta-analysis, CDC estimates that:
•An estimated 4% of U.S. males had same-sex behavior in the past 5 yrs•7% of U.S. males have ever had MSM behavior•MSM account for an estimated 2% of the total U.S. population
CDC notes and disclaimers:
• These estimates are preliminary!
• More complete analysis – Refine meta-analysis estimates
– Re-calculate rates; also do by race and age – May conduct separate analysis for young MSM
• Identify population estimates for IDU and HET
Transmission Rate:Represents the amount of transmission that occurs annually in relation to the population infected with HIV.
Technically, this is HIV incidence divided by
prevalence in a given year.
CDC published in 2008 back-calculation estimates for HIV incidence and prevalence between 1977 and 2006. The new estimates allow retrospective TR calculations.
Hall et al. JAMA. 2008; 300: 520- 529.
HIV Transmission Rate (TR)
HIV Transmission Rate, United States, 1977-2006
0.00
20.00
40.00
60.00
80.00
100.00
120.00
Year
Source: Holtgrave et al. JAIDS 2009
HIV Transmission Rate, United States, 1977-2006
HIV Transmission Rate, United States, 1990-2006
0.00
2.00
4.00
6.00
8.00
10.00
12.00
14.00
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Year
Source: Holtgrave et al. JAIDS 2009
HIV Transmission Rate, United States, 1977-2006
• What are the characteristics of people who become infected with HIV?
• How do we understand population trends in the epidemic?
Research advocates ask critical questions:
•Do the data give an accurate picture of the epidemic?
•Where/when/how was data collected?
•What methodologies were employed in data collection, analysis, and presentation?
•Who was involved?
•How might disease surveillance be improved?
Change HIV/AIDS Surveillance System Categories to More Accurately Reflect How Women Acquire HIV, Advocates Say
•End the “seriously flawed” CDC hierarchical classification system that classifies most cases of HIV among women as “no identified risk”•Allow health departments to classify cases as “presumed heterosexual” when the male partner’s HIV status and/or risk factors are unknown•Collect “acquisition category” information to reflect “sexual networks and/or social networks” of elevated HIV prevalence. New data might include:
– Prevalence of HIV where the person lives– The area’s post-incarceration rates– Drug/alcohol and homelessness partners for the area
ms.foundation.org/File%20Library/NWAC/NWACpolicypropchartformFINALforweb.pdf
Advocates Say Outreach and Surveillance Programs Undercount:
• Transgender populations• Asian/Pacific Islanders• Undocumented people• American Indians/Native Hawaiians• Rural populations
Without accurate surveillance, undercounted populations may receive fewer dollars for HIV prevention, care, and research activities
Person Living with AIDS in 2005 By Region
Region Rank Number
North 2 126,867
Midwest 4 45,666
South 1 169,972
West 3 83,405
http://www.southernaidscoalition.org/policy/southern_states_manifesto_2008.pdf
San Francisco Project maps concentration of HIV viral load across the city to determine where expanded services are needed
To alter the course of the epidemic, We need to model where it is currently headed
Advocates shared a model with the White House comparing stable growth in the epidemic against progress toward defined goals
They call on the federal government to include a scientifically rigorous model in the National HIV/AIDS Strategy
The paper includes other important recommendations
nationalaidsstrategy.org/2010/advocates-recommend-key-components-of-an-effective-strategy/
Year Incidence Deaths Prevalence Minutes per Infection
2006 56,300 18,620 1,106,400 9.302007 58,086 19,000 1,145,486 9.00
2008 62,273 20,876 1,186,151 8.30
2009 62,273 20,876 1,227,548 8.00
2010 64,446 21,605 1,270,389 8.002011 66,695 22,359 1,314,726 7.30
2012 69,023 23,139 1,360,610 7.30
2013 71,432 23,947 1,408,095 7.30
2014 73,505 24,782 1,457,238 7.00
2015 76,505 25,647 1,508,095 7.002016 79,175 26,542 1,560,728 6.30
2007-2016 Projected Epidemic Based on A Constant 5% Transmission Rate
David Ernesto MunarVice President
AIDS Foundation of Chicago312-334-0933
aidsconnect.net/dose
