MicroBio 160 1st Edition Lecture 26 Outline of Last Lecture I II Testing for HIV What do CD4 Cell Counts Mean III Purpose of Viral Load Tests IV Routine Tests V VI VII VIII IX X XI XII XIII Interventions Against HIV Goals of HIV Treatment Major Classes of Anti retroviral Drugs Combination Therapy HAART Combinations Atripla Mother to Child Transmission MTCT Goals Quality of Life Issues When is it time to Change Therapies Outline of Current Lecture I II Facts Diagnosis of HIV infection III Persons Living with Diagnosed or Undiagnosed HIV infection HIV Care Continuum Outcomes IV The Public s Experience with HIV Testing V VI VII Facts Worldwide Different Countries Experiences Another Success Story These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute VIII AIDS Orphans Current Lecture Facts in the US Since the epidemic began an estimated 1 155 792 people in the United States have been diagnosed with AIDS Approximately 636 000 of those people have died Currently 1 201 100 persons aged 13 years and older are living with HIV infection and almost 1 in 7 14 are unaware of their infection Gay bisexual and other MSM particularly young black African American MSM are most seriously affected by HIV By race blacks African Americans face the most severe burden of HIV Diagnosis of HIV Infection and Population by Race Ethnicity 2013 US Diagnosis of HIV infection The pie chart on the left illustrates the percentage distribution of diagnoses of HIV infection in 2013 by race ethnicity in the United States The pie chart on the right shows the percentage distribution of the population in the United States by race ethnicity in 2013 In 2013 blacks African Americans made up approximately 12 of the population of the United States but accounted for 46 of diagnoses of HIV infection Whites made up 63 of the population of the United States but accounted for 28 of diagnoses of HIV infection Hispanics Latinos made up 17 of the population of the United States but accounted for 21 of diagnoses of HIV infection Diagnosis of HIV Infection and Population among Adolescents by Race Ethnicity 2011 Black African American adolescents aged 13 to 19 years have been disproportionately affected by HIV In 2011 in the United States 15 of adolescents were black African American yet an estimated 67 of diagnoses of HIV infection in 13 to 19 year olds were in black African American adolescents AIDS Classifications among Persons Aged 13 years and older with HIV Infection by Race Ethnicity and Age Group 2011 US and 6 Dependent Areas This slide compares the racial ethnic percentage distributions of stage 3 AIDS classifications in adolescents 13 19 years of age young adults 20 24 years of age and adults 25 years and over diagnosed during 2011 in the United States and 6 dependent areas o In all three age groups blacks African Americans had the largest percentage of stage 3 AIDS classifications although the percentage decreased as age group increased 66 in persons aged 13 to 19 years 64 in persons aged 20 to 24 years and 48 in persons aged 25 years and over o Hispanics Latinos accounted for relatively similar percentages of stage 3 AIDS classifications in all three age groups they represented the second largest percentage of persons 13 19 years 21 and persons 20 24 years 18 and the third largest percentage of persons among adults over 25 years of age 21 The percentage of stage 3 AIDS classifications among whites in 2011 increased as age group increased 10 in persons aged 13 to 19 years 13 in persons aged 20 to 24 years and 27 in persons aged 25 years and over Persons Living with Diagnosed or Undiagnosed HIV infection HIV Care Continuum Outcomes 2009 2010 2011 US and Puerto Rico Four HIV care continuum outcomes HIV diagnosis based on data from the National HIV Surveillance System and receipt of HIV medical care antiretroviral prescription and viral suppression the denominator is the estimated number of persons aged 13 years with diagnosed or undiagnosed HIV infection in the United States Percentages of persons who were diagnosed with HIV infection received HIV medical care were prescribed ART and who achieved viral suppression were relatively stable from 2009 to 2011 National HIV Surveillance System Estimated number of persons aged 13 years with diagnosed or undiagnosed HIV infection denominator who were alive at the end of the specified year estimated number of persons aged 13 years with diagnosed HIV infection numerator who were alive at the end of the specified year calculated as part of the overall prevalence estimate Medical Monitoring Project Estimated number of persons aged 18 years who received HIV medical care January to April of the specified year whose medical record contained documentation of antiretroviral therapy prescription or whose most recent VL in the previous 12 months was undetectable or 200 copies mL United States and Puerto Rico Diagnosis of HIV infection among Children aged 13 years by age at diagnosis 2008 2011 US and 6 Dependent Areas During 2008 through 2011 in the United States and 6 dependent areas approximately 36 of children aged 13 years diagnosed with HIV infection were diagnosed within the first year of life and 30 within the first 6 months This distribution could change if more HIV infected childbearing women become aware of their HIV status and seek medical care early in their pregnancy The Public s Experience with HIV Testing 14 of individuals that have HIV or AIDS do not know they are infected 48 have been tested either in the last 12 months or more 50 have never been tested Facts Worldwide There were 35 0 million people living with HIV in 2013 up from 29 8 million in 2001 the result of continuing new infections people living longer with HIV and general population growth The global prevalence rate the percent of people ages 15 49 who are infected has leveled since 2001 and was 0 8 in 2013 1 5 million people died of AIDS in 2013 a 35 decrease since 2005 Deaths have declined due in part to antiretroviral treatment ART scale up o HIV is a leading cause of death worldwide and the number one cause of death in Africa New HIV infections globally have declined by 38 since 2001 In 27 countries with sufficient quality data new HIV infections have decreased by more than 50 and by more than 75 in 10 countries o There were about 2 1 million new infections in 2013 This means there are about 6 000 new infections per
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