The Georgia Department of Public Health Trends in HIV Diagnoses in Georgia: 2010-2016 This fact sheet describes trends in HIV diagnoses in Georgia between 2010 and 2016 by sex, transmission category, race/ethnicity and age. The figures in this report are based on HIV cases diagnosed through December 31, 2016, and reported through December 2017. Technical Notes Overall, approximately 30% of Georgia HIV cases are missing risk information. Multiple imputation (MI) is used in this report to assign a risk to each person. MI is a statistical approach in which each missing transmission category with a set of plausible values that represent the uncertainty about the true, but missing, value.1 Transmission categories presented here follow the standards created by the Centers for Disease Control and Prevention (CDC). Transmission category is the term for the classification of cases that summarizes a person's possible HIV risk factors. The summary classification results from selecting the one most likely risk factor to have been responsible for HIV transmission from the presumed hierarchical order of probability. For more information, see HIV Surveillance Summary, Georgia 2016. 1. Harrison KM, Kajese T, Hall HI, Song R. Risk factor redistribution of the national HIV/AIDS surveillance data: an alternative approach. Public Health Rep 2008;123:61827. HIV Diagnoses by Gender, Georgia, 2010-2016 2500 Number of Cases 2000 1500 1000 500 Gender Male Female Transgender 0 2010 2011 2012 2013 2014 2015 2016 Year of Diagnosis Since 2010, the annual number of diagnoses among men has remained fairly stable, and has declined among women. The number of diagnoses among transgender persons is low, with 2030 per year since 2010. This low figure reflects limitations of surveillance data in ascertainment of transgender status, which depends upon information reported by providers. 2 Peachtree Street, Atlanta, Ga 30303 | health.state.ga.us February 2018 TRENDS IN HIV DIAGNOSES IN GEORGIA: 2010-2016 HIV Diagnoses among Males, by Transmission Category, Georgia, 2010-2016 2000 1500 1000 500 0 2010 2011 2012 2013 2014 2015 2016 Year of Diagnosis MSM IDU MSM/IDU Het Among males, men who have sex with men (MSM) have consistently accounted for the great majority of newly diagnosed HIV cases. Diagnoses among MSM have remained fairly stable since 2010. The annual number of new diagnoses among heterosexual contacts (HET) has increased slightly since 2012, while the number among persons with a history of injection drug use (IDU) and among MSM/IDU has declined. Number of Cases HIV Diagnoses among Females, by Transmission Category, Georgia, 2010-2016 700 600 500 400 300 200 100 0 2010 2011 2012 2013 2014 Year of Diagnosis 2015 2016 Transmission Category IDU HET Among females, women infected through heterosexual contact have consistently accounted for the majority of new diagnoses. The number of annual cases has declined for both heterosexual contacts and for IDU. TRENDS IN HIV DIAGNOSES IN GEORGIA: 2010-2016 Number of Cases HIV Diagnoses among MSM, by Race/Ethnicity, Georgia, 2010-2016 1400 1200 1000 Race/Ethnicity 800 Black/Non Hispanic 600 White/Non Hispanic 400 200 0 2010 2011 2012 2013 2014 2015 2016 Hispanic, Any Race Other/Unknown Year of Diagnosis Between 2010 and 2016, the annual number of new HIV diagnoses has remained fairly stable for Black MSM, it has increased for Hispanic MSM, and declined for White MSM. Number of Cases 800 700 600 500 400 300 200 100 0 2010 HIV Diagnoses among Black MSM, by Age Group, Georgia, 2010-2016 2011 2012 2013 2014 Year of Diagnosis 2015 2016 Age Group (years) 13-19 20-29 30-39 40-49 50-59 60+ Number of Cases 70 60 50 40 30 20 10 0 2010 HIV Diagnoses among Hispanic MSM, by Age Group, Georgia, 2010-2016 2011 2012 2013 2014 Year of Diagnosis 2015 2016 Age Group (years) 13-19 20-29 30-39 40-49 50-59 60+ TRENDS IN HIV DIAGNOSES IN GEORGIA: 2010-2016 Number of Cases 120 100 80 60 40 20 0 2010 HIV Diagnoses among White MSM, by Age Group, Georgia, 2010-2016 2011 2012 2013 2014 Year of Diagnosis 2015 2016 Age Group (years) 13-19 20-29 30-39 40-49 50-59 60+ Among Black MSM aged 20 to 29 years, annual new HIV diagnoses increased between 2010 and 2016. During the same time, diagnoses remained stable for men aged 30-39 years, and declined for men aged 40-59 years. Among Hispanic MSM, the annual number of new HIV diagnoses increased for men aged 20-29 years between 2012 and 2016, and remained fairly stable in other age groups. Among White MSM, new diagnoses declined between 2010 and 2016 among men age 40-49, and remained fairly stable among other age groups. Number of Cases HIV Diagnoses among Males with a History of Injection Drug Use, by Age Group, Georgia, 2010-2016 35 30 25 20 15 10 5 0 2010 2011 2012 2013 2014 Year of Diagnosis 2015 Age Group (years) 13-19 20-29 30-39 40-49 50-59 60+ 2016 TRENDS IN HIV DIAGNOSES IN GEORGIA: 2010-2016 Number of Cases Number of Cases HIV Diagnoses among Females with a History of Injection Drug Use, by Age Group, Georgia, 2010-2016 Age Group 20 (years) 15 13-19 20-29 10 30-39 5 0 2010 2011 2012 2013 2014 Year of Diagnosis 2015 2016 40-49 50-59 60+ HIV Diagnoses among MSM with a History of Injection Drug Use, by Age Group, Georgia, 2010-2016 45 Age Group (years) 40 35 13-19 30 20-29 25 20 30-39 15 40-49 10 5 50-59 0 60+ 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Year of Diagnosis The annual number of HIV diagnoses among heterosexual men and among women with a history of drug injection declined overall between 2010 and 2016. The number of HIV diagnoses among men and women aged 20-29 years shows some increases in 2014-2016, but given the small number of diagnoses, it is too early to determine if this represents a true increase. Diagnoses of hepatitis C among persons aged less than 30 years, an early indicator of unsafe injection practices, have also increased (based on unpublished data reported through the State Electronic Notifiable Disease Surveillance System (SendSS). The annual number of HIV diagnoses among MSM who have a history of drug injection declined overall between 2010 and 2016, but small increases were observed between 2014 and 2016. TRENDS IN HIV DIAGNOSES IN GEORGIA: 2010-2016 HIV Diagnoses Attributed to Heterosexual Contact among Females, by Age Group, Georgia, 2010-2016 200 Age Group (years) 150 13-19 20-29 100 30-39 50 0 2010 2011 2012 2013 2014 2015 2016 40-49 50-59 60+ Year of Diagnosis Number of Cases Number of Cases HIV Diagnoses Attributed to Heterosexual Contact among Males, by Age Group, Georgia, 2010-2016 Age Group 70 (years) 60 13-19 50 20-29 40 30 30-39 20 40-49 10 0 2010 2011 2012 2013 2014 2015 2016 50-59 60+ Year of Diagnosis The annual number of new HIV diagnoses has declined among women aged 20-49 years with infection attributed to heterosexual transmission, and has remained fairly stable for women 50 years and older. Among men, the annual number of new HIV diagnoses was fairly stable by age, with some increases observed between 2012 and 2015 in men aged 20-29 years. Given that the same increase was not seen in women, this increase is most likely an artifact related to incorrect application of the surveillance definition for heterosexual contact, potentially as a result of new data sources utilized starting 2013 to ascertain transmission category. TTRREENNDDSS IINN HHIIVV DDIIAAGGNNOOSSEESS IINN GGEEOORRGGIIAA:: 22001100--22001166 HIV/AIDS Surveillance Georgia DPH began collecting name based data on AIDS cases in the early 1980's. Name based reporting of HIV (not AIDS) to DPH was mandated by Georgia law beginning on December 31, 2004. Complete and timely reporting of HIV infections by clinical providers and laboratories is critical for monitoring the epidemic and ensuring adequate funding for prevention and care services in Georgia. Race, sex and especially transmission category information are missing for a large number of HIV case report forms submitted in Georgia. In 2013, 71% of new cases with HIV infection among adults and adolescents had no information on their transmission category. Incomplete reporting leads to underestimation of the impact of HIV in Georgia and limits funding for services among HIV populations. HIV Reporting All health care providers diagnosing and/or providing care to a patient with HIV are obligated by Georgia law (O.C.G.A. 31-121) to report HIV infection using the HIV/AIDS Case Report Form to the Georgia Department of Public Health. Case report forms should be completed within seven (7) days of diagnosing a patient with HIV and/or AIDS or within seven (7) days of assuming care of an HIV positive patient who is new to the provider, regardless of whether the patient has previously received care elsewhere. Adult and Pediatric case report forms are available at http://dph.georgia.gov/reporting-formsdata-requests For more questions on HIV case reporting in Georgia please contact the HIV Surveillance Coordinator at 1-800-827-9769 Acknowledgements: Publication of this report would not have been possible without the hard work and contribution of the Core Surveillance Unit, HIV Epidemiology Section, Epidemiology Program, Division of Health Protection, and Georgia Department of Public Health. We would like to thank Lauren Barrineau-Vejjajiva, Thelma Fannin, Rodriques Lambert, Mildred McGainey, Latoya Moss, Rama Namballa, A. Eugene Pennisi, Emory Searcy, Akilah Spratling, and Gerriana Williams. This report was prepared by Brian Huylebroeck, MSPH, Pascale Wortley, MD, MPH and Cherie Drenzek, DVM, MS. The HIV Transmission Category Fact Sheet is published by the Core Surveillance Unit, HIV/AIDS Epidemiology Section, Epidemiology Program, Division of Health Protection, and Georgia Department of Public Health. It is not copyrighted and may be used and reproduced without permission. Citation of the source is appreciated. Suggested citation: Georgia Department of Public Health. Trends in HIV Diagnoses, Georgia, 2010-2016 http://dph.georgia.gov/georgias-hivaids-epidemiology-surveillance-section. Published March 2018, Accessed [date]