Northwest Region of VirginiaHIV/AIDS and STD TrendsData through 2006

Northwest Region •ALBEMARLE•AUGUSTA•BATH•BUENA VISTA•CAROLINE•CHARLOTTESVILLE•CLARKE•CULPEPER•FAUQUIER•FLUVANNA•FREDERICK

•FREDERICKSBURG•GREENE•HARRISONBURG•HIGHLAND•KING GEORGE•LEXINGTON•LOUISA•MADISON•NELSON•ORANGE•PAGE

•RAPPAHANNOCK•RICHMOND CO.•ROCKBRIDGE•ROCKINGHAM•SHENANDOAH•SPOTSYLVANIA•STAFFORD•STAUNTON•WARREN•WAYNESBORO•WINCHESTER

Notes to Accompany Virginia HIV/AIDS TrendsAll data is reported as of December 31st, 2005 unless otherwise indicated.

HIV and AIDS reportingVirginia regulations require reporting of HIV and AIDS cases separately. As a result, a person canbe listed as either a Virginia HIV case, a Virginia AIDS case, or as both (HIV and AIDS). A personfirst diagnosed with HIV infection with no AIDS defining events will always be an HIV case. If at alater time, the patient is diagnosed as AIDS; the person will be listed as both an HIV and AIDScase. If a patient's initial diagnosis of HIV infection is accompanied with an AIDS defining event,the person will be listed as only an AIDS case.

UnduplicatedAs a result of Virginia reporting regulations for HIV and AIDS (see note above), an individualcould be reported twice, once as an HIV case and once as an AIDS case. An unduplicated reportwill count this individual only once. In the case of both HIV and AIDS diagnoses for one individual,age and place of residence at the time of diagnosis will derive from the HIV report. Unduplicated counts will be indicated.

LivingWhen active (e.g., review of charts at provider’s offices) or passive (e.g., receipt of death certificate from Division of Vital Records) surveillance indicates that a patient with HIV or AIDS has died, the reporting database is updated to reflect this information. Living counts will be indicated.

Notes to Accompany Virginia HIV/AIDS TrendsGeographyAll location information is based on the address that is reported to the Division at the time of report.

Report Date vs. Diagnosis DateTime frames are selected based on either the date of report or date of diagnosis. The report date is the date the morbidity is entered into the database. Diagnosis date is the date the disease was diagnosed by a health professional. Statistical reports prepared based on diagnosis dates are likely to change over time, given that disease reports sometimes involve time lags of varying degrees.

AIDS Case Definition ChangeOn January 1, 1993, the AIDS surveillance case definition for adolescents and adults was expanded to include three additional clinical conditions (pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer) as well as a laboratory marker of severeimmunosuppression in HIV-infected persons

HIV*/AIDS Trends Between 2005-2006, statewide increase (3%) in reported

HIV/AIDS Northwest Region saw a 24% decrease in reported

HIV/AIDS In the Northwest Region, Fauquier and Fluvanna each

showed the most notable decrease (88%) In 2006, 49% of reported cases of HIV/AIDS in the

Northwest region were White, 38% Black and 11% were Hispanic and 2% reported another race

Majority of the reported cases of HIV/AIDS were male (76%)

*Includes those that may have progressed to AIDS

VirginiaHIV*/AIDS Cases by Region (N=34,585**)

**Data through 2006

Northwest6.3%

Southwest8.3%

Central24.4%

Northern27.3%Eastern

33.7%

*Includes those that may have progressed to AIDS

Northwest Region of Virginia (N=1,286)Cases of HIV/AIDS* (1996-2006)

61

50 51

34

71

58

35

79

66

90

5142

76 77

6154

61

505143

6659

0102030405060708090

100

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006Year of Report

Repo

rted

Cas

es_

Cases of HIV (n=576)Cases of AIDS (n=710)

*Includes those that may have progressed to AIDS

People living with HIV(not AIDS)/AIDS Trends Number of people living with HIV(not

AIDS)/AIDS in Northwest Virginia at the end of 2006 ≈ 1217

7% of Virginia’s living total Most of cases are 35 years old 73% male 48% white

Number of People Living with HIV(not AIDS) or AIDS,

in Virginia, by Region, at the end of 2006 (N=18,119)

4379

58515263

1217 1409

0500

100015002000250030003500400045005000550060006500

Repo

rted

Livi

ng

Region

CentralEasternNorthernNorthwestSouthwest

Percentage of People Living with HIV (not AIDS), by Region (N=10,088*)

Northwest5.8%

Southwest7.6%

Central25.8%

Northern26.0%

Eastern34.8%

*Data through 2006

Percentage of People Living with AIDS, by Region, (N=8,031*)

Northwest7.9%

Southwest8.0%

Central22.1%

Northern32.8%Eastern

29.2%

*Data through 2006

Individuals Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia by Locality at the end of 2006 (N=1,217)

7363

53 46 4232 29 23 20 16 9 8 7 7 7 6 3

79

151621273137445056

86

156

8867

0

50

100

150

200CH

ARLO

TTES

VILL

EST

AFFO

RD C

O.SP

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Locality

Repo

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Liv

ing_

Individuals Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia, by Race, at the end of 2006 (N=1,217)

4

559

681 2

583

0

50

100

150

200

250300

350

400

450

500550

600

650

Repo

rted

Livin

g

Race

Asian/Pacific IslanderBlackHispanicMultipleUnknownWhite

Individuals Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia, by Risk at the end of 2006 (N=1,217)

5

239178

490

53 4917 16

050

100150200250300350400450500550

Repo

rted

Livi

ng

Risk Factor

HemophiliaHeterosexual ContactInjecting Drug Use (IDU)Men Having Sex with Men (MSM)MSM & IDUMultiple Heterosexual ContactsPediatricTransfusion

*170 cases unidentified risk or undetermined risk

Females Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia by Risk at the end of 2006 (N=331*)

165

219 7

57

0

50

100

150

200

HeterosexualContact

Injecting Drug Use(IDU)

MultipleHeterosexual

Contacts

Pediatric Transfusion

Risk Factor

Repo

rted

Liv

ing_

Females (n=331)

*72 cases unidentified risk or undetermined risk

Males Living with HIV(not AIDS)/AIDS in the Northwest Region by Risk at the end of 2006 (N=886*)

5

121

490

53

8 9

74

280

100

200

300

400

500

Hemophilia HeterosexualContact

Injecting DrugUse (IDU)

Men Having Sexwith Men(MSM)

MSM & IDU MultipleHeterosexual

Contacts

Pediatric Transfusion

Risk Factor

Repo

rted

Liv

ing_

Males (n=886)

*98 cases unidentified risk or undetermined risk

Total Early Syphilis* Trends Between 2005-2006, statewide increase (21%)

in reported syphilis Northwest Region had a 5% decrease in

reported syphilis In 2006, 72% of reported cases of Syphilis in the

Northwest region were white, 22% black Majority of the reported cases of Syphilis were

male (94%)

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Virginia Total Early Syphilis* Cases by Region, 2006 (N=351)

Northwest5.1%

Southwest6.0%

Central17.1%

Northern26.8%

Eastern45.0%

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Northwest Health Region Cases of Total Early Syphilis* (1998-2006)

6

3

7 76

10

1918

11

02468

101214161820

1998 1999 2000 2001 2002 2003 2004 2005 2006Year of Report

Repo

rted

Cas

es

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Northwest Health Region, by locality in 2006 (N=18)

3

2 2

1 1 1 1 1 1 1 1 1 11

0

1

2

3

4

5SP

OTSY

LVAN

IA

AUGU

STA

STAU

NTON

ALBE

MAR

LE

CHAR

LOTT

ESVI

LLE

CULP

EPER

FAUQ

UIER

FLUV

ANNA

FRED

ERIC

K

KING

GEO

RGE

LEXI

NGTO

N

ROCK

INGH

AM

STAF

FORD

WAR

REN

Locality

Repo

rted

Cas

es

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Northwest Health Region, by Race, in 2006 (N=18)

1

4

13

0123456789

101112131415

Repo

rted

Case

s

Race

Asian/Pacific IslanderBlackWhite

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Northwest Health Region, by age in 2006 (N=18)

1 1

4

2

4

0

4

2

0

1

2

3

4

513

- 19

20 -

24

25 -

29

30 -

34

35 -

39

40 -

44

45 -

49 50+

Age

Repo

rted

Cas

es

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Gonorrhea Trends Between 2005-2006, statewide decrease (22%) in

reported gonorrhea. 34% decrease in reported Hispanic cases.

Northwest Region saw a 23% decrease in reported Gonorrhea

In the Northwest Region, Charlottesville showed the most notable decrease (63%)

In 2006, 38% of reported cases of Gonorrhea in the Northwest region were White, 54% Black, and 4% were unknown

Majority of the reported cases of Gonorrhea were female (60%)

VirginiaGonorrhea Cases by Region, 2006 (N=6,474)

Northwest6.5%

Southwest15.1%

Central29.7%

Northern6.9%

Eastern41.8%

Northwest Health Region Cases Gonorrhea (1998-2006)

513448 470 462 441

629

546

422487

0

100

200

300

400

500

600

700

1998 1999 2000 2001 2002 2003 2004 2005 2006Year of Report

Repo

rted

Cas

es_

Individuals Reported with Gonorrhea in the Northwest Health Region, by Race, in 2006 (N=422)

1 2

226

10 417

162

0

50

100

150

200

250

Repo

rted

Cas

es

Race

American Indian/AlaskanNativeAsian/Pacific Islander

Black

Hispanic

Multiple

Unknown

White

Individuals Reported with Gonorrhea in the Northwest Health Region, by locality in 2006 (N=422)

34 33 3128 28

25 2420 20 18 17

11 9 9 7 7 5 5 4 3 3 3 1 1 1

48

1611

0

10

20

30

40

50

60

STAF

FORD

ALBE

MAR

LE

SPOT

SYLV

ANIA

FAUQ

UIER

FRED

ERIC

KSBU

RG

WIN

CHES

TER

CHAR

LOTT

ESVI

LLE

CULP

EPER

AUGU

STA

ORAN

GE

WAR

REN

CARO

LINE

LOUI

SA

FRED

ERIC

K

WAY

NESB

ORO

HARR

ISON

BURG

MAD

ISON

SHEN

ANDO

AH

STAU

NTON

KING

GEO

RGE

ROCK

INGH

AM

RAPP

AHAN

NOCK

CLAR

KE

FLUV

ANNA

GREE

NE

NELS

ON

PAGE

ROCK

BRID

GE

Locality

Repo

rted

Cas

es

Individuals Reported with Gonorrhea in the Northwest Health Region, by Age, in 2006 (N=422)

1

133151

75

2411 13 6 8

0

50

100

150

2000-

12

13-1

9

20 -

24

25 -

29

30 -

34

35 -

39

40 -

44

45 -

49 50+

Age

Repo

rted

Cas

es

Chlamydia Trends Between 2005-2006, statewide increase (6%) in reported

Chlamydia and 26% increase in reported Hispanic Cases Northwest Region saw a 8% increase in reported

Chlamydia In the Northwest Region, Spotsylvania showed the most

notable increase (39%) In 2006 in the Northwest Region, 43% of reported cases

of Chlamydia were white, 34% black and 13% were unknown

Majority of the reported cases of Chlamydia were female (77%)

VirginiaChlamydia Cases by Region, 2006 (N=24,081)

Northwest11.5%

Southwest11.9%

Central22.5%

Northern13.4%

Eastern40.6%

Northwest Health Region Cases Chlamydia (1998-2006)

1491 16091859

2175 20702203

24162578

2777

0

500

1000

1500

2000

2500

3000

1998 1999 2000 2001 2002 2003 2004 2005 2006Year of Report

Repo

rted

Cas

es

Individuals Reported with Chlamydia in the Northwest Health Region, by Race, in 2006 (N=2,777)

2 30

931

234

23

354

1203

0

300

600

900

1200

1500

Repo

rted

Cas

es

Race

American Indian/AlaskanNativeAsian/Pacific Islander

Black

Hispanic

Other

Unknown

White

Individuals Reported with Chlamydia in the Northwest Health Region, by locality in 2006 (N=2,777)

202186

159144 141 137 135 132

10885

68 66 63 63 53 48 36 33 28 26 22 21 15 9 7 7 5

311318

80 69

0

50

100

150

200

250

300

350

400

STAF

FORD

SPOT

SYLV

ANIA

CHAR

LOTT

ESVI

LLE

ALBE

MAR

LE

HARR

ISON

BURG

WIN

CHES

TER

FRED

ERIC

KSBU

RG

FRED

ERIC

K

AUGU

STA

CULP

EPER

FAUQ

UIER

CARO

LINE

ROCK

INGH

AM

WAY

NESB

ORO

LOUI

SA

WAR

REN

ORAN

GE

STAU

NTON

SHEN

ANDO

AH

KING

GEO

RGE

PAGE

GREE

NE

FLUV

ANNA

ROCK

BRID

GE

NELS

ON

CLAR

KE

MAD

ISON

BUEN

A VI

STA

BATH

LEXI

NGTO

N

RAPP

AHAN

NOCK

Locality

Repo

rted

Cas

es

Individuals Reported with Chlamydia in the Northwest Region, by age in 2006 (N=2,777)

6

10191099

417

13253 31 10 10

0

100

200

300400

500600700

800

900

1000

1100

12001300

0-12

13-1

9

20 -

24

25 -

29

30 -

34

35 -

39

40 -

44

45 -

49

50+

Age

Repo

rted

Cas

es

Prepared by:

Carrie Dolan, MPHEpidemiologist

Lindsey Matthews, MPH (updated)

Division of Disease PreventionJuly 2007carrie.dolan@vdh.virginia.gov

*Data accessed from HIV/AIDS Reporting System (HARS) and Sexually Transmitted Disease Management Information System (STDMIS) July 2007