1995-1997 GEORGIA STD/HIV REPORT
Georgia Department of Human Resources

Division of Public Health . . . . . . . . . . . . . Kathleen E. Toomey, M.D., M.P.H.-- Director

Epidemiology and Prevention Branch . . . Kathleen E. Toomey, M.D., M.P.H.-- Acting Director
Epidemiology Section . . . . . . . . . . . . . . . Paul Blake, M.D., M.P.H.-- Chief STD/HIV Epidemiology Unit . . . . . . . . . John Beltrami, M.D., M.P.H. & T.M.-- Chief
Roger Davis Project Assistant

Lyle McCormick, M.P.H AIDS Data Manager and Statistician
Mildred McGainey AIDS Surveillance Technician

Andrew Margolis, M.P.H. STD Data Manager
Ann Buckley, M.P.H. Chlamydia Project Data Manager
Julienne Sajous Secretary

Acknowledgments

District AIDS liaisons, District STD coordinators, Alan Fann, M.Sc. (Grady Infectious Disease Program), Mark V. Schrader, M.P.A. (Chief, STD/HIV Program Section), and Jimmy Clanton, Jr. (Visual Information Specialist, Epidemiology and Prevention Branch)

Publication Document Tracking Number

DPH98.67HW

TABLE OF CONTENTS

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AIDS Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HIV Seroprevalence Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fulton and DeKalb County STD clinics . . . Fulton County drug treatment clinic . . . . . . Rural Georgia hospitals . . . . . . . . . . . . . . .. Supplement to HIV/AIDS Surveillance (SHAS) Project . . . . . . . . . . . . . Adult/Adolescent Spectrum of HIV Disease (ASD) Project . . . . . . . . . . STD Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Syphilis . . . . . . . . . . . . . . . . . . . . . . . . . . Gonorrhea . . . . . . . . . . . . . . . . . . . . . . . . . . Chlamydia . . . . . . . . . . . . . . . . . . . . . . . . . Chlamydia Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gonococcal Isolate Surveillance Project (GISP) . . . . . . . . . . . . . . . . . . . .

Page 3 Page 6 - 23 Page 24 Page 25 - 30 Page 31 - 33 Page 33 - 36 Page 37 - 40 Page 41- 43 Page 44 Page 45 - 59 Page 59 - 70 Page 71 - 82 Page 83 - 86 Page 87 - 89

2

INTRODUCTION
Purpose of Report
The purpose of this report is to a) provide information on the human immunodeficiency virus (HIV), the acquired immunodeficiency syndrome (AIDS), and sexually transmitted diseases (STDs), b) show the interrelatedness of HIV/AIDS with STDs and drug use, c) inform persons who are infected and affected by these conditions, and d) inform health care providers, public health workers, and policy makers who are responsible for the control, prevention, and reporting of these diseases.
Because Ryan White funding, Housing Opportunities for Persons with AIDS (HOPWA) funding, the HIV Prevention Community Planning process, public health policy, and various grant proposals are based

on data, the information in this report is extremely important and useful. This report contains data which have been confidentially released to a) acquire and distribute federal Ryan White and HOPWA funds to persons infected and affected by HIV/AIDS, b) acquire and distribute federal funds to sponsor HIV prevention activities conducted by community-based organizations, c) help make public health policy at the national, state, and local levels, d) support grant proposals from several organizations, and e) complete hundreds of data requests each year.

Editorial Notes

1) Data in this report may change over time due 6) Forthisreport,metropolitanAtlantaincludes

to reporting delays and quality assurance

8 counties: Clayton, Cobb, DeKalb,

activities.

Douglas, Fulton, Gwinnett, Newton, and

Rockdale.

2) Thepopulationsusedtocalculateratesinthis

report are estimates from the Epidemiology 7) Abbreviations and terminology used in this

and Prevention Branch, Center for Health

report include a) "IDU" for injection drug

Information.

use, b) "MSM" for men who have sex with

men (bisexual and homosexual), c) "pediat-

3) Rates based on small numerators (i.e.,

ric" for persons less than 13 years old, d)

number of cases) or denominators (i.e.,

"adolescents and adults" for persons at least

population) may not be accurate.

13 years old, e) "SHAS" for the Supplement

to HIV/AIDS Surveillance Project, f)

4) As with most public health surveillance

"ASD" for the Adult/Adolescent Spectrum

systems, the interpretation of data is limited

of Disease Project, and g) "CAGE" for 4

by incomplete reporting.

questions related to alcohol (i.e., Have you

ever felt you should cut down on drinking?,

5) Because of the protocols used for the HIV

Have people annoyed you by criticizing your

seroprevalence surveys, some of the data

drinking?, Have you ever felt bad or guilty

from these studies represent persons who

about your drinking?, and Have you ever had

have visited the same facility in different

a drink first thing in the morning to steady

years.

your nerves or rid yourself of a hangover?).

3

Overview of Current HIV/AIDS and STD Epidemiology in Georgia

In the last few years, Georgia has ranked in the top 10 among all states for AIDS, syphilis, gonorrhea, and chlamydia. In 1997, the most frequently reported infectious diseases in Georgia were gonorrhea, chlamydia, syphilis, and AIDS.
AIDS surveillance: As of 12/31/97, there were 18,652 cumulative cases of AIDS reported in Georgia. The number of cases reported in the state increased each year from 1981 to 1996, followed by a decrease in 1997. The number of persons living with AIDS has increased each year since 1981, whereas the number of AIDS deaths has been decreasing in recent years. The recent decrease in deaths and reported cases has been attributed to the successes of new antiretroviral medications, which delay the progression of an HIV-infected person to AIDS. The AIDS epidemic remains significant in MSMs and those who use drugs, and continues to rise among women, minorities, heterosexuals, and persons living in small cities and rural areas. Young adults 20 to 29 years old account for 21% of all AIDS cases reported in the state. Because AIDS may not occur for an average of 8 to 10 years after HIV infection, most of these young persons are likely to have been infected during adolescence. Pediatric AIDS cases have decreased since 1994, which likely reflects the effectiveness of antiretroviral medications given to pregnant women and newborns to reduce perinatal HIV transmission.
HIV seroprevalence surveys in STD clinics: After a gradual decrease in HIV seropositivity from 1992 to 1994, the percentage of persons testing HIV positive at the Fulton and DeKalb STD clinics increased from 2.9% in 1995 to 4.1% in 1997. For each year from 1992 to 1997, the percent of persons testing HIV positive has been higher in the Fulton STD clinic than in the DeKalb STD clinic.
HIV seroprevalence survey at the Fulton County Alcohol and Drug Treatment Center: Data presented from this survey are from persons
4

being treated primarily for cocaine use. For each year from 1990 to 1996, the percent of persons testing HIV positive increased, from 9% in 1990 to 13.9% in 1996; in 1997 the percent was 11.4%.
HIV seroprevalence surveys in five hospitals in rural Georgia: For each year from 1993 to 1997, the percent of persons testing HIV positive overall has been between 1.0% and 1.5%, and in African American males, between 4.0% and 5.6%.
Supplement to HIV/AIDS Surveillance (SHAS) Project: SHAS has been conducted at the Grady Infectious Disease Clinic (Grady IDC) since 1990, and in the Albany and Waycross Health Districts from 1995 to 1996. For this report, data from the SHAS interviews represent questions about sexual and drug use behaviors. The percent of persons at Grady IDC who reported having ever used crack increased from 14% in 1990 to 42% in 1997, and the percent of persons reporting at least one visit to a doctor or clinic for an STD was at least 50% each year between 1990 and 1997. Data from persons interviewed in the Albany and Waycross Health Districts show that reported alcohol and drug use and inconsistent condom use were common, and in some instances more frequent than in persons interviewed at Grady IDC.
Adult/Adolescent Spectrum of Disease (ASD) Project: For this report, data from ASD include information abstracted from the medical records of HIV-infected persons at the time of enrollment. Of 8,119 persons enrolled from 1989 to 1997, 57% had AIDS, 43% were HIV-infected (non-AIDS), 52% were from Grady IDC, 38% were from private medical offices in Atlanta, and 10% were from the Infectious Disease Clinic at the Atlanta Veterans Administration Hospital (VA IDC).
STD surveillance: For each year from 1995 to 1997, the numbers of reported cases of syphilis and gonorrhea have been decreasing, in contrast to the

increasing number of reported cases of chlamydia. Part of the increase in reported chlamydia is due to the expansion of the number of sites in Georgia that screen and treat for chlamydia. Despite the decrease of syphilis and gonorrhea, more than 13,000 young persons 10 to 19 years old were reported with an STD in 1997.
Chlamydia Project: In 1997, the Chlamydia Demonstration Project was conducted in 43 Family Planning clinics and 8 STD clinics throughout Georgia. Of the more than 28,000 women screened, 6.5% had chlamydia. Of the 248 pregnant women screened, 12% had chlamydia.

Data requests can be directed to:
Roger Davis GA Dept. of Human Resources STD/HIV Epidemiology Unit 2 Peachtree Street, NW 6th Floor, Room 6-407 Atlanta, GA 30303-3186 Phone: 404-657-2604 Fax: 404-657-2586 Email: RAD@DHR.STATE.GA.US

Gonococcal Isolate Surveillance Project (GISP): GISP has been conducted at the Fulton County STD clinic since 1988. Of the 202 males diagnosed with gonorrhea in 1997, there was no antimicrobial resistance to ceftriaxone or spectinomycin, the two antibiotics used to treat gonorrhea in these 202 males.

Comments or questions about this report can be directed to Dr. John Beltrami: Phone: 404-657-2601, Fax: 404-657-2586, Email: JXB0600@DHR.STATE.GA.US

5

AIDS Surveillance
6

AIDS Cases and Rates by Year of Report Georgia, 1983-1997

Number of cases 2500

Rate 40

35

2000 30
Number of cases Rate*

1500

25

20

1000

15

10 500
5

0

0

83 84 85 86 87 88 89 90 91 92 93 94 95 96 97

Number of cases 29 66 174 329 544 825 1156 1232 1530 1960 2011 2380 2276 2424 1716 Rate* 0.5 1 3 5 9 13 18 19 23 29 29 34 32 34 23

* Rate = cases/100,000 population

AIDS Cases by Year of Report and Year of Diagnosis Georgia, 1981 - 1997
Number of cases 2500

2000 1500

Year of Report Year of Diagnosis

1000

500

0 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Year of Report 3 7 29 66 174 329 544 825 1156 1232 1530 1960 2011 2380 2276 2424 1716 Year of Diagnosis 10 15 48 111 241 430 728 998 1208 1592 1866 2051 2158 2203 2121 1875 1218

7

Persons Living with AIDS by Year Georgia, 1984 - 1997
Number of cases (Thousands) 10

8

6

4

2

0
Cases

84 85 86 87 88 89 90 91 92 93 94 95 96 97
0.104 0.217 0.417 0.796 1.265 1.762 2.475 3.309 4.214 5.282 6.514 7.158 7.906 8.544

AIDS Case Fatality Rates by Year of Diagnosis Georgia, 1983 - 1997
Case fatality rate 100
80
60
40
20
0 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Percent deceased 96.5 93.9 96 90.3 89.9 87.4 83.6 81.7 74.4 64.4 55.2 45.1 36.2 19.8 14.3
8

AIDS Deaths by Year Georgia, 1981 - 1997
Number of deaths* 1600 1400 1200 1000
800 600 400 200
0 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Deaths 1 7 17 56 130 226 354 525 707 892 1037 1155 1087 970 1465 1155 525
* Does not include cases with unknown dates of death

AIDS Cases by Age Group at Diagnosis and Year of Report Georgia, 1990-1997

Percent of cases 60

50

40

30

20

10

0
13-19 20-29 30-39 >= 40

1990
0.5 22.8 49.4 27.3

1991
0.5 21.3 47.8 30.4

1992
0.5 22.6 48.3 28.7

1993
1 23.8 43.2 32.1

1994
0.7 20.2 47.6 31.5

1995
0.5 18.8
48 32.6

1996
0.8 17 47.9 34.4

1997
0.5 16.4 46.6 36.4

13-19 20-29 30-39 >= 40

9

AIDS Cases in Women by Year of Report Georgia, 1983-1997

Number of cases 500

Percent of all cases 25

400

20

Number of cases

Percent of all cases

300

15

200

10

100

5

0

0

83 84 85 86 87 88 89 90 91 92 93 94 95 96 97

Number of cases 2 1 7 19 31 51 89 121 179 264 301 412 415 451 355

Percent of all cases 0.1 0 0.3 1 1 2 4 10 12 14 15 18 19 19 21

AIDS Cases by Race/Ethnicity and Year of Report Georgia, 1987-1997

Percent of all cases 100 80 60

White Black Hispanic Other

40

20

0

87 88 89 90 91 92 93 94 95 96 97

White 63

57

54

50

46

38

33

33

35

33

25

Black 36

41

45

49

52

61

65

65

62

65

72

Hispanic 1.7

1.7

1.2

1.2

1.5

1.7

1.6

1.4

2.9

2.2

2.5

Other 0

0.2

0.1

0

0.2

0.1

0.2

0.2

0.3

0.2

0.3

10

AIDS Cases by Mode and Year of Report Adults/Adolescents in Georgia, 1990-1997

Percent of all cases 70

60

50

40

30

20

10

0
MSM IDU
MSM&IDU Heterosexual
Other*

1990
63 16 7 7 7

1991
57 21 6 9 7

1992
51 22
8 11
8

MSM

1993
44 23 6 13 14

1994
43 22 6 13 16

1995
46 20
5 15 14

IDU

MSM&IDU

1996
43 17 4 16 20

Heterosexual Other*

*Other includes primarily "No identified risk" category

1997
39 19 4 18 20

AIDS Cases by Mode and Year of Report Male Adults/Adolescents in Georgia, 1990-1997

Percent of all cases 80

70

60

50

40

30

20

10

0 1990 1991

MSM 69

65

IDU 14

18

MSM&IDU

8

7

Heterosexual 3

4

Other* 6

6

1992
59 19
9 6 7

1993
52 20 7 7 14

1994
52 20 7 6 15

1995
56 18
6 8 12

1996
53 16 5 9 17

1997
49 18 5 10 18

MSM

IDU

MSM&IDU

Heterosexual Other*

*Other includes primarily "No identified risk" category

11

AIDS Cases by Mode and Year of Report Female Adults/Adolescents in Georgia, 1990-1997

Percent of all cases 60

50

40

30

20

10

0
IDU Heterosexual
Other*

1990
34 50 16

1991
41 41 18

1992
44 43 13

1993
38 45 17

1994
34 43 23

1995
28 47 25

1996
24 47 29

1997
24 47 29

IDU Heterosexual Other*

*Other includes primarily "No identified risk" category

Pediatric AIDS Cases by Year of Report Georgia, 1985-1997
Number of cases 40
30
20
10
0 85 86 87 88 89 90 91 92 93 94 95 96 97
Cases 1 6 9 11 7 9 12 22 10 38 29 18 3
12

Cumulative Pediatric AIDS Cases by Risk Category Georgia, 1981 - 1997

N=177 pediatric cases

41 22 13 9 3 3 0.6 4 1 4
Percent of all pediatric cases

AIDS Cases by Residence and Year of Report Georgia, 1990-1997
Percent of all cases 80

60

Metro Atlanta

40

Small cities*

Rural Areas

20

0 1990 1991 1992 1993 1994 1995 1996 1997
Metro Atlanta 75 75 66 64 67 65 67 67 Small cities* 12.5 10 18 16 14 13 13 12 Rural Areas 12.5 15 16 20 19 22 20 21
*Small cities: Albany, Athens, Augusta, Columbus, Macon, Savannah
13

Cumulative AIDS Cases by Public Health District Georgia, 1981 - 1997
Metropolitan Atlanta Area

AIDS Cases and Rates by Year of Report Rome (1-1) Health District, 1990-1997

Number of cases 100

Rate 10

80

8

60

6

Cases

Rate*

40

4

20

2

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 15

16

9

31

24

22

38

35

Rate* 4

4

2

7

6

5

9

8

*Rate = cases/100,000 population

14

AIDS Cases and Rates by Year of Report Dalton (1-2) Health District, 1990 -1997

Number of cases 100

Rate 10

80

8

60

6

Cases

Rate*

40

4

20

2

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 10

9

10

18

22

16

18

21

Rate* 4

4

4

7

9

6

7

8

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Gainesville (2-0) Health District, 1990 -1997

Number of cases 100

Rate 10

80

8

60

6

Cases

Rate

40

4

20

2

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 12

15

19

15

19

15

19

12

Rate 4

5

6

5

6

4

5

3

*Rate = cases/100,000 population

15

AIDS Cases and Rates by Year of Report Marietta (3-1) Health District, 1990 -1997

Number of cases 200

Rate 20

150

15

Cases

100

10

Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 59

56

73

54

89

77

118

63

Rate* 11

10

13

9

15

13

19

10

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Fulton (3-2) Health District, 1990 -1997

Number of cases 2000

Rate 200

1500 1000
500

150 Cases
100 Rate*
50

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 624 828 866 839 1032 991 1051 768

Rate* 96 126 131 125 153 145 152 110

*Rate = cases/100,000 population

16

AIDS Cases and Rates by Year of Report Clayton (3-3) Health District, 1990 -1997

Number of cases 200

Rate 40

150

30

Cases

100

20

Rate*

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 21

21

24

36

42

43

54

35

Rate* 12

11

13

19

21

21

26

17

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Gwinnett (3-4) Health District, 1990 -1997

Number of cases 200

Rate 20

150

15

Cases

100

10

Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 38

47

52

44

74

63

62

53

Rate* 9

10

11

9

14

11

11

9

*Rate = cases/100,000 population

17

AIDS Cases and Rates by Year of Report DeKalb (3-5) Health District, 1990 -1997

Number of cases 800

Rate 80

600

60

Cases

400

40

Rate*

200

20

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 180 202 281 312 356 307 336 227

Rate* 33

37

50

55

62

53

57

38

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report LaGrange (4-0) Health District, 1990 -1997

Number of cases 200

Rate 20

150

15

Cases

100

10

Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 20

33

46

53

60

79

70

66

Rate* 4

7

10

11

12

16

13

12

*Rate = cases/100,000 population

18

AIDS Cases and Rates by Year of Report Dublin (5-1) Health District, 1990 -1997

Number of cases 80

Rate 20

60

15

Cases

40

10

Rate*

20

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 6

6

6

12

13

11

15

7

Rate* 5

5

5

10

11

9

12

6

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Macon (5-2) Health District, 1990 -1997

Number of cases 250

Rate 25

200

20

150

15

Cases

Rate*

100

10

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 49

33

62

49

81

75

98

67

Rate* 12

8

15

11

19

17

22

15

*Rate = cases/100,000 population

19

AIDS Cases and Rates by Year of Report Augusta (6-0) Health District, 1990 -1997

Number of cases 400

Rate 40

300

30

Cases

200

20

Rate*

100

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 50

60

137 135 132 122 106

61

Rate* 13

15

35

34

33

30

26

15

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Columbus (7-0) Health District, 1990 -1997

Number of cases 400

Rate 40

300

30

Cases

200

20

Rate*

100

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 26

32

81

79

94

71

91

72

Rate* 8

10

23

23

27

21

26

21

*Rate = cases/100,000 population

20

AIDS Cases and Rates by Year of Report Valdosta (8-1) Health District, 1990 -1997

Number of cases 100

Rate 25

80

20

60

15

Cases

Rate*

40

10

20

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 6

9

6

12

41

38

46

30

Rate* 3

5

3

6

20

19

22

14

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Albany (8-2) Health District, 1990 -1997

Number of cases 200

Rate 40

150

30

Cases

100

20

Rate*

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 24

28

84

93

105

92

86

74

Rate* 8

9

26

29

32

28

26

22

*Rate = cases/100,000 population

21

AIDS Cases and Rates by Year of Report Savannah (9-1) Health District, 1990 -1997

Number of cases 300

Rate 60

250

50

200

40

Cases

150

30

Rate*

100

20

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 49

66

121 123

92

83

114

59

Rate* 20

27

48

48

36

32

43

22

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Waycross (9-2) Health District, 1990 -1997

Number of cases 200

Rate 40

150

30

Cases

100

20

Rate*

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 7

31

42

43

44

89

43

28

Rate* 3

11

15

15

16

31

15

10

*Rate = cases/100,000 population

22

AIDS Cases and Rates by Year of Report Brunswick (9-3) Health District, 1990 -1997

Number of cases 200

Rate 40

150

30

Cases

100

20

Rate*

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 16

23

24

44

50

28

33

23

Rate* 9

13

13

23

26

14

17

11

*Rate = cases/100,000 population

AIDS Cases and Rates by Year of Report Athens (10-0) Health District, 1990 -1997

Number of cases 200

Rate 20

150

15

Cases

100

10

Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 20

15

17

19

10

54

25

15

Rate* 8

5

6

7

3

18

8

5

*Rate = cases/100,000 population

23

HIV Seroprevalence
Surveys
Fulton and DeKalb County STD Clinics Fulton County Drug Treatment Clinic Rural Georgia Hospitals
24

Fulton and DeKalb County STD Clinics
Blinded HIV Seroprevalence Survey: Fulton & DeKalb STD Clinics HIV positivity by clinic and year

Percent HIV positive 6

5

4

3

2
1
0
Fulton DeKalb
Total

Fulton Total

DeKalb

1992
5 2.2 3.6

1993
3.6 2.7 3.2

1994
4.4 2.1 3.2

1995
4 1.7 2.9

1996
4.9 3.2 3.9

1997
5.2 2.8 4.1

Blinded HIV Seroprevalence Survey: Fulton & DeKalb STD Clinics HIV positivity by sex and year

Percent HIV positive 7

6

Men

Women

5

4

3

2

1

0
Men Women

1992
4.7 2.2

1993
4.2 1.9

1994
4.1 2.1

1995
4.1 1.2

1996
5.9 1.4

1997
5.7 1.9

25

Blinded HIV Seroprevalence Survey: Fulton & DeKalb STD Clinics HIV positivity by race and year

Percent HIV positive 6

5

4

3

2

1

0
Black White

1992
3.5 4.4

1993
3.2 4

1994
3.2 5.3

Black White

1995
3.1 1.1

1996
4 3.9

1997
4.2 3.4

Blinded HIV Seroprevalence Survey: Fulton & DeKalb STD Clinics HIV positivity by sexual orientation and year

Percent HIV positive 60

50

40

30

20

10

0
MSM Heterosexual

1992
53 2.2

1993
43 2.1

1994
39 2.3

MSM Heterosexual

1995
38 1.9

1996
43 2.3

1997
36 2.5

26

Blinded HIV Seroprevalence Survey: Fulton & DeKalb STD Clinics Persons aged 15-44: HIV positivity by age group and year

Percent HIV positive 10
15-24 8
35-44 6

25-34

4

2

0
15-24 25-34 35-44

1992
1.1 6.2 6.9

1993
1.1 5.3 3.8

1994
1.2 5.3 4.9

1995
0.8 4.7 3.3

1996
1.1 4.5 8.6

1997
1.2 6.7 5.2

Blinded HIV Seroprevalence Survey: Fulton & DeKalb STD Clinics Women aged 15-44 : HIV positivity by clinic and year

Percent HIV positive 5

4

3

2

1

0
Fulton DeKalb
Total

1992
4.7 0.5 2.3

1993
2.5 1.4 1.9

Fulton DeKalb Total

1994
3.8 0.7 2.2

1995
1.5 1
1.2

1996
2.3 0.8 1.4

1997
3.3 0.5 1.9

27

Blinded HIV Seroprevalence Survey: Fulton STD Clinic HIV positivity by sex and year

Percent HIV positive 7

6

5

4

3

2

1

0
Men Women

1992
5.3 4.4

1993
4.4 2.3

1994
4.9 3.6

Men Women

1995
5.6 1.5

1996
6.4 2.5

1997
6.3 3.1

Blinded HIV Seroprevalence Survey: Fulton STD Clinic HIV positivity by race and year

Percent HIV positive 12

10 Black White
8

6

4

2

0
Black White

1992
4.7 8.8

1993
3.7 3.4

1994
4.4 5.4

1995
4.2 1.4

1996
4.7 11

1997
5.2 3.6

28

Blinded HIV Seroprevalence Survey: Fulton STD Clinic HIV positivity by sexual orientation and year

Percent HIV positive 60

50

40

30

20

10

0
MSM Heterosexual

1992
52 3.5

1993
46 2.6

1994
38 3.5

MSM Heterosexual

1995
50 2.6

1996
52 3

1997
40 3.5

Blinded HIV Seroprevalence Survey: DeKalb STD Clinic HIV positivity by sex and year

Percent HIV positive 6 5

Men Women

4

3

2

1

0
Men Women

1992
3.9 0.5

1993
3.8 1.5

1994
3.2 0.7

1995
2.3 0.9

1996
5.4 0.7

1997
4.7 0.6

29

Blinded HIV Seroprevalence Survey: DeKalb STD Clinic HIV positivity by race and year

Percent HIV positive 5

4

3

2

1

0
Black White

1992
2.2 2.9

1993
2.5 4.3

Black White

1994
1.8 1.6

1995
1.8 0.9

1996
3.5 1.7

1997
2.8 3.4

Blinded HIV Seroprevalence Survey: DeKalb STD Clinic HIV positivity by sexual orientation and year

Percent HIV positive 60

50

40

30

20

10

0
MSM Heterosexual

1992
54 0.9

1993
40 1.5

MSM Heterosexual

1994
39 1.1

1995
22 1.2

1996
37 1.9

1997
32 1.1

30

Fulton County Drug Treatment Clinic
Blinded HIV Seroprevalence Survey: Fulton Drug Treatment Clinic HIV positivity by year

Percent HIV positive 16

14

12

10

8

6

4

2

0
% positive

1990
9

1991
9.5

1992
10.1

1993
9.7

1994
9.9

1995
10.8

1996
13.9

1997
11.4

Blinded HIV Seroprevalence Survey: Fulton Drug Treatment Clinic HIV positivity by sex and year

Percent HIV positive 20
Men 15

Women

10

5

0
Men Women

1990
9.7 7

1991
10.3 7.8

1992
10.6 8.4

1993
10.3 8.1

1994
11.3 7

1995
12.7 7.3

1996
16.5 9.7

1997
15.2 7.3

31

Blinded HIV Seroprevalence Survey: Fulton Drug Treatment Clinic HIV positivity by race and year

Percent HIV positive 16

14

Black White

12

10

8

6

4

2

0
Black White

1990
9.1 6.8

1991
9.7 7.5

1992
10.4 3

1993
9.9 5.2

1994
10 7.5

1995
10.9 8.5

1996
14.6 5.5

1997
11.8 9.7

Blinded HIV Seroprevalence Survey: Fulton Drug Treatment Clinic HIV positivity by sexual orientation and year

Percent HIV positive 50 40

MSM Heterosexual

30

20

10

0
MSM Heterosexual

1990
36 8.4

1991
25 9

1992
47 9

1993
33 8.6

1994
26 9

1995
14 11

1996
32 13

1997
14 11

32

Blinded HIV Seroprevalance Survey: Fulton Drug Treatment Clinic Persons aged 15-44: HIV positivity by age group and year

Percent HIV positive 20

15-24

15

35-44

25-34

10

5

0
15-24 25-34 35-44

1990
4 8.8 12.3

1991
6.1 10.4
9.9

1992
3.9 10.1 12.3

1993
6.3 10.1
9.8

1994
1.8 9.9 12.2

1995
7.8 10.9 11.5

1996
5.2 13.8 16.6

1997
4.3 11 13

Rural Georgia Hospitals

Blinded HIV Seroprevalence Survey: 5 Rural Georgia Hospitals HIV positivity by sex and year

Percent HIV positive 3

2.5

2

Males Females

Total

1.5

1

0.5

0
Males Females
Total

1993
2.3 0.7 1.1

1994
2.6 0.9 1.4

1995
2.9 1
1.5

1996
2.1 0.6
1

1997
1.7 0.7
1

33

Blinded HIV Seroprevalence Survey: 5 Rural Georgia Hospitals HIV positivity by race and year

Percent HIV positive 3.5

3

2.5

2
Blacks Whites 1.5

1

0.5

0
Blacks Whites

1993
2.3 0.4

1994
2.6 0.5

1995
3.1 0.5

1996
2 0.3

1997
2.1 0.4

Blinded HIV Seroprevalence Survey: 5 Rural Georgia Hospitals HIV positivity by race, sex, and year

Percent HIV positive 6

5

4

3

2

1

0
Black males Black females
White males White females

1993
4.9 1.4 0.9 0.2

1994
5.2 1.7
1 0.3

1995
5.6 2.3 1.3 0.2

1996
4.4 1.3 0.8 0.1

1997
4 1.5 0.7 0.2

Black males Black females White males White females

34

Blinded HIV Seroprevalence Survey: 5 Rural Georgia Hospitals

HIV positivity by age group and year
Percent HIV positive 3

2.5

2

1.5

1

0.5

0
15-24 25-34 35-44 45-54

1993
0.5 1.9 1.7 0.4

1994
0.5 1.9 2.5 0.6

1995
0.7 1.7 2.6 1.5

1996
0.1 1.6 1.8 0.8

1997
0.5 1.2 1.4 0.9

15-24 25-34 35-44 45-54

Blinded HIV Seroprevalence Survey: 5 Rural Georgia Hospitals Women aged 15-44: HIV positivity by race and year

Percent HIV positive 2.5

2

1.5

Blacks Whites

Total

1

0.5

0
Blacks Whites
Total

1993
1.5 0.2 0.8

1994
1.9 0.4
1

1995
2.4 0.2
1

1996
1.3 0.2 0.6

1997
1.4 0.1 0.6

35

Blinded HIV Seroprevalence Survey: 5 Rural Georgia Hospitals

HIV positivity by hospital service and year

Percent HIV positive 3

2.5

2

1.5

1

0.5

0
Medicine ER
Surgery Day surgery
Obstetrics

1993
2.7 0.9 0.4 0.6 0.5

1994
2.6 1.2 1.7 0.7 0.5

1995
2.8 1.5 1.2 1.2 0.1

1996
1.8 1
0.4 1.1
0

1997
1.1 1
1.1 1.6 0.5

Medicine ER Surgery Day surgery Obstetrics

36

Supplement to HIV/AIDS Surveillance
(SHAS) Project
37

SHAS Project: Persons with AIDS at Grady IDC
Have you ever used mind-altering substances other than alcohol, have you ever used crack cocaine, and have you ever injected drugs with a needle?

Percent answering yes 100

80

60

40

20

0
Non-alcohol drug Crack IDU

1990
77 14 20

1991
84 32 28

1992
86 35 31

1993
78 41 31

1994
82 36 31

1995
79 44 25

Year of Interview

1996
79 41 28

1997
77 42 28

Non-alcohol drug Crack IDU

SHAS Project: Persons with AIDS at Grady IDC
Number of visits to a doctor or clinic for an STD in the last 10 years

Percent answering 0, 1, or >= 2 60

50

40

30

20

10
0 1990
0 46 1 11 >= 2 43

1991
34 20 46

0 1 >= 2

1992
41 23 36

1993
42 20 36

1994
49 20 30

Year of Interview

1995
44 23 33

1996
47 28 25

1997
47 26 27

38

SHAS Project: Persons with AIDS, 1995 -1996
Possible alcoholism in Blacks and Whites at Grady IDC (n=628) and the Albany (n=152) and Waycross (n=109) Health Districts
Percent 50

40

30

20

10

0
Alcoholism*

Grady IDC
40

Albany HD
37

Waycross HD
28

*Possible alcoholism defined by answering "yes" to at least 2 of 4 CAGE questions

SHAS Project: Persons with AIDS, 1995 -1996
Drug use in Blacks and Whites at Grady IDC (n=628) and the Albany (n=152) and Waycross (n=109) Health Districts
Percent answering "yes" 50

40

30

20

10

0
Ever inject drugs? Ever use crack?

Grady IDC
26 43

Albany HD
15 41

Waycross HD
13 26

39

SHAS Project: Persons with AIDS, 1995-1996
History of STDs in Blacks and Whites at Grady IDC (n=628) and the Albany (n=152) and Waycross (n=109) Health Districts

Percent answering "yes" 70

60

50

40

30

20

10

0
STD in last 10 years? Ever have syphilis?

Grady IDC
54 29

Albany HD
61 47

Waycross HD
31 28

SHAS Project: Persons with AIDS, 1995 -1996
When you had sex with casual partners, how often were condoms used in the year before knowing of your HIV infection and since knowing of your HIV infection?
Percent* answering "always" 80

60

40

20

0
Year before HIV infection Since HIV infection

Grady IDC
27 61

Albany HD
4 41

Waycross HD
35 72

*Of those sexually active with casual partners during specified time period

40

Adult/ Adolescent Spectrum of HIV Disease (ASD) Project
41

Adult/Adolescent Spectrum of HIV Disease Project, Atlanta
Age group at baseline and race/ethnicity of 8,119 persons enrolled, 1989-1997

Age group

n percent

13-19 20-29 30-39 40-49 >= 50

52 1933 4014 1669
451

1% 24% 49% 21%
5%

Race/ethnicity

White

3452

Black

4440

Hispanic

207

Other/unknown 20

42% 55%
3% <1%

Adult/Adolescent Spectrum of HIV Disease Project, Atlanta
Mode and gender of 8,119 persons enrolled, 1989-1997

Mode MSM IDU MSM & IDU Heterosexual Other* Total

Male n percent 4477 (66%) 786 (12%) 524 (8%)
122 (2%)
842 (12%) 6751 (100%)

Female n percent
NA 326 (24%)
NA
505 (37%)
537 (39%) 1368 (100%)

*Other includes primarily "No identified risk" category
42

Adult/Adolescent Spectrum of HIV Disease Project, Atlanta
Number of persons by diagnosis and year of enrollment, 1990 -1997

Number of persons 2500

2000 1500

HIV AIDS Total

1000

500

0
HIV AIDS Total

1990
1146 1267 2413

1991
480 335 815

1992
354 322 676

1993
490 825 1315

1994
300 589 889

1995
305 525 830

Year of enrollment

1996
232 424 656

1997
202 322 524

Adult/Adolescent Spectrum of HIV Disease Project, Atlanta
Number of persons by site and year of enrollment, 1990 -1997

Number of persons 1400 1200 1000

Grady IDC

VA IDC

12 private offices

800

600

400

200

0
Grady IDC VA IDC
12 private offices

1990
937 203 1273

1991
438 37
340

1992
108 103 465

1993
921 129 265

1994
647 88
154

1995
574 92
164

1996
369 75
212

Year of enrollment

1997
232 101 191

43

STD Surveillance
Syphilis Gonorrhea Chlamydia
44

Early Syphilis by Year of Diagnosis Georgia, 1945 - 1997
Number of cases (Thousands) 20
15
10
5
0 45 50 55 60 65 70 75 80 85 90 95 Year

Syphilis

Early Syphilis by Year of Diagnosis
Georgia, 1987 - 1997
Number of cases 10,000

8,000

6,000

4,000

2,000

0
Cases

1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
3,070 4,849 7,605 8,359 6,999 5,265 3,919 2,703 2,612 1,998 1,556

* Includes primary, secondary, and early latent syphilis

45

Congenital Syphilis Cases and Female Early Syphilis Rates Georgia, 1985 - 1997

Number of cases 250 200

Congenital syphilis cases Early syphilis rate*

Rate 120
100

150

80

60 100
40

50

20

0

0

85 86 87 88 89 90 91 92 93 94 95 96 97

Congenital syphilis cases 10 4 7 8 14 107 136 148 79 58 57 35 22

Early syphilis rate* 27 27 40 59 102 116 96 70 43 33 31 25 18

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Georgia, 1990 - 1997

Number of cases (Thousands)

Rate

4

60

50

3 40

Cases

2

30 Rate*

20
1 10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 3.86

2.905 1.843

1.24

0.89

0.934 0.691 0.506

Rate*

60

44

27

18

13

13

10

7

* Rate = cases/100,000 population
46

Primary and Secondary Syphilis Cases and Rates Males in Georgia, 1990 - 1997

Number of cases 3000

Rate

2500 2000 1500 1000
500

60
40 Cases Rate*
20

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 2210

1590

1016

711

496

553

406

311

Rate*

72

50

31

21

15

16

12

9

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Females in Georgia, 1990 - 1997

Number of cases 2500

Rate

50

2000 40

1500 1000

30 Cases Rate*
20

500

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 1650

1315

827

529

394

381

285

195

Rate*

50

39

24

15

11

10

8

5

* Rate = cases/100,000 population

47

Primary and Secondary Syphilis Cases Blacks in Georgia, 1990 - 1997
Number of cases (Thousands) 4

3

2

1

0
Cases

1990
3.629

1991
2.689

1992
1.701

1993
1.086

1994
0.793

1995
0.842

1996
0.599

1997
0.396

Primary and Secondary Syphilis Cases Whites in Georgia, 1990 - 1997
Number of cases 300

250

200

150

100

50

0
Cases

1990
212

1991
193

1992
109

1993
126

1994
88

1995
81

1996
88

1997
97

48

Primary & Secondary Syphilis by Age Group Georgia, 1990 - 1997

Number of Cases 1,800

1,600

1,400

1,200

1,000

800

600

400

200

0
10-19 20-29 30-39
40+

1990
103 1,249 1,549
938

1991
125 1,007 1,116
635

1992
181 754 608 296

1993
86 488 437 231

1994
76 339 335 187

1995
57 302 351 215

Agegroup 10-19 20-29 30-39 40+

1996
54 203 259 175

1997
28 141 182 154

Early Syphilis Cases by Residence and Year of Report Georgia, 1990-1997
Percent of all cases 60

50

40 Metro Atlanta

30

Small cities*

Rural Areas 20

10

0
Metro Atlanta Small cities* Rural Areas

1990
45 21 34

1991
45 18 37

1992
45 18 37

1993
48 18 34

1994
46 20 34

1995
53 10 37

1996
51 8
41

1997
55 10 35

*Small cities: Albany, Athens, Augusta, Columbus, Macon, Savannah

49

Primary and Secondary Syphilis Cases and Rates Rome (1-1) District, 1990-1997

Number of cases 350

Rate 40

300

250

30

200

Cases

20

150

Rate*

100

10

50

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 40

115

145

107

23

23

17

10

Rate* 10

28

35

25

5

5

4

2

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Dalton (1-2) District, 1990-1997

Number of cases 100

Rate 10

80

8

60

6

Cases

Rate*

40

4

20

2

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 8

11

9

6

0

9

0

2

Rate* 3

5

4

2

0

3

0

1

* Rate = cases/100,000 population

50

Primary and Secondary Syphilis Cases and Rates Gainesville (2-0) District, 1990-1997

Number of cases 120

Rate 14

100

12

80

10

8 Cases

60

Rate*

6

40 4

20

2

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 40

24

14

7

10

5

4

2

Rate* 13

8

5

2

3

1

1

1

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Marietta (3-1) District, 1990-1997

Number of cases 200

Rate 20

150

15

Cases

100

10

Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 86

79

57

63

26

30

51

24

Rate* 17

15

10

11

4

5

8

4

* Rate = cases/100,000 population

51

Primary and Secondary Syphilis Cases and Rates Fulton (3-2) District, 1990-1997

Number of csaes 2000

Rate 250

1500 1000
500

200
150 Cases Rate*
100
50

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 1409

968

624

395

312

366

268

201

Rate* 217

148

94

59

46

54

39

29

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates

Clayton (3-3) District, 1990-1997

Number of cases 200

Rate 25

20 150
15 Cases
100 Rate*
10
50 5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 40

36

21

8

10

8

5

5

Rate* 22

19

11

4

5

4

2

2

* Rate = cases/100,000 population

52

Primary and Secondary Syphilis Cases and Rates Gwinnett (3-4) District, 1990-1997

Number of cases 200

Rate 20

150

15

Cases

100

10

Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 79

58

45

33

17

18

14

26

Rate* 18

12

9

6

3

3

2

4

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates DeKalb (3-5) District, 1990-1997

Number of cases 500

Rate

400

60

300 40 Cases Rate*
200
20 100

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 328

214

147

115

79

76

71

52

Rate* 60

39

26

20

14

13

12

9

* Rate = cases/100,000 population

53

Primary and Secondary Syphilis Cases and Rates LaGrange (4-0) District, 1990-1997

Number of cases 500

Rate 50

400

40

300

30

Cases

Rate*

200

20

100

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 132

172

118

70

62

84

40

28

Rate* 29

37

25

14

12

16

8

5

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Dublin (5-1) District, 1990-1997

Number of cases 200

Rate

60 150

100

40 Cases Rate*

50

20

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 76

63

45

19

6

6

8

7

Rate* 63

52

37

15

5

5

6

6

* Rate = cases/100,000 population

54

Primary and Secondary Syphilis Cases and Rates Macon (5-2) District, 1990-1997

Number of cases 400

Rate 60

50 300
40

Cases

200

30

Rate*

20 100
10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 213

156

101

56

88

32

15

14

Rate* 51

37

24

13

20

7

3

3

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates

Augusta (6-0) District, 1990-1997

Number of cases

Rate

120

600

100

80

400

Cases

60 Rate*

200

40

20

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 479

249

113

66

86

46

41

23

Rate* 124

64

29

16

21

11

10

6

* Rate = cases/100,000 population

55

Primary and Secondary Syphilis Cases and Rates

Columbus (7-0) District, 1990-1997

Number of cases 500

Rate

400

60

300

40 Cases

Rate*

200

20 100

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 186

159

135

91

94

90

38

21

Rate* 54

47

39

27

27

26

11

6

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Valdosta (8-1) District, 1990-1997

Number of cases 200

Rate 50

40 150
30 Cases
100 Rate*
20
50 10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 62

79

31

25

16

15

4

17

Rate* 32

40

16

12

8

7

2

8

* Rate = cases/100,000 population

56

Primary and Secondary Syphilis Cases and Rates Albany (8-2) District, 1990-1997

Number of cases 400

Rate 80

300

60

Cases

200

40 Rate*

100

20

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 220

166

88

79

60

74

64

22

Rate* 69

52

27

24

18

22

19

7

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Savannah (9-1) District, 1990-1997

Number of cases 400

Rate 100

80 300
60 Cases
200 Rate*
40
100 20

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 209

171

65

50

13

16

25

22

Rate* 86

69

26

20

5

6

9

8

* Rate = cases/100,000 population

57

Primary and Secondary Syphilis Cases and Rates Waycross (9-2) District, 1990-1997

Number of cases 300

Rate 60

250

50

200

40

Cases

150

30 Rate*

100

20

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 131

73

33

31

23

10

9

19

Rate* 48

27

12

11

8

3

3

7

* Rate = cases/100,000 population

Primary and Secondary Syphilis Cases and Rates Brunswick (9-3) District, 1990-1997

Number of cases 250

Rate 50

200 40

150 30 Cases

Rate*

100

20

50

10

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 78

88

39

14

3

3

2

0

Rate* 45

49

21

7

2

2

1

0

* Rate = cases/100,000 population

58

Primary and Secondary Syphilis Cases and Rates Athens (10-0) District, 1990-1997

Number of cases 200

Rate 20

150

15

Cases

100

10 Rate*

50

5

0

0

1990 1991 1992 1993 1994 1995 1996 1997

Cases 40

18

6

3

7

15

17

11

Rate* 15

6

2

1

2

5

5

4

* Rate = cases/100,000 population

Gonorrhea

Gonorrhea Cases and Rates by Year of Diagnosis Georgia, 1995-1997

Number of cases (Thousands) 25

20

15

10

5

0
Cases Rate*

1995
21.446
302

1996
19.94
277

* Rate = cases/100,000 population

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
18.525 253

59

Gonorrhea Cases by Gender and Year of Diagnosis

Number of cases 14,000

Georgia, 1995 - 1997

12,000

10,000

8,000

6,000 4,000

Male Female

2,000

0
Male Female

1995
11,158 10,149

1996
10,005 9,817

1997
8,897 9,577

Gonorrhea by Age Group and Year of Diagnosis
Georgia, 1995 - 1997
Number of cases 10,000

8,000 6,000 4,000 2,000

Agegroup 10-19 20-29 30-39 40+

0
10-19 20-29 30-39
40+

1995
6,798 9,077 3,427 2,127

1996
6,415 8,406 3,214 1,890

1997
5,889 7,744 3,017 1,856

60

Gonorrhea Cases and Rates by Year of Diagnosis Females 15-44 years old in Georgia, 1995-1997

Number of cases (Thousands) 10

8

6

4

2

0
Cases Rate*

1995
9.09
537

1996
9.118
535

* Rate = cases/100,000 population

Rate
500
400
300 Cases Rate*
200
100
0 1997
8.851 514

Gonorrhea Cases and Rates by Year of Diagnosis Rome (1-1) District, 1995 - 1997

Number of cases 1000

Rate 200

800 150
600 Cases
100 Rate*
400
50 200

0
Cases Rate*

1995
249 57

1996
254 57

* Rate = cases/100,000 population

0 1997
209
46

61

Gonorrhea Cases and Rates by Year of Diagnosis Dalton (1-2) District, 1995 - 1997

Number of cases 1000

Rate 200

800 150
600 Cases
100 Rate*
400
50 200

0
Cases Rate*

1995
105 39

1996
106 39

* Rate = cases/100,000 population

0 1997
99
35

Gonorrhea Cases and Rates by Year of Diagnosis Gainesville (2-0) District, 1995 - 1997

Number of cases 1000

Rate 200

800 150
600 Cases
100 Rate*
400
50 200

0
Cases Rate*

1995
290 85

1996
367 106

* Rate = cases/100,000 population

62

0 1997
344
97

Gonorrhea Cases and Rates by Year of Diagnosis Marietta (3-1) District, 1995 - 1997

Number of cases 1400

Rate 200

1200 1000
800 600 400 200

150 Cases
100 Rate*
50

0
Cases Rate*

1995
794 130

1996
1092 174

* Rate = cases/100,000 population

0 1997
613
95

Gonorrhea Cases and Rates by Year of Diagnosis Fulton (3-2) District, 1995 - 1997

Number of cases (Thousands) 8

Rate 1000

6

800

600 Cases 4
Rate* 400
2 200

0
Cases Rate*

1995
7.412 1085

1996
5.68 824

* Rate = cases/100,000 population

0 1997
5.437
781

63

Gonorrhea Cases and Rates by Year of Diagnosis Clayton (3-3) District, 1995 - 1997

Number of cases 1000

Rate 400

800 300
600 Cases
200 Rate*
400
100 200

0
Cases Rate*

1995
264 131

1996
330 161

* Rate = cases/100,000 population

0 1997
454
218

Gonorrhea Cases and Rates by Year of Diagnosis Gwinnett (3-4) District, 1995 - 1997

Number of cases 1000
800

Rate 140 120

100

600 80 Cases

Rate*

400

60

40 200
20

0
Cases Rate*

1995
254 46

1996
388 67

* Rate = cases/100,000 population

0 1997
322
54

64

Gonorrhea Cases and Rates by Year of Diagnosis DeKalb (3-5) District, 1995 - 1997

Number of cases 2500

Rate 400

2000 1500 1000
500

300 Cases
200 Rate*
100

0
Cases Rate*

1995
1943 333

1996
2108 356

* Rate = cases/100,000 population

0 1997
2224
371

Gonorrhea Cases and Rates by Year of Diagnosis LaGrange (4-0) District, 1995 - 1997

Number of cases 1400

Rate 250

1200

200

1000 800 600

150 Cases
Rate* 100

400 50
200

0
Cases Rate*

1995
950 186

1996
921 178

0 1997
823
154

* Rate = cases/100,000 population

65

Gonorrhea Cases and Rates by Year of Diagnosis Dublin (5-1) District, 1995 - 1997

Number of cases 1000

Rate 600

800

500

400
600 Cases
300 Rate*
400 200

200

100

0
Cases Rate*

1995
279 223

1996
263 210

* Rate = cases/100,000 population

0 1997
297
235

Gonorrhea Cases and Rates by Year of Diagnosis Macon (5-2) District, 1995 - 1997

Number of cases 2500

Rate 500

2000

400

1500 1000

300 Cases
Rate* 200

500

100

0
Cases Rate*

1995
1778 408

1996
1493 340

* Rate = cases/100,000 population

0 1997
1088
246

66

Gonorrhea Cases and Rates by Year of Diagnosis Augusta (6-0) District, 1995 - 1997

Number of cases 2000

Rate 400

1500 1000
500

300 Cases
200 Rate*
100

0
Cases Rate*

1995
1153 280

1996
1028 247

* Rate = cases/100,000 population

0 1997
914
217

Gonorrhea Cases and Rates by Year of Diagnosis Columbus (7-0) District, 1995 - 1997

Number of cases 2000

Rate 500

1500 1000
500

400
300 Cases Rate*
200
100

0
Cases Rate*

1995
1357 392

1996
1063 305

* Rate = cases/100,000 population

0 1997
1212
345

67

Gonorrhea Cases and Rates by Year of Diagnosis Valdosta (8-1) District, 1995 - 1997

Number of cases 1400

1200

1000

800

600

400

200

0
Cases Rate*

1995
624 304

1996
846 409

* Rate = cases/100,000 population

Rate 600
500
400 Cases
300 Rate*
200
100
0 1997
723 346

Gonorrhea Cases and Rates by Year of Diagnosis Albany (8-2) District, 1995 - 1997

Number of cases 2500

Rate 700

2000 1500 1000
500

600 500 400 Cases 300 Rate* 200 100

0
Cases Rate*

1995
1733 525

1996
1371 414

* Rate = cases/100,000 population

0 1997
1401
420

68

Gonorrhea Cases and Rates by Year of Diagnosis Savannah (9-1) District, 1995 - 1997

Number of cases 1400

1200

1000

800

600

400

200

0
Cases Rate*

1995
679 260

1996
875 330

* Rate = cases/100,000 population

Rate 500
400
300 Cases Rate*
200
100
0 1997
676 251

Gonorrhea Cases and Rates by Year of Diagnosis Waycross (9-2) District, 1995 - 1997

Number of cases 1400

1200

1000

800

600

400

200

0
Cases Rate*

1995
593 208

1996
653 226

* Rate = cases/100,000 population

Rate 400
300
Cases 200
Rate*
100
0 1997
548 188

69

Gonorrhea Cases and Rates by Year of Diagnosis Brunswick (9-3) District, 1995 - 1997

Number of cases 1000

Rate 400

800 300
600 Cases
200 Rate*
400
100 200

0
Cases Rate*

1995
241 123

1996
266 133

* Rate = cases/100,000 population

0 1997
216
106

Gonorrhea Cases and Rates by Year of Diagnosis Athens (10-0) District, 1995 - 1997

Number of cases 1400 1200 1000
800 600 400 200

Rate 400 300 Cases 200 Rate* 100

0
Cases Rate*

1995
689 226

1996
756 244

* Rate = cases/100,000 population

0 1997
915
291

70

Chlamydia

Chlamydia Cases and Rates by Year of Diagnosis Georgia, 1995-1997

Number of cases (Thousands) 25

20

15

10

5

0
Cases Rate*

1995
11.45 161

1996
13.596 189

* Rate = cases/100,000 population

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
16.164 220

71

Chlamydia Cases by Gender and Year of Diagnosis Georgia, 1995 - 1997
Number of cases 16,000

14,000

12,000

10,000

8,000

6,000 4,000

Male Female

2,000

0
Male Female

1995
983 10,417

1996
1,811 11,757

1997
1,978 14,150

Chlamydia by Age Group and Year of Diagnosis Georgia, 1995 - 1997
Number of cases 8,000

6,000 4,000 2,000

Agegroup 10-19 20-29 30-39 40+

0
10-19 20-29 30-39
40+

1995
5,103 4,790
850 693

72

1996
6,061 5,784 1,021
724

1997
7,119 6,971 1,070
979

Chlamydia Cases and Rates by Year of Diagnosis Females 15-44 years old in Georgia, 1995-1997

Number of cases (Thousands) 14

12

10

8

6

4

2

0
Cases Rate*

1995
9.511 562

1996
10.898 639

* Rate = cases/100,000 population

Rate 800
600
Cases 400
Rate*
200
0 1997
13.089 761

Chlamydia Cases and Rates by Year of Diagnosis Rome (1-1) District, 1995 - 1997

Number of cases 1000
800

Rate 150

600

100 Cases

Rate* 400

50 200

0
Cases Rate*

1995
245
56

1996
386
87

* Rate = cases/100,000 population

0 1997
448
99

73

Chlamydia Cases and Rates by Year of Diagnosis Dalton (1-2) District, 1995 - 1997

Number of cases 1000
800 600 400

Rate 200
150 Cases
100 Rate*

200

50

0
Cases Rate*

1995
119 45

1996
141 52

* Rate = cases/100,000 population

0 1997
198
71

Chlamydia Cases and Rates by Year of Diagnosis Gainesville (2-0) District, 1995 - 1997

Number of cases 1000
800 600 400 200

Rate 200
150 Cases
100 Rate*
50

0
Cases Rate*

1995
164 48

1996
182 52

* Rate = cases/100,000 population
74

0 1997
227
64

Chlamydia Cases and Rates by Year of Diagnosis Marietta (3-1) District, 1995 - 1997

Number of cases 1400 1200 1000
800 600 400 200

Rate 200 150 Cases 100 Rate* 50

0
Cases Rate*

1995
395
65

1996
792
126

0 1997
581
90

* Rate = cases/100,000 population

Chlamydia Cases and Rates by Year of Diagnosis Fulton (3-2) District, 1995 - 1997

Number of cases (Thousands) 5 4

Rate 600

3

400 Cases

Rate*

2

200 1

0
Cases Rate*

1995
4.545 666

1996
4.724 685

* Rate = cases/100,000 population

0 1997
4.351
625

75

Chlamydia Cases and Rates by Year of Diagnosis Clayton (3-3) District, 1995 - 1997

Number of cases 1000

Rate 400

800 300
600 Cases
200 Rate*
400
100 200

0
Cases Rate*

1995
251
125

1996
332
162

* Rate = cases/100,000 population

0 1997
472
226

Chlamydia Cases and Rates by Year of Diagnosis Gwinnett (3-4) District, 1995 - 1997

Number of cases 1200
1000

Rate 150

800

100 Cases

600

Rate*

400

50

200

0
Cases Rate*

1995
264
47

1996
495
86

0 1997
617
103

* Rate = cases/100,000 population
76

Chlamydia Cases and Rates by Year of Diagnosis DeKalb (3-5) District, 1995 - 1997

Number of cases 2000

1500

1000

500

0
Cases Rate*

1995
825 141

1996
1288 218

* Rate = cases/100,000 population

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
1655 276

Chlamydia Cases and Rates by Year of Diagnosis LaGrange (4-0) District, 1995 - 1997

Number of cases 1200

Rate 200

1000 800 600

150
Cases 100 Rate*

400 50
200

0
Cases Rate*

1995
479
94

1996
688
133

* Rate = cases/100,000 population

0 1997
716
134

77

Chlamydia Cases and Rates by Year of Diagnosis Dublin (5-1) District, 1995 - 1997

Number of cases 1000

800

600

400

200

0
Cases Rate*

1995
177 142

1996
128 102

* Rate = cases/100,000 population

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
144 114

Chlamydia Cases and Rates by Year of Diagnosis Macon (5-2) District, 1995 - 1997

Number of cases 1400

1200

1000

800

600

400

200

0
Cases Rate*

1995
757
174

* Rate = cases/100,000 population

1996
920
210

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
1280 289

78

Chlamydia Cases and Rates by Year of Diagnosis Augusta (6-0) District, 1995 - 1997

Number of cases 1400

1200

1000

800

600

400

200

0
Cases Rate*

1995
583 142

1996
539 129

* Rate = cases/100,000 population

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
903 214

Chlamydia Cases and Rates by Year of Diagnosis Columbus (7-0) District, 1995 - 1997

Number of cases 1400

Rate 400

1200 1000
800 600

300 Cases
200 Rate*

400

100

200

0
Cases Rate*

1995
1117 323

1996
1117 321

0 1997
1343
383

* Rate = cases/100,000 population

79

Chlamydia Cases and Rates by Year of Diagnosis

Valdosta (8-1) District, 1995 - 1997

Number of cases 1000

Rate 400

800 300
600 Cases
200 Rate*
400
100 200

0
Cases Rate*

1995
258
126

1996
331
160

* Rate = cases/100,000 population

0 1997
475
227

Chlamydia Cases and Rates by Year of Diagnosis Albany (8-2) District, 1995 - 1997

Number of cases 1200

1000

800

600

400

200

0
Cases Rate*

1995
427 129

* Rate = cases/100,000 population

1996
328 99

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
775 232

80

Chlamydia Cases and Rates by Year of Diagnosis Savannah (9-1) District, 1995 - 1997

Number of cases 1200

Rate 400

1000 800 600 400 200

300 Cases
200 Rate*
100

0
Cases Rate*

1995
347
133

1996
451
170

* Rate = cases/100,000 population

0 1997
807
300

Chlamydia Cases and Rates by Year of Diagnosis Waycross (9-2) District, 1995 - 1997

Number of cases 1200

1000

800

600

400

200

0
Cases Rate*

1995
172 60

1996
402 139

* Rate = cases/100,000 population

Rate 300
250
200 Cases
150 Rate*
100
50
0 1997
677 232

81

Chlamydia Cases and Rates by Year of Diagnosis Brunswick (9-3) District, 1995 - 1997

Number of cases 1000

Rate 300

800

250

200
600 Cases
150 Rate*
400
100

200

50

0
Cases Rate*

1995
95 48

* Rate = cases/100,000 population

1996
122 61

0 1997
146
72

Chlamydia Cases and Rates by Year of Diagnosis

Athens (10-0) District, 1995 - 1997

Number of cases 1000

Rate 250

800

200

600

150

Cases

Rate*

400

100

200

50

0
Cases Rate*

1995
174
57

1996
222
72

* Rate = cases/100,000 population

82

0 1997
345
110

Georgia Chlamydia
Project
83

Georgia Chlamydia Project
51 sites (43 Family Planning and 8 STD), 1997
Of women with positive or negative chlamydia (CT) results, 6.5% (1,863/28,628) were positive
Of women with positive or negative gonorrhea (GC) results, 2.3% (655/27,945) were positive
Of women with positive or negative CT and GC results, 0.6% (175/27,548) were positive for both

Georgia Chlamydia Project
Chlamydia positivity by age group, 1997

Age Group 10 - 19 20 - 29 30 - 39 40 - 49

Percent Positive

10%

(984/9,886)

5% (760/15,412)

2%

(57/2,828)

1%

(4/505)

Total

6% (1,805/28,631)

84

Georgia Chlamydia Project
Chlamydia positivity by race/ethnicity, 1997

Race/ethnicity Black White Hispanic Other Total

Percent Positive

8% (1,385/16,305)

4% (376/10,841)

3%

(34/1,018)

4%

(13/361)

6% (1,808/28,525)

Age Group

Georgia Chlamydia Project
Chlamydia positivity by age group and race/ethnicity, 1997

Black

White

Hispanic

10 - 19 14% (735/5,246) 5% (229/4,277) 7% (14/210)

20 - 29 7% (600/8,638) 2% (134/5,669) 3% (18/724)

30 - 39 2% (43/1,987) 2% (12/718) 1% (1/71)

40 - 49 1%

(2/353) 1%

(1/133) 8% (1/12)

Total

9% (1,380/16,224) 3% (376/10,797) 3% (34/1,017)

85

Georgia Chlamydia Project
Chlamydia positivity by age group and symptoms, 1997

Age Group

Symptomatic

Asymptomatic

10 - 19

12% (322/2,651)

9% (611/6,930)

20 - 29

5% (284/5,173)

4% (429/9,587)

30 - 39

2% (27/1,432)

2%

(22/1,156)

40 - 49

0.4%

(1/252)

1%

(2/197)

Total

7% (634/9,508)

6% (1,064/17,870)

Georgia Chlamydia Project
Chlamydia positivity by age group and pregnancy status, 1997

Age Group 10 - 19 20 - 29 30 - 39 40 - 49 Total

Pregnant 18% (17/95) 9% (11/124) 0% (0/26)
0% (0/0) 11% (28/245)

Not Pregnant

10% (839/8,256)

5% (598/11,524)

2% (40/1,694)

0.4%

(1/277)

7% (1,478/21,751)

86

Gonococcal Isolate
Surveillance Project (GISP)
87

Gonococcal Isolate Surveillance Project (GISP), Fulton County STD Clinic: 1988 to 1997

Percentage of isolates resistant to specific antibiotics by year

Number PCN1 TET2 PCN Ciprofloxacin Cefixime Ceftriaxone Spectinomycin

tested

& TET3

1988 236 3% 20% 4%

----

----

0%

0%

1989 240 18% 21% 5%

----

----

0%

0%

1990 236 36% 14% 3%

----

----

0%

0%

1991 240 29% 13% 6%

0%

----

0%

0%

1992 236 22% 19% 4%

0%

0.4%5

0%

0%

1993 238 11% 17% 12%

0%

0%

0%

0%

1994 229 11% 25% 9%

0%

0%

0%

0%

1995 227 4% 35% 18%

0%

0%

0%

0%

1996 193 3% 30% 10%

0%

0%

0%

0%

1997 202 4% 20% 12%

1%4

0%

0%

0%

1 PCN = Plasmid-mediated penicillinase-producing N. gonorrhoeae (PPNG) and chromosomally-mediated resistance to penicillin (PenR) 2 TET = Plasmid-mediated tetracycline resistance (TRNG) and chromosomally-mediated resistance to tetracycline (TetR) 3 The "PCN & TET" category is exclusive of the "PCN" and "TET" categories. 4 In 1997, there was one resistant isolate and one isolate with decreased susceptibility 5 For cefixime, there has been no documented resistance for N. gonorrhoeae. In 1997, there was one isolate with decreased susceptibility at this clinic.
88

Gonococcal Isolate Surveillance Project
Treatment for gonorrhea at Fulton county STD clinic, 1997

Ceftriaxone 90.0% 125 mg IM
Note: 202 males with gonorrhea in project

None 2.0% Missing 7.0%
Spectinomycin 1.0% 2 gm IM

89