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HIV/AIDS Surveillance in Michigan
Michigan HIV/AIDS Surveillance Statistics with latest reports attached
Special
PowerPoint Presentations/
Epi Profiles Where to
send HIV serum tests / Reporting HIV/AIDS Cases / HIV/AIDS
Reporting Contacts for Michigan 5/21/09
- Counties assigned to various surveillance staff have been updated /Resources
for Reporting HIV/AIDS Cases in Michigan / Special Reports
/ Special PowerPoint Presentations Back to HIV &
STD Statistics Special PowerPoint Presentations
HIV in
Southeast Michigan and Detroit
Eve Mokotoff, MPH, HIV Epidemiology Manager, Michigan Department of
Community Health. To see the presenter's notes for each 'slide,' click on the
text bubble, lower left corner of
PDF file.
January 2010
HIV statistics slides
to make it easy for you to work Michigan data into presentations, reports, etc.
http://www.michigan.gov/mdch/0,1607,-132-2940_2955_2982_46000_46004-166892--,00.html
Getting the
picture: HIV/AIDS and Latinos -
PowerPoint Presentation presented at the National Latino AIDS
Awareness Day kick-off on September 15, 2009.
2008 EPI Profiles
2008 Epidemiologic Profiles of HIV in Michigan
These have been posted on the MDCH HIV website
http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982_46000_46003-36307--,00.html
There are three separate profiles- Michigan as a whole, SE Michigan and Outstate
Michigan.
These profiles represent the most comprehensive picture of HIV in our state and
are a great source of information. I encourage you to read the Forward so you
will know more about what is in them.
Michigan HIV/AIDS Surveillance Statistics
Note:
You can subscribe and unsubscribe to the electronic
e-mailing list at: http://www.localhealth.net/hivstats/subscribe.aspx
Michigan Quarterly HIV/AIDS
Report July 1, 2010
The July 1, 2010 HIV/AIDS statistics for the State of Michigan have been posted
on the MDCH website and can be accessed at the address above or directly by
clicking on this link:
http://www.michigan.gov/documents/mdch/Jul_2010_328042_7.pdf
April 1, 2010 Michigan HIV/AIDS statistics
The
April 1, 2010 HIV/AIDS statistics for the State of Michigan have been posted on
the MDCH website and can be accessed at:
http://www.michigan.gov/documents/mdch/Apr_2010_318262_7.pdf
January 1, 2010 Michigan HIV/AIDS Statistics
The October 2009 HIV/AIDS statistics for the State of Michigan have been posted
on the MDCH website and can be accessed at the address directly by
clicking on this link:http://www.michigan.gov/documents/mdch/JAN_2010_307661_7.pdf
- Updated Prevalence Estimate for Michigan
Every January NDCH updates the estimated HIV prevalence in the
state; that is, the number of people we estimate to be currently
living with HIV in Michigan. This number includes reported cases and
is increased to account for people who have been diagnosed but not
reported (estimated at 10%) and the number infected but not yet
diagnosed (estimated at 21%). Because the number of people reported
and living with HIV continues to increase the estimated prevalence
also increases every year; this year it is 18,800. To give you
perspective on this, below are the estimates for the last four
years:
Jan 2007: 17,000
Jan 2008: 18,000
Jan 2009: 18,200
Jan 2010: 18,800
More information on how MDCH calculates these can be found in the
Quarterly Report in the Front Matter, page iii.
- PowerPoint Presentation with latest MI Stats to be
available in February
Power point slides summarizing this Quarter's report will be
released next month. We invite and encourage you to use these
slides for presentations and discussions on the state of the
epidemic in Michigan.
-
Items to
Look for in 2010:
An improved
Michigan Adult/Adolescent HIV/AIDS case report form that:
- Expands
categories for current gender so we can quantify the HIV
epidemic among transgendered persons
- Adds a place
for providers to let us know that the person being reported
represents a suspect case of acute HIV infection.
Acute or primary HIV infection is associated with high viral
load levels in blood plasma with potentially conflicting
antibody results (e.g., ELISA could be negative and/or
confirmatory Western blot antibody may be indeterminate).
P24 antigen blood test is often positive. The infection is
highly transmissible during this stage and an early
diagnosis provides the first opportunity to appropriately
counsel patients in regard to preventing the spread of the
infection. See more information pertinent to
Reporting.
Initial analysis
from the Medical Monitoring Project (MMP).
This project consists of patient interviews and extensive chart
reviews in order to collect information from a representative
sample of HIV infected persons in care in the state that is not
available from routine HIV surveillance. We look forward to
sharing data such as time between diagnosis and entry into care,
antiretroviral use, non-injecting drug use, unprotected sex and
unmet need for ancillary services.
Where to send
HIV serum tests
Effective Jan 1, 2010, all serum HIV testing previously performed at
Kent County and the Detroit Department of Health and Wellness Promotion
Laboratories will be performed at the MDCH Bureau of Laboratories in Lansing.
After Monday, December 14 you can download the new test request (DCH-0583 Dec 4,
2009), with new shipping address located at:
www.michigan.gov/mdchlab -click on "What's New" and utilize these materials
for all specimens shipped after January 1, 2010.
(1.12.10)
Following the transfer of HIV-1 serum testing from City of Detroit and Kent
County Laboratories to the MDCH Bureau of Laboratories in Lansing, we have
prepared a FAQ document for your convenience in order to make the transfer
easier.
Answers to Frequent Questions
1. Question: We send HIV serum specimens to Detroit City HD (or Kent Co. HD) for
testing and receive automatic FAX reports via our secure FAX machine. Will we
need to complete new auto FAX agreements to keep receiving HIV reports via FAX?
Answer: HIV serum reports will continue to arrive via your designated secure
FAX.
Lansing is cross-referencing Detroit City HD and Kent Co HD agency d-bases to
verify correct secure automatic FAX numbers.
In the event Lansing finds a discrepancy your agency will receive an Automatic
FAX Agreement to update and return per included instructions.
2. Question: Do we continue to use the same agency code when completing the
Microbiology/Virology Test Requisition (DCH-0583 December 4, 2009) form, for
sending HIV serum specimens to Lansing?
Answer: Continue to use the current agency code. Lansing is cross-referencing
Detroit City HD and Kent Co HD agency d-bases to verify correct agency codes.
In the event Lansing finds a discrepancy your agency will receive a notice, of
the correct agency code to use when completing the Microbiology/Virology Test
Requisition (DCH-0583).
3. Question: How do we access the MDCH Laboratories Services Guide on line?
Answer:
Web address: www.michigan.gov/mdchlab SAVE this web address as an
*internet favorite* for future reference. To access the Laboratory
Services Guide: Find the section titled Laboratory Services Guide. It
is located in the middle of the screen. Click on it.1. To order test kits
(clinical components) click on Specimen Collection & Shipping Containers then
DCH-0568.
To find information regarding a specific test click on A * Z Test Listing. To
find specimen collection, submission and shipping guidelines and a breakdown of
BOL Lab tests, click on Bureau of Laboratories - Laboratory Services Guide.
4. Question: Can we request multiple testing such as HepB, Syphilis and HIV
serum testing using one serum sample and one requisition form?
Answer: Yes, however the minimum volume of serum, for multiple tests
ordered is 3 ml. NOTE: Whole blood is spun resulting in 3ml serum.
5. Question: Where can we obtain Unit 49 collection kit?
Answer: This kit can be obtained by either -Faxing a DCH-0568 *Clinical Specimen
Shipping Units Requisition* to
517-335-9039
-Mailing a DCH-0568 to Michigan Department of Community Health
Laboratory Support Unit
927 Terminal Road
Lansing, MI 48906
6. Question: Who can we contact with additional questions?
Answer: For HIV testing questions, please contact Bruce Robeson @
517-335-8099 or email your questions to
RobesonB@michigan.gov
For general HIV questions please contact Dr Anthony Muyombwe @
517-335-8099 or email your questions to
muyombwea@michigan.gov
With shipping unit questions please contact Dr Jeff Massey
@517-335-8074 or email questions to
masseyj@michigan.gov
Reporting HIV/AIDS Cases
Updates 7/2010
Current Gender Field
on
Newest Case Report Form
In early June we sent out the link to
Michigan's new adult HIV/AIDS case report form. In that
mailing we pointed out the addition of the "current gender" field. Here we are
supplying a bit more detail on what we would like to collect. From the
instructions that accompany the form:
Current Gender
Please indicate the gender to which the patient most closely
identifies at time of diagnosis (this may or may not be different than the sex
the patient was assigned at birth) and if the patient identifies as a
transgender female (Trans to Female) or as a transgender male (Trans to Male).
Transgender is an umbrella term used for people whose gender identity and/or
gender expression differs from the sex they were assigned at birth. For the
purposes of HIV case surveillance this term includes transgender people
regardless of whether they have altered their bodies hormonally and/or
surgically.
Suspect Acute HIV Infection?
The newly revised adult case report form also has a location in the
Diagnostic Status box to note if the provider suspects that the patient is
recently (acutely) infected with HIV. Please mark this box if the patient
claims a recent exposure, and/or is now testing positive after recent past
negative tests, and/or is experiencing acute retroviral syndrome and/or has
laboratory data pointing to acute infection (for example, indeterminate Western
blot accompanied by a high viral load). Highlighting the possibility of acute
infection will allow Partner Services staff to focus on counseling patients
during their most infectious time period.
The case report form and instructions can be found at:
http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982_46000_46002---,00.html
MMWR REPORT -Summary of Notifiable Diseases, United
States, 2008
The Health-care providers in the United States are required to report
certain infectious diseases to a specified state or local authority. A disease
is designated as notifiable if timely information about individual cases is
considered necessary for prevention and control of the disease. Each year, CDC
publishes a summary of the cases of notifiable disease reported for the most
recent year for which data is available. This report presents a summary of
notifiable diseases for 2008. The Summary is available at
http://www.cdc.gov/mmwr/mmwr_nd/index.html . This site also includes
publications from previous years.
Full Report
New MI Adult HIV/AIDS Case Report Form
The most current HIV/AIDS case report form (6.3.10) - to be used for anyone age
13 or older:
http://www.michigan.gov/documents/mdch/MDCH_Form_1355_-_HIV_AIDS_Final_version_Mar_08_2007_189369_7.pdf
Instructions for completing the form:
http://www.michigan.gov/documents/mdch/INSTRUCTIONS_FOR_COMPLETION_OF_THE_MICHIGAN_ADULT_HIV_CRF_02-07_187486_7.pdf
This form is very similar to the one that it replaces, however the HIV
surveillance team prefers that you start using this version of their form for
reporting. Below is an overview of the changes:
Section V Demographics
1) We have added an option to check if the physician suspects this is a case
of acute HIV infection. We would prioritize these cases for partner services
since they usually have a very high viral load and are capable of readily
transmitting HIV.
2) In addition to 'Sex at Birth' we added a 'Current Gender' variable to capture
cases of HIV infection among transgendered persons. There is interest in
quantifying the HIV infection level in this population and this will allow us to
collect that.
3) Marital status- we added lives with domestic partner as an additional option.
Section IX Documented Laboratory Data
1) We added the option to record specimen type (oral/blood) and if the test
was a rapid test,
2) Clarified that the date that we want is the date the specimen was collected
(as opposed to tested or result returned).
Why we ask for Race and Ethnicity
CDC requires the completion of the race/ethnicity variable for a case
of HIV/AIDS to be counted in the national statistics as well as for a case to
count as a Michigan case. This has a direct impact on federal funding for care
of HIV infected persons in the state.
Additional rationale is related to the disparate rate that HIV affects persons
by race/ethnicity. Among some racial/ethnic minorities, the rate at which people
acquire HIV is disproportionate. The epidemic disproportionately impacts black
and Latino/Hispanic populations in Michigan. For example, blacks comprise 14% of
the state's population and 59% of the state's HIV/AIDS cases with a rate of 607
per 100,000, 9.5 times higher than the rate among non-Hispanic whites (64 per
100,000). Hispanics comprise 4% of HIV/AIDS cases and 4% of the population and
have a rate of 141 per 100,000 (over two times higher than non-Hispanic whites).
Findings such as these are based largely on data collected from public health
surveillance.
An important priority for CDC and MDCH is to eliminate health disparities by
improving the health of racial and ethnic minority populations through the
development of health policies and programs.. To accomplish this goal,
high-quality data on race and ethnicity are necessary to identify and eliminate
health disparities. Accurate and complete data on race and ethnicity provide
important information regarding who is impacted by various health issues and
guides resource allocation and decision-making.
DOCUMENTATION OF MODE OF HIV TRANSMISSION
Information on how persons living with HIV/AIDS became infected continues to be
vital to prevention planning efforts. In addition, national surveillance data on
HIV/AIDS transmission category, as well as demographic risk factors (geographic
location of residence, age, sex, race/ethnicity) are used to allocate funds for
HIV prevention programs and services and target and evaluate interventions and
programs, among other uses. Therefore it is crucial to have complete and
accurate data for these variables. MDCH appreciates your
documentation of modes of HIV transmission in the patient's medical record
and/or your documentation of this information on the HIV/AIDS case report form.
In addition, please call your contact on their staff (see
list below) if you have a patient with a suspected unusual mode of
transmission. Examples of these include an HIV-infected child whose biological
mother is not HIV-infected, a person who has reported no sexual contact in the
previous years, patient report of exposure to possible HIV-infected blood or
body fluids or of transfusions in countries outside of the USA.
Implementation of Michigan's HIV Reporting Law
PA 514, which went became law on April1, 2005, changed the way HIV is reported in
Michigan. Now, physicians and testing sites will share the responsibility with
clinical labs to report confirmed positive HIV tests. (See Lab Based Reporting of HIV). It is important to note that this does not
affect the ability of individuals in our state to obtain anonymous testing at
MDCH designated testing sites.
This law helps to provide a more accurate picture of the epidemic in
Michigan. And it will paved the way for a more equitable assessment of need for
Ryan White CARE Act funding. As more states provide accounting of HIV cases, the
federal government will change its criteria for CARE funding from numbers of
AIDS cases to the numbers of those living with HIV.
For more information on the ramifications of
this new law, see the PowerPoint Presentation made by Eve Mokotoff at the March 2005
MHAC meeting Also, see the letter
sent to clinicians by MDCH regarding the implementation of this new law at
http://www.mihivnews.com/stats/PA514.Clinicianinfo.Memo.pdf.
Lab-Based Reporting of HIV
PA 514 the
e and add to the completeness of reporting of both HIV and AIDS.
Licensed clinical labs are now required to report positive HIV tests, and also
“test results ordered for the management and surveillance of the infection” (CD4
test results under 200 and viral load test results) which would indicate an AIDS
diagnosis. Underblicesting sites for testing that is not requested to be done anonymously.
Medical providers are also required by law to report AIDS diagnosis.
Michigan was actually ahead of the national game for requiring HIV name-based
reporting. It was written into the public health code as part of a package of
HIV laws passed back in 1988. Prior to the Governor signing PA 514 in December,
Michigan was the only name-based HIV reporting state that did not require the clinical laboratory to report HIV according to
Eve Mokotoff, HIV/AIDS Epidemiology Manager for MDCH.
“An integrated, clinically-based HIV/AIDS surveillance system worked well in the
late 1980’s and early 1990’s,” stated Mokotoff in a presentation to
MHAC. (However), as
medical care became more decentralized, the system’s dependence on conducting
surveillance with a manageable number of key physicians became less reliable.”
This new law will not affect a person’s ability to be
tested anonymously in Michigan, which has been unique in allowing anonymous
reporting from the non-anonymous care setting (i.e., physician’s offices)
according to Mokotoff. “We are not interested in, and have no plans for,
changing the availability of anonymous reporting in Michigan.”
See the PowerPoint presentation by Eve Mokotoff, which explains the
ramifications of the bill on surveillance and the possible impact on future Ryan
White funding at
http://www.mihivnews.com/stats/labreportingSB1129.pdf
See the other Michigan HIV Laws
How They Affect Physicians and Other Health Care Providers
Revised
September 2002.
Resources for Reporting HIV/AIDS Cases in Michigan
Many of the forms and information often requested are available on line. The
following summarizes the location of: 1) the booklet, Michigan HIV Laws: How
They Affect Physicians and Other Health Care Providers, 2) adult and pediatric
case report forms and instructions for completion, 3) Form DCH-1221 Confidential
Request for Local Health Department Assistance for Partner Counseling & Referral
Services (PCRS) and 4) the Michigan Communicable Disease rules 5)
PCRS fact sheet
Risk Ascertainment
A reminder from MDCH Surveillance: Ascertainment of mode of transmission of
HIV continues to be important information for planning and evaluating HIV
prevention and care services. Although we know how HIV is transmitted,
obtaining information on how HIV-infected persons were most likely to have
acquired their infection allows us to target persons at highest risk. Please
continue to provide this information in medical records and on any case report
forms you complete.
Risk
Assessment Form
Finding Michigan HIV/AIDS Laws booklet online:
http://www.michigan.gov/documents/mihivlaws_49845_7.pdf
Or navigate through the MDCH website:
www.michigan.gov/mdch
>Physical Health and Prevention
>Prevention
>HIV/STD: Under “HIV” click: HIV/AIDS
>Click here to open a copy of the booklet, Michigan HIV Laws: How They Affect
Physicians and Other Health Care Providers
Finding Adult HIV/AIDS Case Report form or instructions
online:
Form:
http://www.michigan.gov/documents/Frm5042A_6861_7.pdf
Instructions:
http://www.michigan.gov/documents/CRFINST9-02_41194_7.pdf
Or navigate through the MDCH website:
www.michigan.gov/mdch
>Providers
>Departmental Forms
>Communicable Disease Case Definitions and History Forms:
Click on Form # “CDC 50.42A Adult HIV/AIDS” or “Instructions”
Finding Pediatric HIV/AIDS Case Report form or
instructions online:
Form:
http://www.michigan.gov/documents/frm5042b_6862_7.pdf
Instructions:
http://www.michigan.gov/documents/PEDCRF9-02_41195_7.pdf
Or navigate through the MDCH website:
www.michigan.gov/mdch
>Providers
>Departmental Forms
>Communicable Disease Case Definitions and History Forms:
Click on Form # “CDC 50.42B Pediatric HIV/AIDS” or “Instructions”
Finding DCH-1221 Confidential Request for Local Health
Department Assistance for Partner Counseling & Referral Services online:
https://www.hapis.org/dc/PublicPages/DCH1121.pdf
Or navigate through the HAPIS website:
www.hapis.org
Scroll down beyond the username and password boxes.
Under “Partner Counseling & Referral Services Material, click:
“Confidential Request for LHD Assistance for PCRS (Obsoletes Form HP-139)”
Finding the Michigan Communicable Disease Rules online:
http://www.state.mi.us/orr/emi/admincode.asp?AdminCode=Single&Admin_Num=32500171&Dpt=CH&RngHigh=
Or navigate through the MDCH website:
www.michigan.gov/mdch
>Providers
>Communicable and Chronic Diseases
>Communicable Disease Reporting in Michigan
Click on “Michigan Communicable Disease Rules”
MDCH HIV/AIDS Surveillance Section Special Reports/Projects
MDCH Staff Co-authored Research
Quality of Care for
HIV Infection Provided by Ryan White Program-Supported versus Non-Ryan White
Program- Supported Facilities
Patrick S. Sullivan1,2*, Maxine Denniston1,
Eve Mokotoff3, Susan Buskin4,
Stephanie Broyles5, A. D.
McNaghten1
Special Reports and Publications
Young
Men who Have Sex with Men (YMSM) Survey
[In June]
we released our annual review of trends in HIV in Michigan
as well as in Southeast Michigan and
Detroit. Increases among YMSM were noted in both reports.
In SE Michigan we reported on increases among
teens for the fifth consecutive trend report; 85% of newly diagnosed teens were
black, compared to 60% of those aged 20+ and 62% of these newly diagnosed teens
were Black MSM. These trends show an ongoing large increase in HIV among black
male teenagers who have sex with other males.
As a result of seeing this troubling trend in previous annual trend reports we
consulted with partners and in 2009 conducted a survey among teenage MSM in the
City of Detroit.
The results, available in this summary report, provide a glimpse into the
possible risk behaviors of this population. In contrast to non-behavioral
surveillance work that the HIV Surveillance Program conducts, this survey was
conducted among a primarily uninfected population although we did offer HIV
testing to these youth.
This report can be accessed on the State of
Michigan HIV/STD website at:
http://www.michigan.gov/documents/mdch/DET_YMSM_06292010_326598_7.pdf
HIV/Syphilis
Co-Infection Trends 2008-2009 Increase Among MSM
Michigan
did not report significantly more syphilis cases in 2009 compared to 2008;
however, there was a significant increase in male cases, especially men who have
sex with men (MSM) and HIV co-infected males. Syphilis infections increase the
likelihood of acquiring and spreading HIV infection two to five fold. Increases
in syphilis among HIV+ MSM may be attributed to prevention fatigue, serosorting,
a high rate of anonymous partners met on the Internet among some MSM and
prevention messages not reaching marginalized populations.
Please see analysis at:
http://www.michigan.gov/documents/mdch/HIVSyphilis2008_June2010_328039_7.pdf
Review
of Trends in HIV between 2004 and 2008
The
first document covers the State of Michigan. The second one includes both an
overview of trends in Southeast Michigan as well as a two page fact sheet
focused on the City of Detroit.
-
http://www.michigan.gov/documents/mdch/MIReport10_Final_325200_7.pdf
-
http://www.michigan.gov/documents/mdch/SEMI_DetReport10_Final_325201_7.pdf
Key Findings from the
Michigan
Trend Report 2004-2008
Ř
Rates and numbers of new HIV diagnoses decreased in
Michigan.
o
We cannot say whether the overall decrease or any of the subgroup
decreases are due to prevention successes or mirror the population decreases
between 2004 and 2008.
Ř
Increases were noted among teens for the 5th consecutive trend
report and 85% of newly diagnosed teens are black, compared to 60% of those aged
20+. 62% of these newly diagnosed teens were Black MSM.
o
These trends show an ongoing large increase in HIV among black male
teenagers who have sex with other males.
Ř
There were decreases among IDUs-the 5th consecutive report to show
this trend-and black females.
o
We are seeing continued success at decreasing HIV among IDUs. Black
females and heterosexuals showed decreases for the first time.
Ř
Concurrent diagnoses decreased among black males, all males, and
overall for the 2nd consecutive trend report.
o
These decreases are very positive and not directly related to
population decreases. These trends suggest earlier and probably more frequent
HIV testing.
Ř
There were increases among black MSM for the third consecutive
report, and decreases among white MSM for the second consecutive report.
o
Figure 3 in the report shows how different the epidemic is among
black vs. white men who have sex with men. Prevention work needs to continue in
this heavily impacted group of men.
Key Findings from the
Southeast Michigan
Trend Report 2004-2008
Ř
The number of new HIV diagnoses in
Southeast
Michigan decreased while the rate remained stable.
o
A stable rate in a decreasing population suggests that the impact
of the disease on the population is level or increasing.
Ř
Increases were noted among teens for the 5th consecutive
trend report.
Ř
Decreases were seen in
Detroit and
increases observed in
Macomb
County for the 2nd
consecutive trend report.
o
These trends mirror the population shifts in
Southeast Michigan and may be the cause of them.
Ř
There were decreases among IDUs-the 5th consecutive report to show
this trend-and heterosexuals.
Ř
Decreases were observed among white males, black females and whites
overall.
Ř
Concurrent diagnoses decreased among all males and overall for the
2nd consecutive trend report.
Estimate of Recent HIV
Infections
A new method of estimating new HIV infections released by the Centers
for Disease Control and Prevention (CDC) in August revealed that an estimated
56,300 people were infected with HIV in the United States in 2006. Michigan was
among the 22 states and cities that contributed data for the estimate, and our
rate was the lowest at 10 per 100,000 Michiganians newly infected in 2006 – less
than half the national rate of 23 per 100,000. The sex, race, age and risk
breakdowns of the national estimate are being released this week in the Sept.
12, 2008 CDC publication, Morbidity and Mortality Weekly Report. See the entire
MDCH Press Release (9/11/08)
Annual Review of HIV Trends in the Detroit Metro Area
At the end of May, MDCH sent out the Annual Review of HIV Trends in
Michigan*. The companion document, Annual Review of HIV Trends in the Detroit
Metro Area, is now complete and both are available on the web at:
http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982_46000_46003-36304--,00.html
*NOTE: The version of the Statewide review sent out in May had an error in Table
2, New HIV Diagnoses by Race/Sex as well as a typo on the final summary page. If
you saved and/or printed that document please replace it with the one found at
the link above.
Find both the latest Metro Detroit Trends and the Updated Michigan Trends
reports at the MDCH website
Annual Review of HIV Trends
in Michigan 2002-2006
Key findings are:
-
Adolescent
and young adult diagnoses (13-24 year olds) have increased for the third
consecutive year.
-
Three
quarters of newly diagnosed adolescents and young adults are black compared
with 59% of persons diagnosed at older ages.
-
13-24 year
olds are much more likely to be black MSM compared with those diagnosed at
older ages - 48% vs 19%.
-
New
diagnoses among MSM increased by an average of 4% per year 2002-2006.
-
New
diagnoses among IDUs decreased by an average 7% per year 2002-2006.
-
An average
of 890 persons were diagnosed with HIV each year from 2002-2006.
-
New HIV
diagnoses are highest among MSM, black men, 25 -44 year olds and residents
of SE Michigan.
The Adult
and Adolescent Spectrum of Disease (ASD) project
was a supplemental
surveillance project sponsored by the Centers for Disease Control and Prevention
(CDC) to learn more about the disease status of HIV-infected persons. Health
departments in eleven U.S. cities, including Detroit, collected data for a
period of 14 years, 1990-2003. The data from ASD formed the basis for the
revision of the AIDS surveillance case definition in 1993 to include CD4+
T-cell count <200 cells/mm3 as an AIDS-defining event. In the
following years, 1994-2003, ASD continued to track developments in the natural
history of HIV infection, such as the improved health status of HIV-infected
persons following introduction of more effective therapies for HIV and for
opportunistic illnesses, the side-effects of these therapies, and the rise of
liver disease in persons co-infected with HIV and hepatitis. The
report summarizes the
Detroit ASD data. It will also be posted on
www.michigan.gov/hivstd in the near future.
Mokotoff ED, Glynn MK. Surveillance
for HIV/AIDS in the United States.
Chapter 16 in Infectious Disease
Surveillance. Editors: Mikanatha N,
Lynfi eld R, Van Beneden CA, deValk H.
Blackwell Publishers 2007.
McNaghten, A, Wolfe, M, Onorato, I
Nakashima, A, Valdiserri, R, Mokotoff,
E, Romaguera, R, Kroliczak, A
Janssen, R, and Sullivan, P.
Improving
the Representativeness of Behavioral
and Clinical Surveillance for Persons
with HIV in the United States: The
Rationale for Developing a Population-
Based Approach. PLoS ONE. 2007 July
6(e550).
http://www.plosone.org/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1371%2Fjournal.pone.0000550
Characteristics of Persons With Recently Acquired HIV Infection:
Application of the Serologic Testing Algorithm for Recent HIV Seroconversion in
10 US Cities
J Acquir Immune Defic Syndr. 2007;44(1):112-115. ©2007 Lippincott Williams &
Wilkins
Posted 03/14/2007
http://www.medscape.com/viewarticle/551828_print
This reported research on the
serologic testing algorithm for recent HIV
seroconversion (STARHS) project. STARHS is a relatively
new testing strategy that can distinguish persons whose
HIV infection was acquired, on average, in the past 6
months from those who have been HIV infected longer.
Using data collected as part of a multisite (including
Detroit) study of primary HIV drug resistance, the researchers compared the
characteristics of persons whose HIV diagnosis was made within 6 months of
acquiring HIV infection with characteristics of persons whose HIV diagnosis was
made more than 6 months after infection.
Authors of the study included Garald Goza, MS, Manager, HIV/STD & Bloodborne
Infections Surveillance Section, Michigan Department of Community, Health.
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