HomeMy WebLinkAboutMINUTES - 02021993 - I.O.2 TO: BOARD OF SUPERVISORS 1 .0.-2 Contra
FROM: INTERNAL OPERATIONS COMMITTEE
Costa
o ,Z
.County
DATE: January 25, 1993
SUBJECT: REPORT ON THE STATUS OF COMMUNICABLE DISEASES IN CONTRA COSTA
COUNTY AND ON EFFORTS TO PREVENT AND TREAT THESE DISEASES
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS:
1 . Accept this report, along with the attached report from the
Health Services Director, on the status of various
communicable diseases in Contra Costa County.
2 . Request. the Health Services Director to prepare a Tuberculosis
Fact Sheet which can be shared with various groups .of County
employees, as is outlined in the attached report.
3 . Endorse the planned actions which are being undertaken by the
Health Services Department in the area of control of various
communicable diseases, including AIDS, Tuberculosis and
Hepatitis .
4 . Request the Health Services Director to report to our
Committee again on a quarterly basis in April, 1993 .
BACKGROUND:
The Internal Operations Committee has been providing oversight to
the subject of communicable diseases, notably AIDS and
Tuberculosis . On January 25, 1993 our Committee met with Wendel
Brunner, M.D. , Public Health Director and Francie Wise, R.N. ,
Director of Communicable Disease Control in the Health Services
Department ' s Public Health Division. Dr. Brunner and Ms . Wise
reviewed the attached report with us .
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOAWJ
APPROVE OTH �y �C
SIGNATURE(S): SUNNE WRIGHT MCPEAK TH
ACTION OFBOARD ON Februaly , APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE E SHOWN.
ATTESTED
Contact: PHIL BATCHELOR,CLERK OF THE BOARD OF
CC: SUPERVISORS AND COUNTY ADMINISTRATOR
See Page ,2 .
BY ,DEPUTY
e .
I .O.-2
Dr. Brunner highlighted the fact that with the newly broadened
definition of "AIDS" , several hundred new cases are expected to be
reported in Contra Costa County during 1993, in addition to the ,
consistent annual growth of about 200 new cases . To date there
have been 925 cases of AIDS diagnosed and reported in Contra Costa
County, 70% of whom have died.
Dr. Brunner also noted that the Health Services Department will be
focusing their attention of the five cities with the highest
numbers of AIDS cases (Richmond, Concord, Walnut Creek, Pittsburg
and San Pablo) in an effort to get the cooperation of the city to
taking additional public education steps to prevent AIDS from
spreading. We suggested that it would also be helpful to see these
figures displayed on a per capita basis as well so we can see what
areas of the County have the highest incidence of AIDS as well as
simply the highest total number of cases .
Dr. Brunner also noted that while Tuberculosis in a healthy adult
is a nearly totally treatable disease, in an AIDS patient whose
immune system is damaged, Tuberculosis can become a deadly partner
to HIV infection and AIDS. Tuberculosis rates are seeing an
increase which is very troubling in a disease which we thought was
almost eliminated a few years ago. Health Services has developed
a Tuberculosis Fact Sheet which can be tailored to specific at-risk
groups like health professionals, law enforcement personnel and.
others who run an increased risk of being exposed to Tuberculosis.
We hope each Board member will read the Health Services
Department ' s attached report and we look forward to the
Department' s next quarterly report to our Committee.
cc: County Administrator
Health Services Director
Public Health Director
Francie Wise, R.N. , Director, Communicable Disease Control
-2-
i
Contra Costa County
The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR
Tom Powers, 1st District
Nancy C. Fanden, 2nd District Mark Finucane, Director
Robert 1. Schroder, 3rd District e:......,•_.,° 20 Allen Street
Sunne Wright McPeak, 4th District :'` �_ -i.; Martinez, California 94553-3191
Tom Torlakson, 5th District ,r % (510) 370-5003
n0 ;`�
County Administrator °`� "'�"" (510) 370-5098 Fax
Phil Batchelor °u T••• _•..•
County Administrator
January 20, 1993
To: Internal Ope a 'ons Commit
From: Mark Finucane, Direct , ealth Services D partment
by Wendel Brunner, M. D., Assistant Health Services Director for Public Health
Subject: Quarterly Report on Communicable Diseases
Attached is an update of communicable disease issues in the last quarter of the year. As you will
note:
• There are now 925 Contra Costa residents who have been diagnosed with AIDS.
• The Centers for Disease Control has expanded the case definition for AIDS diagnosis.
Since it became effective January 1, there have been 61 new cases reported in Contra
Costa County.
• Contra Costa County continues to have rates of HIV infection among childbearing
women that are higher than State averages. At the current rates approximately 16
children per year are born to infected mothers in Contra Costa and five are likely to
be infected with HIV.
• The rate of Tuberculosis is continuing to increase in Contra Costa County. Expanded
service hours and increased focus on the highest risk populations will be needed to
stem this epidemic,
• Countywide education through an informational fact sheet will help county employees
protect themselves and educate others to help in this anti-tuberculosis effort.
• Hepatitis is one of the important disease for which we have effective vaccine and
identified high risk population groups. We need to make a strong effort to use all of
the tools available to eradicate this potential killer.
Merrithew Memorial Hospital&Clinics • Public Health • Mental Health • Substance Abuse • Environmental Health
Contra Costa Health Plan • Emergency Medical Services • Home Health Agency • Geriatrics
A-345 (8/91)
Contra Costa County
The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR
Tom Powers, 1st District Mark Finucane, Director
Nancy C. Fanden, 2nd District
Robert I. Schroder, 3rd Districts---- 20 Allen Street
Sunne Wright McPeak, 4th District .;' `' ..
` ., Martinez, California 94553-3191
Tom Torlakson, 5th District 'P - (510) 370-5003
County Administrator (510) 370 5098 Fax
Phil Batchelor fid•
County Administrator rA .......
+t
January 20, 1993
To: In rnalOperatio Committee
From: ar Finucane Director, ea th Services Department
by Wendel Brunner, M. D., Assistant Health Services Director for Public
Health
Subject: Quarterly Report on Communicable Diseases
AIDS
NEW CASE DEFINITION FOR AIDS
Effective January 1, 1993, the,Centers for Disease Control published an expanded case
definition for AIDS. The new definition includes, in addition to the existing criteria published
in 1987, all adult or adolescent persons with documented HIV infection and any of the following
conditions:
1) A CD4+ T-lymphocyte count of less than 200 cells/ml (or a CD4+ percent < 14)
2) Pulmonary Tuberculosis
3) Recurrent pneumonia
4) Invasive cervical cancer
Monitoring of CD4+ T-lymphocytes counts has become standard in HIV care enabling
clinicians to measure directly the immunosuppressive effect of HIV infection. These measure-
ments provide the basis for therapies that delay the appearance of AIDS-indicator diseases. The
new definition intends to more accurately count and describe the characteristics of those at the
highest risk of severe HIV related morbidity and most in need of close medical follow-up.
Prior to January 1993, 856 Contra Costa residents had been diagnosed and reported with
AIDS according to the 1987 case definition (70% are known to have died). In the first three
weeks of 1993, there are an additional 61 persons reported who qualify under the new CDC
definition.
Merrithew Memorial Hospital&Clinics • Public Health • Mental Health Substance Abuse Environmental Health
Contra Costa Health Plan • Emergency Medical Services Home Health Agency Geriatrics
A-345 (arol)
Report to the Internal Operations Committee January 25, 1993
On Communicable Disease in Contra Costa County Page 2
Without any changes in their actual symptomotolgy or conditions that people with HIV
have, some 200-350 will be considered AIDS cases right away. Current epidemiological
projections are that although we would have expected 200 new cases in the year 1993, there may
as many as 700 qualifying under the new definition.
AIDS CASES REPORTED IN CONTRA COSTA
As of January 20, 1993, 925 AIDS cases had been reported to the Public Health
Division. This includes 61 cases added to the registry since January 1, 1993 when the new
Centers for Disease Control case definition became effective.
Of the total cases, six are children: three boys; three girls; five under age five years.
Of the 919 adult cases, 64 are women and 855 are men. Of the 925 total cases, 603 (65%) have
died.
RATES OF HIV-1 INFECTION AMONG CHILDBEARING WOMEN, 1988 - 1991
The results of the third annual 1991 HIV seroprevalence survey of childbearing women
in California were recently released by the State Department of Health Services Office of AIDS.
Blood samples taken from infants shortly after birth to screen for genetic diseases were tested
for HIV antibodies. All births during the third quarter of each year are included. Because
infants acquire HIV antibodies from their mothers, a positive anti-body test is indicative of the
mother's infection but not necessarily that of the child. Approximately one third of the infants
are infected themselves.
The rate of HIV infection in California was one in 1,249 women (0.08%); in the San
Francisco Bay Area it was one in 713 women (0.14%), and in Contra Costa County it was one
in 852 women (0.117%).
During this time period there were 3,406 births in Contra Costa County. Four
childbearing women had evidence of HIV infection at the time of delivery.
HIV infection was reported in childbearing women from 21 counties. Women from
Contra Costa had the third highest rate in the Bay Area, after San Francisco and Alameda. The
1991 rate for Contra Costa County was similar to the 1990 rate and lower than that of 1989.
Contra Costa's rate for 1991 was also similar to neighboring Sacramento (0.119%) and San
Joaquin (0.118%) counties.
At the current rates approximately 16 children a year are born to infected mothers in
Contra Costa County and five are likely to be infected with HIV. HIV infection from mother
to child may occur after birth. Knowledge about HIV status is essential to prevent any such
cases. Treatment protocols are under study to determine ways to limit further HIV transmission
before and during birth. Confidential HIV testing is strongly recommended for all women
entering prenatal care.
Report to the Internal Operations Committee January 25, 1993
On Communicable Disease in Contra Costa County' Page 3
Annual HIV Seroprevalence Rates among
Childbearing Women in California and
Contra Costa County, 1988-1991
Per 10,000 births
27.7
_...._......__......................__ .............. ._ ........... _
.._.............._................................_.....................................................
30 _. ._....... 12 3 ................
........_.
25 .........._._.._....__........ _..._...._....
_
11.7
6.6
20 _._.. _..... ........ ................
15 6.4 7 8
10
5
0
1988 1989 1990 1991
State of California Contra Costa County
Surveys Include all births during the
third quarter of each year
HIV HOUSING TASK FORCE.
The Health Services and Housing & Community Development Departments met in
November to further collaborative efforts regarding housing needs of people with HIV and
AIDS. There was agreement to form an HIV Housing Task Force to combine the knowledge
and programmatic efforts of housing providers and HIV services providers to assess the needs
of Contra Costa residents and to plan for needed services. Staff from both departments are
involved in organizing this task force.
AIDS SUBVENTION FUNDING
The State Department of Health Services Office of AIDS has announced recently, and
without evaluation or justification, an end to the subvention funding program that began three
years ago. This is a significant change for counties which for the past three years have received
funds to cover efforts in disease surveillance, education and prevention, and HIV testing in a
subvention agreement based on the local health department's plan. It has been the responsibility
of the local health department to plan, administer and coordinate the planned program including
contracting with local community-based organizations. The State Office of AIDS has abandoned
this model and instead put forward an inherently competitive model for funding of the prevention
education programs statewide. The Contra Costa HIV/AIDS Consortium has chosen to submit
an application which is a collaborative program plan and disavows. the competitive approach to .
which the State is reverting.
Report to the Internal Operations Committee January 25, 1993
On Communicable Disease in Contra Costa County Page 4
TUBERCULOSIS
In our report.to this committee in September 1992 we discussed the rising number of
tuberculosis cases in our county and the relationship of our numbers to the "Healthy People
2000" goals. In 1991 we had a tuberculosis rate of 13.2 per 100,00 population, 108 cases. In
1992 we reported 113. new cases of active tuberculosis, with a rate of 13.5 per 100,000
population.
Although the 1992 data does not represent a statistically significant change, the data
obviously represent a continued upward trend in the rate of active tuberculosis disease. Identi-
fied cases continue to live mostly in West County (62%). This increase is at least partially
asssociated with HIV infection and the rise in the AIDS epidemic.
In September we proposed a course of action which we will continue through 1993, with
focus on: directly observed therapy for all persons at risk for non compliance, cooperative
outreach with community based organizations and increased screening and preventive treatment; .
for those at high risk for infection.
Additionally, we are planning to expand hours of the tuberculosis to provide closer.
medical supervision of all active tuberculosis cases in treatment, their contacts and newly infect-
ed persons who need evaluation and/or treatment.
This committee requested a Tuberculosis Fact Sheet, which is attached. Due to the
increasing number of cases and the potential for exposure of all county employees, who work
directly with the public, it is our recommendation that this document be circulated to all county
employees for informational purposes.
HEPATITIS
We are continuing to review significant areas of Public Health to ready ourselves to meet
the goals of the "Healthy People 2000". The second area which we are submitting to this
committee is a review of Hepatitis.
Report to the Internal Operations Committee January 25, 1993
On Communicable Disease in Contra Costa County Page 5
HEPATITIS RATES
National Objectives:
YEAR 2000 OBJECTIVE FOR HEPATITIS B (HBV)
NO MORE THAN; 40 CASES PER 100,000 POPULATION
YEAR 2000-:0BJECTIVEFOR HEPATITIS A (HAV):
NO MORE MAN,, 23 CASES PER;100,000 POPULATION
The year 2000 Objective for reported cases of Hepatitis B has already been met. The rate
of 13.6 reported for 1990 is well below this objective which was set at 40.0. Additionally,
starting in 1991, more stringent criteria for reporting an acute case of Hepatitis B have been
established by the California Department of Health Services. Without a clear date of onset or
laboratory confirmation of an infection as one of recent nature (positive anti-HBc IgM test) a
Hepatitis B infection will be reported as a carrier and not a case. In the past some of these were
accepted as acute cases. This protocol is likely to reduce further the reported cases of Hepatitis
B. Behavior modification among high risk groups (gay/bisexual men, injection drug users,) for
HIV/AIDS prevention is likely contributing to the stable low hepatitis B incidence levels
observed in this decade.
The year 2000 Objective for reported cases of Hepatitis A has also been met. The
underreporting of this condition seems to be significant all across the US. Improvement in
reporting may change the decreasing trend observed since 1985.
In order to secure the progress observed in Hepatitis A and to maintain the relatively
stable low rate of Hepatitis B the following additional Year 2000 Objectives
are presented:
YEA....W.............2.. 000 OBJECTIVE FOR HEPATITIS:.B MMUNIZATION:
Increase Immumzaton levels among high risk populations mc..ludmg:
* 90 of infants of surface antigen positive mothers
90% of occupat►onally exposed workers
* 50% of injection drug users m.treatment
* 50% of gay/bisexual men
Local data is not available yet to evaluate the level of immunity among these high risk
populations. Decreases in the incidence of Hepatitis B will difficult to achieve, particularly
among drug abusers, unless people can be motivated to receive the vaccine, and programs can
be established to deliver the vaccine to these individuals.
Report to the Internal Operations Committee January 25, 1993
On Communicable Disease in Contra Costa County Page 6
Table HEP-1
1980-1991 Incidence rates per 100,000 population for cases of Hepatitis A and B
YEAR I E .ATITIS A HEPATITIS B
1980 35.8 12.5
1981 28.6 9.1
1982 19.0 9.3
1983 9.6 6.6
1984 13.6 8.4
1985 20.7 12.4
1986 21.1 13.4
1987 19.5 9.5
1988 8.4 8.0
1989 15.5 12.9
1990 16.1 13:6
1991 9.9 4.6
Y�Z000 oblboe 23 40
Figure HEP-1
1980-1991 Incidence rates per 100,000 population for cases of Hepatitis A and B
Hepatitis "A" Objective
40
HEPATITIS 'A'
30
Hepatitis "B" Objective
20
10
HFRAIITIq .
0
80 81 82 83 84 85 86 87 88 89 90 91 92 94 96 98 2000
Report to the Internal Operations Committee January 25, 1993
On Communicable Disease in Contra Costa County Page 7
RECOMMENDATIONS FOR CONTROL
A. Given the high levels of immunity among drug injectors, developed through
prior infections, institute routine screening for Hep B immunity in drug
programs attended by drug injectors. Offer Hepatitis B immunization to all
injection drug users in treatment who are susceptible to the disease.
B. Collaborate with organizations reaching out-of-treatment drug injectors to
include Hepatitis B education, screening'for immunity and referrals of
susceptible people to Public Health clinics for.immunization.
C. Coordinate with HIV prevention organizations in Contra Costa County already
reaching gay and bisexual men, particularly young, to include in their outreach
and education, recommendations for Hepatitis B immunization. Including
referrals to their usual health provider for the immunization series.
D. Distribute information on Hepatitis B and immunization to all gay/bisexual men and drug
injectors presenting at HIV Alternative Test Sites, Sexually
Transmitted Disease (STD) clinics and Merrithew Memorial hospital and clinics
in the county. Study the feasibility of offering Hepatitis B immunization to all
or high risk clients of STD clinics. Similarly, encourage all Merrithew
Memorial clinicians to offer the immunization series to clients of high risk
groups when they are presenting for treatment.
E. Encourage all health maintenance organizations(HMO), hospitals and medical emergency
services in the county to assure immunization of staff and of all clients in high risk
groups. Additionally, evaluate if appropriate protocols exist in each organization to offer
post-exposure immunizations.
F. Use the local cable system and other inexpensive ways of mass communication to educate
the general public on the consequences Hepatitis, both A and B, and on the availability
of immunizations against the B virus and IG prophylaxis for travelers to highly endemic
areas.
G. Encourage improve reporting of Hepatitis B carriers and cases. All reported
Surface antigen positive tests must be accompanied by anti-HBc IgM test.
H. Develop informational fact sheets on Hepatitis A and B for distribution to health
providers and the general public. Have this information delivered through public
announcements in local/regional mass media in both English and Spanish.
I. Increase surveillance efforts, including laboratory surveillance, to detect
Hepatitis B carriers.
CONTRA COSTA COUNTY HEALTH SERVICES
PUBLIC HEALTH
TUBERCULOSIS FACTS
Tuberculosis (TB) is on the rise in Contra Costa County, as it is across the United
States. In 1990 there were 25,700 cases reported in the U.S. That is 16% more than in
1985. In Contra Costa there were 1.08 TB cases reported in 1991. That was an increase
of 35% since 1987..
The bacteria that causes TB (Mycobacterium tuberculosis) usually infects the lungs, but
can infect many other organs of the body including the kidneys, bones and meninges
around the brain. Symptoms include coughing, shortness of breath, fever, weight loss
and sometimes coughing blood.
Tuberculosis is transmitted from person to person through the air. When a person with
TB disease in the lungs coughs, sneezes, talks or sings, the TB bacteria comes out into
the air. The bacteria can stay airborne for a few minutes up to several hours depending
on air flow and moisture in the air. If another person inhales the bacteria into his/her
lungs, it can cause TB infection.
To check if a person is infected, he/she is given a tuberculin skin test (PPD). This does
not tell if the person has TB disease, only that he/she has TB infection. He/she is not .
infectious to anyone else if the chest x-ray is normal. About 90% of people with TB
infection will never get TB disease.
The first time a person has a positive skin test, he/she should have an chest x-ray. If the
x-ray is normal he/she has TB infection and not.TB disease. In this case, the person
should see a physician to discuss preventive medication to make sure TB disease does
not develop.
If a'person has signs of TB disease on the chest xray he/she will need to be treated for
at least six months with 2-4 drugs to get well. TB is curable, especially if found early and
if the person takes medication as prescribed. If a person does not take medication
correctly, this may lead to drug resistant TB. This means that the usual medications
used to treat TB will not work. Drug resistant is harder to treat and cure. This person
will need to be treated with more medications for a longer time. About 50% of the
people with drug resistant TB will die of that disease.
Once a person has a positive skin test it will stay positive for life. If a person has had a
negative skin test within the past two year and now has apositive skin test, he/she is
called a converter. If a person has had a positive skin test for many years or has never
had a skin test before and is now positive, he/she is called a reactor. Converters can be
identified if people have yearly skin tests. Skin testing is done on a yearly basis for
employees in specific jobs and is also done for contacts of a person with TB disease. In
either case, if converters are identified, it indicates that TB is being transmitted to previ-
ously uninfected people. This may be related to a currently identified problem, or it may
indicate a new problem which needs to be investigated. If reactors are identified, it does
not necessarily indicate TB transmission or a current problem.
2
Tuberculosis is increasing because of many factors; homelessness, poverty, chemical
dependency and HIV infection are four major factors.
Homeless persons have a high rate of TB which is promoted through crowding into
shelters, poor nutrition, lack of access to medical care, poor follow through with medical
care regimens as well as high rates of chemical dependency and HIV infection.
Poverty increases disease rates for many of the same reasons as homelessness. Addition-
ally, poor general health and poor nutrition lead to increased and more rapid progres-
sion from infection to disease after infection occurs.
Chemical dependency includes excessive use of alcohol, intravenous drugs and crack
cocaine. Many patients use more than one of these substances. Most substance abusers
have poor general health and poor nutritional status. Most of these patients will fail to
follow through with prescribed medical treatment. This failure to take medications
correctly may lead to drug resistant TB.
HN Infection - An increasing proportion of TB patients are also HIV infected. Persons
with HIV infection who become infected with TB have a much greater risk (60-80 times)
of developing active TB disease than a non HIV infected person.
People who are in these four categories should have a skin test for TB at least once a
year. If a person in these categories develops symptoms of TB - night sweats, fevers
and/or a cough lasting more than three weeks, he/she should see a physician and be
evaluated for tuberculosis.
Persons who work with people in the categories listed above (medical personnel, law
enforcement, social service and others) should also have a yearly skin test. If the test is
positive it should be followed by a chest x-ray. If the chest x-ray is normal, preventive
medication should be considered and discussed with his/her physician. They should also
be aware of symptoms of tuberculosis and have a medical evaluation if they have any of
these symptoms.
It is important to remember how TB is transmitted and how it is not transmitted:
• In general it takes prolonged contact with a person who.has active disease
to become infected (at least several hours face to face) or living with the
person who has TB disease.
• It is not spread from articles such as pencils, table tops, bedding, papers or
food. You must inhale the bacteria and get it into your lungs. Persons
with TB infection, who do not have TB disease, are not infectious.
The most important information to remember is that TB is in the community and if you.
work with high risk people, get tested yearly. If you have symptoms of TB, see your
physician immediately.
1/93
THE AIDS EPIDEMIC IN CONTRA COSTA COUNTY
November 1992
What is the problem?
• AIDS stands for Acquired Immune Deficiency Syndrome, a condition that destroys the body's defenses
against certain infections and cancers. AIDS is a fatal disease.
• AIDS results from infection with the Human Immunodeficiency Virus (HIV). HIV is passed from one
person to another through blood or sexual contact. HIV infection can result from one sexual encounter
or from sharing a needle to inject drugs.
• Many people with HIV infection appear healthy and do not know they are infected. HIV infection can
be detected through an HIV antibody test - but many people most at risk for HIV infection have not yet
taken a test.
• Although medications can slow the deterioration of the immune system, there is no cure for AIDS.
• AIDS can be avoided. But risky behaviors are often difficult to change even when people know the
facts.
Who is being affected by HIV/AIDS?
• Since 1982, 833 cases of AIDS have been reported in Contra Costa County. At least 557 persons have
died. Currently an estimated 3,600 Contra Costans are infected with HIV. An additional 440 AIDS
cases are projected by the end of 1994. To date 777 men, 50 women, and 6 children have been
diagnosed with AIDS.
• The majority of.people with AIDS are gay and bisexual men (69%) although increasing proportions of
the people with AIDS are injection drug users, women, African Americans and Latinos. The numbers
of cases are disproportionate to the population size.
• Injection drug users account for 19% of the cases. If the spread of HIV among injection drug users is
not dramatically curtailed, this population could reach levels of infection found on the East Coast of the
United States (60-70%) by 1996. Currently the rate of infection among African American injection drug
users in Contra Costa County is 30%.
• At least .5% of the general population, 12% of all drug injectors, 14% of gay and bisexual men, and
1.5 per thousand women delivering babies in Contra Costa are estimated to be infected with HIV.
• Increasingly, AIDS is occurring in West County and East County. Of people with AIDS, 45% now live
in Central County, 36% in West County and 19% in East County.
• The spread of AIDS in poor communities puts an increasing burden on the public health care system.
a
What are the social and economic costs of HIV/AIDS?
• AIDS is largely a disease of the young. Already, early deaths of Contra Costa County residents from
AIDS represents a loss of 19,000 potential years of life. If all HIV-infected Contra Costa residents
develop AIDS, our communities could lose 130,000 potential,years of life.
• The estimated potential earnings lost by Contra Costa residents who have died from AIDS totals $388
million. Using the same rates for all persons estimated to be HIV-infected, the potential lost earnings
could amount to more than $2.5 billion.
• Resources for HIV care and treatment are increasing - but funds for disease monitoring, counseling,
testing and prevention education have been reduced.
• The annual cost of medical care for each person with AIDS is now estimated to be $38,000. The
lifetime cost of caring for all Contra Costa residents estimated to be.HIV-infected could.require an
additional $300 million. The amount of suffering by these persons and their families is immeasurable.
What needs to be done?
• Learn all you can about HIV and AIDS. Inform your families and friends and influence them to adopt
healthy behaviors.
• Increase AIDS awareness so that Contra Costa residents understand the disease. Understanding helps to
eliminate unnecessary_fears and prejudices and encourages a compassionate and supportive response to
those who are suffering.
• Protect people living with HIV infection from discrimination.
• Provide testing, counseling, medical care and support for all people infected with HIV.
• Increase HIV/AIDS prevention efforts by county, city and community agencies.
• Reach the populations most at risk with concentrated,prevention messages and innovative programs.
• Expand efforts to involve city, community and church leaders in delivering AIDS prevention messages
in the most affected areas of the county.
For more information contact.
• Health Services Department HIV/AIDS Program, 313-6770
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