HIV Surveillance Summary
Georgia, 2015
HIV/AIDS Epidemiology Section Epidemiology Program Division of Health Protection Georgia Department of Public Health

2015 Georgia HIV Surveillance Summary

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The HIV Surveillance Summary, Georgia 2015 is published by the Georgia Department of Public Health (DPH), HIV/AIDS Epidemiology Section (HAES), 2 Peachtree Street NW, Atlanta, Georgia 30303. Data are presented from known diagnoses and laboratory reports entered into the Georgia Enhanced HIV/AIDS Reporting Sytem (eHARS). All data are provisional. The HIV Surveillance Summary, Georgia 2015 is not copyrighted and may be used and reproduced without permission. Citation of the source is, however, appreciated. SUGGESTED CITATION: Georgia Department of Public Health, HIV/AIDS Epidemiology Section HIV Surveillance Summary, Georgia 2015, https://dph.georgia.gov/data-fact-sheet-summaris, Published March 2017, [Accessed: date]
ACKNOWLEDGEMENTS: Publication of this report was made possible with the contributions of the Georgia DPH HAES Core HIV Surveillance staff, HIV Case Report Forms submitted by Georgia health care facility staff, HIV infection related laboratory test results transmitted by laboratory facilities in Georgia, data linkages with other DPH program data, and the ongoing efforts of multiple individuals from public and private sector organizations dedicated to improving surveillance, prevention, testing, and care of persons living with HIV infection.
Georgia HIV Core Surveillance Team contributors: Lauren Barrineau, Thelma Fannin, Brian Huylebroeck, Latosha Johnson, Jane Kelly, Rodriques Lambert, Mildred McGainey, Latoya Moss, Rama Namballa, Doris Pearson, A. Eugene Pennisi, Akilah Spratling, Caroline Stamatakis, Lakecia Vanerson, and Andrenita West.
This report was prepared by the following staff from the Georgia Department of Public Health: Victoria N. Davis, MPH; Pascale Wortley, MD, MPH; Cherie Drenzek, DVM, MS.

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Table of Contents
Executive Summary....................................................................................................................................................................4 Technical Notes ...........................................................................................................................................................................5 Data Limitations...........................................................................................................................................................................8 Highlights of Analyses.................................................................................................................................................................8 Table 1. Distribution of the general population by race/ethnicity......................................................................................12 Table 2. Diagnoses of HIV infection and Stage 3 (AIDS) by sex, age, race/ethnicity.........................................................13 Table 3. Diagnoses of HIV infection and Stage 3, AIDS by transmission category and sex..............................................14 Table 4. Diagnoses of HIV infection and Stage 3 (AIDS) by public health district..............................................................15 Table 5. Persons living with HIV infection and Stage 3 (AIDS) by sex, age, race/ethnicity...............................................16 Table 6. Persons living with HIV infection and Stage 3 (AIDS) by transmission category and sex...................................17 Table 7. Persons living with HIV infection and Stage 3 (AIDS) by public health district....................................................18 Table 8. Cumulative diagnoses of HIV infection and Stage 3 (AIDS) by sex, age, race/ethnicity.....................................19 Table 9. Cumulative diagnoses of HIV infection and Stage 3 (AIDS) of HIV infection by transmission category and sex..........................................................................................................................................................................................20 Table 10. Cumulative diagnoses of HIV infection and Stage 3 (AIDS) by public health district.......................................21 HIV/AIDS Resources and Reporting..........................................................................................................................................22

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Executive Summary
Human immunodeficiency virus (HIV) damages specific cells of the immune system called CD4 cells. Untreated, HIV eventually overwhelms the immune system, resulting in a chronic life-threatening condition called acquired immune deficiency syndrome (AIDS). In this report, the term HIV infection refers to HIV diagnoses regardless of stage of disease; that is, HIV infection includes HIV (not AIDS) and AIDS. Based on the CD4 count (cells/ml), HIV infection is defined as Stage 1 (CD4>500 cells/ml), Stage 2 (CD4 200-499 cells/ml) and Stage 3 (AIDS) (<200 cells/ml). There is no cure for HIV infection, but with antiretroviral therapy (ART), HIV infection can be controlled. Advances in HIV treatment with ART have led to improved quality of life and prolonged lifespan for people living with HIV. Further, achieving viral suppression with effective ART use reduces HIV transmission due to decreased levels of circulating virus.
HIV infection remains an important public health problem in the state of Georgia. In 2015, Georgia was ranked the fifth-highest in the nation for the total number of new diagnoses of HIV infection among adults and adolescents after Florida, California, Texas, and New York1. There were 2,741 new diagnoses of HIV infection during 2015 in Georgia. The majority of these new diagnoses were among males (80%). The highest percentage of new HIV diagnoses and Stage 3 (AIDS) diagnoses was seen among those aged 30 to 39
1 Centers for Disease Control and Prevention. HIV Surveillance Report, 2015; vol.27. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdchiv-surveillance-report-2015-vol-27.pdf.
2015 Georgia HIV Surveillance Summary

years of age, 22% and 26%, respectively. Among all races/ethnicities, Black/non-Hispanics accounted for the majority of diagnoses (72% of new HIV infections and 73% of Stage 3 (AIDS)). Eighty-three percent (1,849) of new HIV infections among Georgia males during 2015 were attributed to male to male sexual (MSM) contact. Among women, 90% (473) of new HIV diagnoses were attributed to heterosexual contact.
As of December 31, 2015, there were 54,754 persons living with diagnosed HIV infection in Georgia. Similar to the new diagnoses of HIV infection, the majority of prevalent cases are among Black/Non-Hispanic persons (67%) and males (75%). Seventy-eight percent (32,429) of prevalent HIV cases among males were attributed to MSM sexual contact and 82% (10,873) of cases among females were attributed to heterosexual contact.
Monitoring the HIV/AIDS epidemic and understanding the burden of HIV infection in Georgia are essential for meeting the goals stated in the 2020 National HIV/AIDS Strategy to: 1) reduce HIV infections; 2) increase access to care and optimize health outcomes for persons living with HIV; 3) reduce HIV-related health disparities, and; 4) achieve a more coordinated national response to the HIV epidemic2.
2 The White House Office of National AIDS Policy, National HIV/AIDS Strategy for the United Sates: Updated to 2020, Washington, DC, July 2015
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Technical Notes
HIV Surveillance Georgia statutes and regulations (O.C.G.A. 3112-2(b))3 require healthcare providers (such as nurses, nurse practitioners, doctors, physician assistants) and laboratories licensed in the state of Georgia to report all cases of HIV infection and/or Stage 3 (AIDS) to the Georgia DPH within seven days of diagnosis. The information is used to monitor the HIV/AIDS epidemic in Georgia and guide program planning and evaluation. The data presented in the accompanying tables are based on confidential case reports collected through the Georgia DPH enhanced HIV/AIDS Reporting System (eHARS).
This report includes surveillance data through December 31, 2015 by diagnostic category for newly diagnosed HIV cases, persons living with, and cumulative cases of HIV infection and Stage 3 (AIDS). The data are displayed based on date of diagnosis and are not adjusted for reporting delays or incomplete reporting. Persons residing in correctional facilities are included in this report and may inflate rates in certain geographic regions where there are large numbers of HIV-positive inmates. Tables depicting "Persons living with HIV infection and Stage 3 (AIDS)" comprise persons with current residence in the state of Georgia based on current information available for them in the Georgia HIV/AIDS surveillance system regardless of where the persons were diagnosed. Persons represented in the "New Diagnoses" and "Cumulative" tables were

diagnosed in the state of Georgia. Due to the difference in residency criteria and the influx of cases to Georgia, the number of persons living with HIV infection in Georgia may be higher in some sub-categories than cumulative HIV infections. HIV infection includes persons with a diagnosis of HIV infection regardless of the stage of disease at diagnosis; i.e., both HIV (not AIDS) and AIDS.
Name-based AIDS reporting began nationally in the early 1980s, and name-based HIV reporting began in Georgia on December 31, 2003. Electronic lab reporting began in 2011. There are known delays in case reporting; we expect that the number of HIV diagnoses in 2015 will continue to increase as additional case reports are received. The Georgia electronic laboratory reporting (ELR) system makes it possible to use laboratory-based measures (e.g., CD4 count, viral load) to estimate the HIV Care Continuum for persons with a diagnosis of HIV infection in the state of Georgia (https://dph.georgia.gov/hiv-care-continuum).
Transmission Categories Persons with a diagnosis of HIV infection with no
reported and/or identified exposure to HIV through any of the routes listed in the hierarchy of transmission categories by the Centers for Disease Control and Prevention are classified as either `no risk factor identified or no risk factor reported' (NIR/NRR). In 2015, 29% of new HIV diagnoses in Georgia were reported with no or insufficient risk information to determine

3 Department of Public Health, Rules and regulations 290-5-48.11 (2003); Official Code of Georgia Annotated (O.C.G.A.) 31-22-9.2 (2011)
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transmission category. Among newly diagnosed cases, improvements were seen in transmission ascertainment, therefore, the "other" category decreased (44% in 2014). Multiple imputation, a statistical approach, was used in this report to replace each missing transmission category with a set of plausible values that represent the uncertainty about the true, but missing, value. The methods were applied to HIV cases among the adult and adolescent population only and not to the pediatric (age less than 13 years) population of Georgia. To identify and reduce HIV-related disparities in prevention and care, it is necessary to have the best available estimate for the distribution of known transmission categories among the HIV-infected population of Georgia. Multiple imputation is considered by the Centers for Disease Control and Prevention to be the best method for redistribution of missing data in large databases.4
Ascertainment of Race/Ethnicity Ascertainment of race/ethnicity improved substantially in 2015. Cases that are missing information on race/ethnicity are not assigned a transmission category using multiple imputation (MI). As a result of improved race/ethnicity ascertainment (2% in 2015, compared to 14% in 2014), more cases were assigned a transmission category. Therefore, the percent of male cases attributed to male-to-male sexual contact (MSM) increased from 75% in 2014 to 83% in 2015. In addition, the percent of female cases attributed to heterosexual contact increased from 81% in 2014 to 90% in 2015.
4 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.
2015 Georgia HIV Surveillance Summary

When examining trends by transmission category, it is important to take these factors into consideration.
Categorization of Cases by Public Health District HIV cases missing county of residence are geocoded based on their address using the Arc GIS Desktop Version 10.3 Software. This process was implemented in 2014, resulting in reduced numbers of cases in the unknown Public Health District category.
Gender Categories Persons diagnosed with HIV for whom the current identity box "transgender" was checked are classified as transgender. Because providers often do not complete all case report form fields, the numbers reported here are most likely an underestimate. Also, because the current identity fields were added to the case report form in 2007, cumulative and prevalent counts of HIV among transgender persons are incomplete.
Definition of Measures
NEW DIAGNOSES of HIV infection (Stage 1-3) and/or Stage 3 (AIDS) are cases who were diagnosed between January 01, 2015 and December 31, 2015 in Georgia and reported to the Georgia DPH. Cases with a diagnosis of Stage 3 include two groups: 1) persons newly diagnosed with HIV and found to be Stage 3 (CD4 <200 cells/ml) at diagnosis; and, 2) persons previously diagnosed with HIV who were found to meet the Stage 3 definition in 2015.
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PERSONS LIVING WITH a diagnosis of HIV infection (Stage 1-3) and /or Stage 3 (AIDS) are cases who were diagnosed, alive as of December 31, 2015 and currently living in Georgia. Persons living with a diagnosis of Stage 3 (AIDS) are persons who were alive as of December 31, 2015, were ever diagnosed with Stage 3 (AIDS) and currently living in Georgia. CUMULATIVE DIAGNOSES of HIV infection (Stage 1-3) and Stage 3 (AIDS) are cases who were reported to the Georgia DPH, diagnosed as of December 31, 2015 and were diagnosed in Georgia and include persons living and deceased. TRANSMISSION CATEGORIES presented in this report follow the standards created by the Centers for Disease Control and Prevention (CDC)5 and have been used for many years. According to the 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 surveillance purposes, HIV and AIDS cases are counted only once in the hierarchy of transmission categories. Persons with more than one reported risk factor for HIV infection are classified in the transmission category according to the behavior that is most likely to have resulted in transmission. The exception is men who report sexual contact with other men and injection drug use; this group makes up a separate transmission category. Persons whose transmission category is classified as heterosexual contact are persons who report heterosexual contact
5 Centers for Disease Control and Prevention. HIV Surveillance Report, 2015; vol. 27.
2015 Georgia HIV Surveillance Summary

specifically with a person known to have or be at high risk for HIV infection (e.g., an injection drug user/IDU). The term high risk is not included in the transmission category label for heterosexual contact in the tables because heterosexual contact itself is the risk factor most likely to have been responsible for transmission. However, the Table 3 footnote regarding this category clarifies how the data are defined: "heterosexual contact with a person known to have, or to be at high risk for, HIV infection". Cases among persons with no reported exposure to HIV through any of the routes listed in the hierarchy of transmission categories are classified as either no risk factor identified or reported (NIR/NRR)1 CURRENT RESIDENCE is used to determine the number of persons living with HIV infection in Georgia. Current address is determined using the date of the most recentlyentered residential address into the Georgia eHARS. VITAL STATUS: Persons are assumed to be alive unless otherwise documented or reported. The Georgia DPH performs an annual match of the eHARS database with the Georgia Vital Records death data, the National Death Index and the Social Security Death Index to ascertain vital status and identify any cases deceased from an HIV-related cause not otherwise reported. RATES: Denominators for population rates are based on the 2015 estimates of the resident population retrieved from the Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). Rates are per 100,000 population. Rates based on estimated case numbers less than 12 should be interpreted with
https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdchiv-surveillance-report-2015-vol-27.pdf.
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caution because these rates have relative standard errors greater than 30% and are considered unreliable. REPORTING PERIOD: Case numbers are based on data entered through December 2016 and are not adjusted for reporting delays. PERCENTAGES: Total percentages may not add up to 100% due to rounding.
Data Limitations
Complete and timely reporting of HIV infections to the Georgia DPH is critical for monitoring the HIV epidemic. Delays and incomplete reporting lead to underestimation of the impact of HIV in Georgia. Data in this report are not adjusted for reporting delays. Although multiple imputation methods were used to assign a known risk category to cases with missing information, a proportion of cases remain without any identified and /or reported risk factor. In addition, populations for which data are missing (e.g. birth sex, race, transmission category, geographic location) may be fundamentally different. All registered laboratories are also mandated by state law to report laboratory results on any HIV-related laboratory test to the Georgia DPH. However, some facilities may not comply or send only some test results and not others. Missing laboratory data may limit accurate estimation of unmet need for the state of Georgia and the Atlanta Eligible Metropolitan Area (EMA).

Highlights of Analyses
Table 1: Population
Distribution of the general population by race/ethnicity, Georgia, 2015
There were an estimated 10.2 million persons living in Georgia during 2015
Of these individuals, the majority were White, Non-Hispanic (54%)
The largest minority group in the state was Black, Non-Hispanic (31%)
Individuals who were Hispanic/Latino comprised 9% of the state's population.
The smallest racial/ethnic groups in the state were Asian, Non-Hispanic (4%); American Indian/Alaskan Native, Non-Hispanic (<1%); Native Hawaiian/Pacific Islander, Non-Hispanic (<1%); and Multiracial/Other, Non-Hispanic (2%).
Tables 2 to 4: New Diagnoses of HIV Infection and Stage 3 (AIDS)
New Diagnoses of HIV infection, Georgia, January 01, 2015 to December 31, 2015 There were 2,741 persons with a new diagnosis of
HIV infection in Georgia during 2015. Gender, Age and Race/Ethnicity The majority of new HIV diagnoses were among males (81%). Persons aged 30-39 years at the time of diagnosis represented the largest age group (24%) for new diagnoses of HIV infection in Georgia during 2015. There were racial/ethnic disparities among persons with new diagnoses of HIV infection in Georgia in 2015.

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o Black/Non-Hispanics accounted for 72% of new HIV infection diagnoses and comprised 31% of Georgia's population.
o White/Non-Hispanics accounted for 16% of new HIV infection diagnoses and comprised 54% of Georgia's population.
o Hispanics/Latinos of all races accounted for 6% of new diagnoses of HIV infection and comprised 9% of Georgia's population.
Transmission The number of cases and proportions stratified by
transmission category are shown both unadjusted and adjusted after multiple imputation. Using multiple imputation, 83% of HIV infections diagnosed among males in Georgia during 2015 were attributed to MSM sexual contact. Among women, 90% of HIV infections diagnosed in 2015 were attributed to heterosexual contact. Public Health District The overall state rate for new diagnoses of HIV infection in 2015 was 27 cases per 100,000 population. In 2015, several Public Health Districts had newly diagnosed HIV infection rates that exceeded the overall state rate: Fulton (71 per 100,000), DeKalb (62 per 100,000) and Clayton (57 per 100,000).
New Diagnoses of Stage 3 (AIDS), Georgia, January 01, 2015 to December 31, 2015 There were 1,296 persons with new diagnoses of
Stage 3 (AIDS) in Georgia during 2015. Gender, Age and Race/Ethnicity The majority of new diagnoses with Stage 3 (AIDS) were among males (74%).

Persons aged 30-39 years at the time of diagnosis represented the largest age group (26%) for new diagnoses of Stage 3 (AIDS) in Georgia during 2015.
There were racial/ethnic disparities among persons with new diagnoses of Stage 3 (AIDS) in Georgia during 2015. o Black/Non-Hispanics accounted for 73% of new Stage 3 (AIDS) diagnoses and comprised 31% of Georgia's population. o White/Non-Hispanics accounted for 14% of new Stage 3 (AIDS) diagnoses and comprised 54% of Georgia's population. o Hispanics/Latinos of all races accounted for 7% of new diagnoses of Stage 3 (AIDS) and comprised 9% of Georgia's population. Transmission
Among males, 83% of new Stage 3 (AIDS) diagnoses were attributed to MSM sexual contact.
Among females, 89% of new Stage 3 (AIDS) diagnoses were attributed to heterosexual contact. Public Health District
The overall state rate for new diagnoses of Stage 3 (AIDS) in 2015 was 13 cases per 100,000 population. In 2015, several Public Health Districts had newly diagnosed Stage 3 (AIDS) rates that exceeded the overall state rate: Fulton (33 per 100,000), DeKalb (28 per 100,000) and Clayton (24 per 100,000).

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Tables 5 to 7: Persons Living with HIV Infection and Stage 3 (AIDS)
Persons Living with Diagnosed HIV infection, Georgia, through December 31, 2015 There were 54,754 persons living with diagnosed
HIV infection in Georgia through December 31, 2015. Gender, Age and Race/Ethnicity The majority of persons living with diagnosed HIV infection were male (75%). The largest age category for persons living with diagnosed HIV in Georgia was 50-59 years (27%). There were racial/ethnic disparities among persons living with diagnosed HIV infection in Georgia during 2015.
o Black/Non-Hispanics accounted for 67% of persons living with diagnosed HIV infection and comprised 31% of Georgia's population.
o White/Non-Hispanics accounted for 19% of persons living with diagnosed HIV infection and comprised 54% of Georgia's population.
o Hispanic/Latinos of all races accounted for 6% of persons living with diagnosed HIV infection and comprised 9% of Georgia's population.
Transmission Among males living with diagnosed HIV infection in
Georgia, 78% of cases were attributed to MSM sexual contact. Among females living with diagnosed HIV infection in Georgia, 82% of cases were attributed to the heterosexual contact. Public Health District The overall state prevalence rate for diagnosed HIV infection in 2015 was 536 cases per 100,000
2015 Georgia HIV Surveillance Summary

population. Three Public Health Districts had HIV prevalence rates that exceeded the overall state rate in 2015: Fulton (1597 per 100,000), DeKalb (1249 per 100,000) and Clayton (851 per 100,000).
Persons Living with Stage 3 (AIDS), Georgia, as of December 31, 2015 There were 28,998 persons living with Stage 3
(AIDS) in Georgia during 2015. Gender, Age and Race/Ethnicity The majority of persons living with Stage 3 (AIDS) were male (76%). The largest age category of persons living with Stage 3 (AIDS) in Georgia was 50-59 years (33%). There were racial/ethnic disparities among persons living with Stage 3 (AIDS) in Georgia during 2015
o Black/Non-Hispanics accounted for 68% of persons living with Stage 3 (AIDS) and comprised 31% of Georgia's population.
o White/Non-Hispanics accounted for 19% of persons living with Stage 3 (AIDS) and comprised 54% of Georgia's population.
o Hispanic/Latinos of all races accounted for 6% of persons living with Stage 3 (AIDS) and comprised 9% of Georgia's population.
Transmission Among males living with Stage 3 (AIDS), 76% of
cases were attributed to MSM sexual contact. Among females living with Stage 3 (AIDS), 81% of
cases were attributed to heterosexual contact.
Public Health District The overall state prevalence rate for Stage 3 (AIDS)
in 2015 was 284 cases per 100,000 population. Three Public Health Districts had AIDS prevalence rates that exceeded the overall state rate in 2015:
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Fulton (855 per 100,000), DeKalb (666 per 100,000) and Clayton (433 per 100,000).
Table 8 to 10: Cumulative Diagnoses of HIV Infection and Stage 3 (AIDS)
Cumulative diagnoses of HIV infection, Georgia, as of December 31, 2015 There were 73,688 cumulative diagnoses of HIV
infection in Georgia as of December 31, 2015. Gender, Age and Race/Ethnicity The majority (77%) of cumulative HIV cases were male. The largest age category at diagnosis for cumulative cases of HIV infection in Georgia was 30-39 years (33%). There were racial/ethnic disparities among cumulative HIV infections in Georgia during 2015.
o Black/Non-Hispanics accounted for 66% of cumulative HIV infections
o White/Non-Hispanics accounted for 23% of cumulative HIV infections
o Hispanic/Latinos of all races accounted for 4% of cumulative HIV infections
Transmission Among male adults/adolescents, 73% of cumulative
cases were attributed to MSM sexual contact. Among female adults/adolescents, 80% of cases
were attributed to the heterosexual contact. Public Health District The highest cumulative numbers of HIV infection diagnoses in Georgia were in the Fulton (23,393) and DeKalb (12,319) Public Health Districts.

Cumulative diagnoses of Stage 3 (AIDS), Georgia, as of December 31, 2015 There were 45,609 cumulative diagnoses of stage 3
(AIDS) in Georgia as of December 31, 2015. Gender, Age and Race/Ethnicity The majority of cumulative Stage 3 (AIDS) cases were male (78%) The largest age category at diagnosis for cumulative cases of Stage 3 (AIDS) in Georgia was 30-39 years (38%). There were racial/ethnic disparities among cumulative Stage 3 (AIDS) cases in Georgia during 2015.
o Black/Non-Hispanics accounted for 66% of cumulative Stage 3 (AIDS) cases
o White/Non-Hispanics accounted for 25% of cumulative Stage 3 (AIDS) cases
o Hispanic/Latinos of all races accounted for 4% of Stage 3 (AIDS) cases
Transmission Among male adult/adolescents, 69% of cumulative
stage 3 (AIDS) cases were attributed to MSM sexual contact. Among female adults/adolescents, 76% of cumulative Stage 3 (AIDS) cases were attributed to heterosexual contact. Public Health District The highest cumulative numbers of Stage 3 (AIDS) diagnoses in Georgia were in the Fulton (16,438) and DeKalb (7,382) Public Health Districts.

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Table 1: Distribution of the General Population by Race/Ethnicity, Georgia, 2015
Race/Ethnicity White, Non-Hispanic Black, Non-Hispanic Hispanic/Latino, Any Race Asian, Non-Hispanic American Indian /Alaskan Native, Non-Hispanic Native Hawaiian/Pacific Islander, Non-Hispanic Multiracial/Other, Non-Hispanic Total

Number1 (%) 5,501,469 (54) 3,151,631 (31)
955,434 (9) 400,569 (4) 23,502 (<1) 6,518 (<1) 175,737 (2) 10,214,860

1 Population estimates are based on data obtained from Georgia Department of Public Health, Office of Health Indicators for Planning(OHIP)
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Table 2: Diagnoses of HIV infection and Stage 3 (AIDS) by gender, age and race/ethnicity, Georgia, January 01, 2015 to December 31, 2015

HIV infection1

Stage 3 (AIDS)2

Gender Male Female Transgender Unknown

Count 2,208 525
6 3

Percent3 81% 19% <1% <1%

Count 965 325
5 1

Percent3 74% 25% <1% <1%

Age Group at Diagnosis (years) <13 13-19 20-24 25-29 30-39 40-49 50-59 60+

Count 6
138 515 576 625 452 324 105

Percent <1 5% 18% 21% 22% 16% 11% 3%

Count 3 27
125 201 339 292 236 73

Percent <1 2% 9% 15% 26% 22% 18% 5%

Race/Ethnicity Black/Non-Hispanic White/Non-Hispanic Hispanic/Latino, Any Race American Indian/Alaska Native Asian/Native Hawaiian/Pacific Islander Multiple races Unknown Total

Count 1,980 440 183
-23 52 63 2,741

Percent 72% 16% 6% -<1 1% 2%

Count 953 194 99
1 3 28 18 1,296

Percent 73% 14% 7% <1 <1 2% 1%

1 HIV stage 1-3 2 This group includes newly diagnosed persons with Stage 3 HIV (AIDS) at initial diagnosis and previously diagnosed persons who first met the
Stage 3 definition in 2015. 3 Total percentages may not add up to 100% due to rounding and represent the percentage of the subtotal.

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Table 3: Diagnoses1 of HIV Infection and Stage 3 (AIDS) by sex2 and transmission category, Georgia, January 01, 2015 to December 31, 2015

Male adult or adolescent MSM7 IDU8 MSM & IDU9 Heterosexual10 Other11
Subtotal

HIV infection3

Unadjusted

Adjusted5

Estimates

Estimates

Count 1,432
23 24 176 554 2,209

Percent6 64% 1% 1% 7% 25%

Count 1,849
46 37 226 52 2,210

Percent6 83% 2% 1% 10% 2%

Stage 3 (AIDS)4

Unadjusted

Adjusted5

Estimates

Estimates

Count 600 21 14 68 264 967

Percent6 62% 2% 1% 7% 27%

Count 787 36 24 104 16 967

Percent6 81% 3% 2% 10% 1%

Female adult or adolescent IDU8 Heterosexual10 Other11
Subtotal

17

3%

40

7%

265

50% 473

90%

241

46%

10

1%

523

523

14

4%

28

8%

164

50%

290

89%

147

45%

7

2%

325

325

Child (<13 years at diagnosis) Perinatal12 Other13 Subtotal Total

5

83%

1

16%

6

2,738

2

66%

1

33%

3

1,295

1 New diagnoses with no information on birth sex were excluded from this table. 2 Male and female categories are based on sex at birth 3 HIV stage 1-3 4 Includes newly diagnosed persons with Stage 3 HIV (AIDS) at initial diagnosis and previously diagnosed persons who first met the Stage 3
definition in 2015. 5 Adjusted for missing risk using multiple imputation methods. Adjusted subtotals may be different from unadjusted subtotals due to rounding. 6 Total percentages may not add up to 100% due to rounding and represent the percentage of the subtotal. 7 MSM: Male-to-male sexual contact 8 IDU: Injection drug use 9 MSM & IDU: Male-to-male sexual contact and injection drug use 10 Heterosexual: Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to
females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and or person with AIDS or documented HIV. 11 Other (Adult): Includes hemophilia, blood transfusion, perinatal exposure (first diagnosed at age 13 years or older), and risk factor not reported (the latter account for great majority). 12 Perinatal: Cases born to HIV-infected mother (includes cases that were not born in 2015 but first diagnosed under the age of 13 years to HIV -infected mother). 13 Other (Perinatal): Includes hemophilia, blood transfusion, and risk factor not reported (the latter account for great majority).

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Table 4: Diagnoses of HIV infection and Stage 3 (AIDS) by Public Health District of residence at diagnosis, Georgia, January 01, 2015 to December 31, 2015

Public Health Districts
1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb-Douglas 3-2 Fulton 3-3 Clayton (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast (Athens) Unknown Health District Total

HIV infection

Count

Rate2

44

7

33

7

38

6

188

21

732

72

159

58

166

15

460

63

140

17

13

9

126

24

95

20

93

25

68

27

76

22

109

18

53

15

53

11

95

--

2,741

27

Stage 3 (AIDS)1

Count

Rate2

14

2

16

3

17

3

80

9

335

33

67

24

89

8

209

28

51

6

12

8

69

13

49

10

47

12

31

12

41

12

56

9

18

5

31

6

53

--

1,285

13

1 AIDS counts were ascertained using county from laboratory documents. 2 Crude rates are per 100,000 population and are not adjusted for significant factors such as age, sex, and race/ethnicity which might influence the rate. Population denominators used to calculate the rates were retrieved from Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP)

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Table 5: Persons living with diagnosed HIV infection and Stage 3 (AIDS) by sex, age and race/ethnicity, Georgia through December 31, 2015

HIV infection1

Stage 3 (AIDS)

Gender Male Female Transgender Unknown

Count 41,266 13,198
192 98

Percent2 75% 24% <1% <1%

Count 21,980 6,846
114 58

Percent2 76% 23% <1% <1

Current Age Group (years) <13 13-19 20-24 25-29 30-39 40-49 50-59 60+ Missing

135

<1

17

<1

349

<1

74

<1

2,106

3%

501

1%

4,946

9%

1,446

4%

11,352

20%

4,914

16%

14,691

26%

8,421

29%

15,008

27%

9,608

33%

6,152

11%

4,015

13%

15

<1

2

<1

Race/Ethnicity

Black/Non-Hispanic

36,944

67%

19,767

68%

White/Non-Hispanic

10,720

19%

5,678

19%

Hispanic/Latino, Any Race

3,322

6%

1,836

6%

American Indian/Alaska Native

30

<1

10

<1

Asian/Native Hawaiian/Pacific Islander

245

<1

100

<1

Multiple races

1,940

3%

1,182

4%

Unknown

1,553

2%

425

1%

Total

54,754

28,998

1 HIV stages 1-3 2 Total percentages may not add up to 100% due to rounding and represent the percentage of the subtotal.
2015 Georgia HIV Surveillance Summary

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Table 6: Persons living1 with diagnosed HIV Infection and Stage 3 (AIDS) by sex2 and transmission category, Georgia, through December 31, 2015

HIV infection3 Unadjusted Estimates Adjusted4 Estimates

Stage 3 (AIDS)

Unadjusted

Adjusted4

Estimates

Estimates

Male adult or adolescent MSM6 IDU7 MSM & IDU8 Heterosexual9 Other10 Subtotal

Count 24,860 1,479 1,832 2,046 11,133 41,350

Percent5 60% 3% 4% 4% 26%

Count 32,429 2,149 2,326 3,014 1,431 41,349

Percent5 78% 5% 5% 7% 3%

Count 13,294 1,101 1,231 1,292 5,013 21,931

Percent4 60% 5% 5% 5% 22%

Count 16,707 1,487 1,488 1,854
395 21,931

Percent5 76% 6% 6% 8% 1%

Female adult or adolescent IDU7 Heterosexual9 Other10
Subtotal

1,033

7%

1,731

13%

685

10% 1,041

15%

6,075

46%

10,873

82%

3,451

50% 5,589

81%

6,048

45%

552

4%

2,691

39%

197

2%

13,156

13,156

6,827

6,827

Child (<13 years at end of

year)

Perinatal11

95

70%

Other12

40

29%

Subtotal

135

Total

54,641

12

70%

5

29%

17

28,775

1 Persons living with HIV infection and Stage 3 (AIDS) with no information on birth sex and date of birth were excluded from the table. 2 Male and female categories are based on sex at birth 3 HIV stages 1-3 4 Adjusted for missing risk using multiple imputation methods. Adjusted subtotals may be different from unadjusted subtotals due to rounding. 5 Total percentages may not add up to 100% due to rounding and represent the percentage of the subtotal. 6 MSM: Male-to-male sexual contact 7 IDU: Injection drug use 8 MSM & IDU: Male-to-male sexual contact and injection drug use 9 Heterosexual: Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to
females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and or person with AIDS or documented HIV. 10 Other (Adult): Includes hemophilia, blood transfusion, perinatal exposure (first diagnosed at age 13 years or older), and risk factor not reported (the latter account for great majority). 11 Perinatal: Cases born to HIV-infected mother (including cases that were not born in 2015 but first diagnosed under the age of 13 years to HIV -infected mother). 12 Other (Perinatal): Includes hemophilia, blood transfusion, and risk factor not reported (the latter account for great majority).

2015 Georgia HIV Surveillance Summary

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Table 7: Persons living with diagnosed HIV infection and Stage 3 (AIDS) by Public Health District of current residence, Georgia, through December 31, 2015

Public Health Districts
1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb-Douglas 3-2 Fulton 3-3 Clayton (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast (Athens) Unknown Health District Total

Count 985 620 707 3,643 16,134 2,330 3,648 9,179 1,849 604 2,059 2,148 1,654 1,070 1,668 2,569 1,186 893 1,808 54,754

HIV infection

Rate1 151 134 105 413 1597 851 335 1249 222 401 392 448 439 420 475 422 325 184 -536

Stage 3 (AIDS)

Count

Rate1

540

83

329

71

387

57

1,873

212

8,637

855

1,187

433

1,902

174

4,894

666

995

119

322

214

1,110

211

1,143

238

817

217

572

225

917

261

1,394

229

607

166

499

103

873

--

28,998

284

1 Crude rates are per 100,000 population and are not adjusted for significant factors such as age, sex, and race/ethnicity which might influence the rate. Population denominators used to calculate the rates were retrieved from Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP)

2015 Georgia HIV Surveillance Summary

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Table 8: Cumulative1 diagnoses of HIV Infection and Stage 3 (AIDS), by sex, age and race/ethnicity, Georgia, as of December 31, 2015

Gender Male Female Transgender Unknown Age Group at Diagnosis (years) <13 13-19 20-24 25-29 30-39 40-49 50-59 60+ Missing Race/Ethnicity Black/Non-Hispanic White/Non-Hispanic Hispanic/Latino, Any Race American Indian/Alaska Native Asian/Native Hawaiian/Pacific Islander Multiple races Unknown Total

HIV Infection

Count

Percent2

56,530

77%

16,902

23%

174

<1

82

<1%

620

<1

2,496

3%

8,915

12%

11,920

16%

24,836

33%

16,254

22%

6,567

8%

2,068

2%

12

<1

49,338

66%

17,289

23%

3,378

4%

31

<1

253

<1

2,028

2%

1,371

1%

73,688

Stage 3 (AIDS)

Count

Percent2

35,655

78%

9,833

22%

100

<1%

21

<1%

243

<1

497

1%

2,637

5%

6,176

13%

17,639

38%

12,323

27%

4,626

10%

1,467

3%

1

<1

30,374

66%

11,787

25%

1,895

4%

15

<1

124

<1

1,192

2%

222

<1

45,609

1 Represents all cases ever diagnosed in Georgia and alive as of December 2015. 2 Total percentages may not add up to 100% due to rounding and represent the percentage of the subtotal.
2015 Georgia HIV Surveillance Summary

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Table 9: Cumulative1 diagnoses of HIV Infection and Stage 3 (AIDS) of HIV infection by sex2 and transmission category, Georgia, as of December 31, 2015

Male adult or adolescent MSM5 IDU6 MSM & IDU7 Heterosexual8 Other9 Subtotal

HIV infection

Unadjusted Estimates

Count Percent4

32,012

56%

4,223

7%

2,860

5%

3,121

5%

14,142

25%

56,358

Adjusted3 Estimates

Count Percent

41,514 73%

5,423

9%

3,536

6%

4,642

8%

1,243

2%

56,358

Stage 3 (AIDS)

Unadjusted

Adjusted3

Estimates

Estimates

Count Percent Count Percent

20,297

56% 24,895 69%

3,677

10% 4,482 12%

2,219

6% 2,612 7%

2,289

6% 3,220 9%

7,138

20%

411

1%

35,620

35,620

Female adult or adolescent

IDU6

1,935

11%

2,957

17%

1,520

15% 2,113 21%

Heterosexual8

7,320

44%

13,304 80%

4,674

48% 7,465 76%

Other9

7,362

44%

356

2%

3,530

36%

146

1%

Subtotal

16,617

16,617

9,724

9,724

Child (<13 years at diagnosis)

Perinatal10

472

76%

Other11

148

23%

Subtotal

620

Total

73,595

226

93%

17

6%

243

45,587

1 Cumulative numbers of HIV infection and Stage 3 (AIDS) with no information on birth sex and date of birth were excluded from the table. 2 Male and female categories are based on sex at birth 3 Adjusted for missing risk using multiple imputation methods. 4 Total percentages may not add up to 100% due to rounding and represent the percentage of the subtotal. 5 MSM: Male-to-male sexual contact 6 IDU: Injection drug use 7 MSM & IDU: Male-to-male sexual contact and injection drug use 8 Heterosexual: Defined as sexual contact with someone of the opposite sex with known risk such as injection drug use, bisexual male (applies to
females only), person with hemophilia/coagulation disorder, transfusion recipient with HIV documentation, and or person with AIDS or documented HIV. 9 Other (Adult): Includes hemophilia, blood transfusion, perinatal exposure (first diagnosed at age 13 years or older), and risk factor not reported (the latter account for great majority). 10 Perinatal: Cases born to HIV-infected mother (includes cases that were not born in 2015 but first diagnosed under the age of 13 years to HIV -infected mother). 11 Other (Perinatal): Includes hemophilia, blood transfusion, and risk factor not reported (the latter account for great majority).

2015 Georgia HIV Surveillance Summary

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Table 10: Cumulative diagnoses of HIV Infection and Stage 3 (AIDS) by Public Health District of residence at diagnosis, Georgia, as of December 31, 2015

Public Health Districts
1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2 North (Gainesville) 3-1 Cobb-Douglas 3-2 Fulton 3-3 Clayton (Jonesboro) 3-4 East Metro (Lawrenceville) 3-5 DeKalb 4 LaGrange 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta) 7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast (Athens) Unknown Health District Total

HIV Infection Count 1,098 762 795 3,879 23,393 2,989 3,102 12,319 2,552 819 3,088 3,369 2,579 1,510 2,513 3,974 1,561 1,172 2,214 73,688

Stage 3 (AIDS) Count 651 438 492 2,252 16,438 1,647 1,754 7,382 1,453 429 1,856 2,197 1,528 839 1,620 2,529 922 760 422 45,609

2015 Georgia HIV Surveillance Summary

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HIV/AIDS Resources:
Georgia Department of Public Health http://dph.georgia.gov/what-hiv-and-aids
Centers for Disease Control and Prevention http://www.cdc.gov/hiv/

AIDSVu http://aidsvu.org/

Reporting All healthcare providers diagnosing and/or providing care to a patient with HIV are required by Georgia law (O.C.G.A. 31-12-1) to report HIV infection using the HIV/AIDS Case Report Form. 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-forms-data-requests For more questions on HIV case reporting in Georgia please contact the HIV Surveillance Coordinator at 1800-827-9769

2015 Georgia HIV Surveillance Summary

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