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MINUTES - 05121998 - P2
The Board of Supervisors of Contra Costa County In the Matter Resolution No. 9 812 0 0 RECOGNITION OF TRY TRANSIT WEEK, MAY 11--15, 1998 WHEREAS, increased public investment in transit services', provides the potential to create jabs and enhance business prosperity; and WHEREAS, public transportation is vital to the quality of life ',and economic well-beim of the citizens of Contra Costa County; and WHEREAS, workers, school children, senior citizens, people with disabilities, and those unable to afford an automobile use public transportation to gain access to jabs, schools,medical facilities,and other fundamental services; and WHEREAS, the nation, our communities, and our citizens face the risks to health and the environment that are brought on by automobile exhaust emissions;and WHEREAS, traffic congestion that wastes productive time can be alleviated through the increased availability and use of public transportation and other forms of high-occupancy, shared-ride services; and WHEREAS, Tri Delta Transit, the American Public Transit Association. the U.S. Department of Transportation, the Federal Transit Administration. the American Association -of State Highway and Transportation Officials, the Association for Commuter Transportation, the Association of Metropolitan Planning Organizations, the National Association of Counties, the National League of Cities. the Surface Transportation Policy Project, the U.S. Conference of Mayors. and the Community Transportation Association of America, have declared May 11-15, 1998 to be TRY TRANSIT WEEK and have called upon all citizens to join in a nationwide effort to promote transit's benefits,honor transit employees, and encourage new riders. NOW, THEREFORE, BE IT RESOLVED, that the Board of Supervisors of the County of Contra Costa, California does hereby recognize the week of May 11-15, 1998 as TRY TRANSIT WEEK. We call upon all citizens to examine their personal travel choices, to commute via transit or share the ride during TRY TRANSIT WEEK, and to become more active in education and advocacy efforts to promote the vital role of public transit. PASSED by unanimous vote of the Board Members present on this 12'h day of May, 1998. I hereby certify that the foregoing is a true and correct copy of a resolution entered on the minutes of the Board of Supervisors on the state aforesaid. Witness my hand and the Seal of the Board of Supervisors affixed on this 12'h day of May, 1998. PHIL BATCHELOR., Clerk of the Beard of Supervisors and County Administrator By ' Introduc#d by: Deputy pe rloflo?eCanciami Ila, District V ........................................................................ ..................................................... .................................................... .......................... 3 Contra Costa County HIVIAIDS Epidemiology Report Recently Detected HIV Infections January 1997 - June 1997 Clients tested for HIV at county Anonymous Test Sites*without prior positive test(tested+ltotal tested) Men Race Gay/ Gay/ Hetero- Hetero- Blood/ Health Other/ Tbtai bisexual bisexual sexual sexual blood Care unkrjjD" IDU IDU partner product worker White 2/64 1/16 0/169 01215 0/1 0/1 0/60 ................. African American 0/9 0/2 1/54 1/124 0/1 012 1/28 ::::-:1.31220;- Latino 1/22 0/5 0/45 0/127 0/1 0/1 0148 Asian 0/3 0/0 012 0/10 0/0 0/0 0/8 0/23' .......... ..... .... Native American 0/0 0/0 0/3 0/5 0/0 0/0 0/0 . 018 Other 0/3 0/1 0/9 0113 0/0 0/0 0/7 124 11282 1149 Ota 014 1'151 71'I 059 Women Race Heterosexual Heterosexual Health Care Otherlunknown Totat IDU partner worker White 1/139 01197 0/8 0/73 '41 African American 0/44 3/123 0/3 0/64 111��: -:i�,3)234Ii Latino 0/18 0/89 0/3 0/122 Asian 0/0 0111 0/0 0/10 Native American 0/3 0/5 010 0/0 . ........ ..... ... .............. ........ Other 0/1 0/7 0/0 1/7 1115 Total _ 12,05 3143 Ek/14 1128 52? Locations and schedules of ATS: Concord Pittsburg Richmond 2355 Stanwell Circle 550 School Street 100 39th Street Tuesday Wednesday Thursday 5:00-8:30 p.m. 6:00-8:00 p.m. 6:00-8:30 p.m. For more info call 1-800-287-0200 Free-Donations accepted ............... ..........-.............. January 1998 4 1138 NTRA +CC?STA Dt UNTY RE IDENTS 131AONf SED WITH AIDS iF Thrau h Dacernber 31, 997, a;curnu#at ve.0tai of 1,938 cases�#{SIRS r e e reparieci ljr Cnmt�nicable i�isease Ccntrol. This re�resnts a cumulatve incidence of 22.0 per X10,# Q `pnpuiatit n using 1996Oopulaticr prci U. n plata.fr.""' the Ca�ifc,M Smote iepartnrent Finance. This estimate. based on reported cases. Total AIDS cases reported through 12131/97 Mode of infection and gender distribution Adult and adolescent cases (n=1,926) Mode of HIV infection Male {°!o) f=emale {°!o) Total Gay/bisexual 1184 (71.0) 0 (0) 1184(61.5) Heterosexual injection drug use 280 (16.8) 130 (50.4) 410 (21.3) Gay/bisexual injection drug use 104 (6.2) 0 (0) 104(5.4) Hemophilia 16 (0.9) 0 (0) 16(0.8) Heterosexual contact 8 (0.5) 99 (38.4) 107(6.5) Transfusion with blood/blood product 28 (1.7) 16 (6.2) 44(2.3) Risk under investigation 48 (2.9) 13 (5.0) 61 (3.2) Total 1668 (100) 258 (100) 1926 (100) Pediatric cases (n=12) Mode of HIV infection Mate {°lo) Female (°!o) Total Parent at risk or has H1V/AIDS 4 (57.1) 5(100) 9 (76.0) Transfusion with blood/blood product 3 (42.9) 0 (0) 3 (26.0) Total 7 ('100) 5 (100) 12(100) ..................................... ...................... _ _..... ......... ......... __..... ......... .........._....... _. .._..................... 5 Contra Costa County HIV/AIDS Epidemiology Report Race Ethnicity Distribution Race/Ethnicity Aduit/adolescent cases (°I°} Pediatric cases(%) Total(%) White 1135(58.9) 4 (33.3) 1139(58.8) African American 548(28.5) 4(33.3) 552(28.5) Latino 199(10.3) 4(33.3) 203(10.5) Asian/Pacific Islander 35(1.8) 0(0) 35(1.8) Native American/Alaskan 9(0.5) 0 (0) 9(0.4) Total 1926(100) 12(100) 1938(100) Age Distribution Year of Diagnosis (Age at time of diagnosis) (New diagnoses) Age Total(%) Groups 250 <5 8(0.4) 232 222 ' 222 5-12 4(0.2) 13-19 6 (0.3) 4x: 182 ISO 20-29 233(12.0) 30-39 820(42.3) 146 40-49 593(30.6) 133 i 133 50.59 182(9.4) 105 + 60-69 69(3.6) x 81 >69 23(1.2) 65 Total 1938(100) 53 39 } } L2 i 1 I I I I i i I I I 1982 1983 1934 1986 1989 1997 1989 19891990 1991 1902 1993 1994 1995 1996 1997 January 1998 6 Residents Living with AIDS as of 12131/97 (n-656) Mode of infection and Gender Distribution Mode of infection Male(%) Female (°fo) Total (%) Gay/bisexual 373(69.6) 0 (p) 373 (56.9) Heterosexual injection drug user 103 (19.2) 58 (48.3) 161 (24.5) Gaylbisexual injection drug user 31 (5.8) 0 (0) 31 (4.7) Hemophilia 4 (0.7) 0 (0) 4(0.6) - Heterosexual (0.6)Heterosexual contact 2 (0.4) 48 (40.0) 511(7.7) Transfusion with bloodiblood product 1 (0.2) 7 (5.8) 8(1.2) Parents at risk for HIV 2 (0.4) 2 (1.7) 4(0.6) Risk under investigation 20 (3.7) 5 (4.2) 26(3.8) Total 536 (400) 120(100) 656(100) Race/Ethnicity Race/Ethnicity Adult/Adolescent cases(%) Pediatric cases(°lo) Total White 353(54.1) 0 (0) 353 (53.8) African American 215 (33.0) 2 (50-0) 217 (33.1) Latino 68 (10.4) 2 (50.0) 70 (10.7) Asian/Pacific Islander 14 (2.2) 0 (0) 14(2.1) Native American/Alaskan ' 2 (0.3) 0 (0) 2(0.3) Total 652(100) 4(100) 656(100) 7 Conga Costa County HIVIAIDS E idemiolo Report ESTIMATE OF CONTRA COSTA COUNTY RESIDENTS INFECTED WITH HIV Based on back calculations a total of approximately 4,004 Contra Costa County residents are estimated to have been infected with HIV. Of these, 1,938 (48.50/6) have already been diagnosed with and reported to have AIDS; 1282 people have died of AIDS. HIV only 40.9% Never reported 1840 5.0% \\\ i' Projected new AIDS diagnoses in 1997 858 0.5% 18.4% 5.2% Living with AIDS` HIV positive at death 1282 without AIDS 32.0% Death due to AIDS Local estimate of the number of people living with HI VIAIDS: -2,600 Global Vl w of'the AIC3S Ep de iic Cases deaths Contra 1930, 1;282 (12I3fiJ.3 day A rea* (State�3t ice df.AI 3S) 38 0fia 26085 ( 2T31I 7} Galiarniia {state ace of AlL)S) 104,144 46 '139 ( M ) U:S.. (CnC&P) £12}1?8 379;258 (06130197} lorld iso).. 30;6000€30 11,708,000 ( 1I261 ) Sy AKea-Counties:Alameda,Contra Costa,Made,Napa,San Francisco,San Mateo,sanfa Clara,so#ano,Sonoma January 9998 8 California Counties with Highest Cumulative incidence of AIDS Cases per 700,000 population using 4997 population prrrjecdon data from Catifomia State Department of Finance, as of 42/31/97 San Francisca ,858.6 Marin fr r, .r 42.5 Los Angeles 88.2 Alameda E: 69.1 Sonoma 50.4 San Diego =532 Solano51.9 Riverside Z:545.5 San Mateo EZ537.8 Contra Costa fir':420.2 Contra Costa Cities with Highest Cumulative Incidence of AIDS Incidence per 7,000 population using 1996 population projection data from California State Department of Finance;reported for cities with>50 cases,as of 12/34!97 Richmond 8 San Pablo 2 Pittsburg �. . Walnut Creels 8 6 Martinez .4 Concord .. Pleasant Hill q2.2 Antioch .., 1.4 9 Contra Costa County HIVJAIDS Epidemiology Report Deaths among people diagnosed with AIDS By year of death,as of 12/31197(n=1,282) 179 150 156 , 137 ` aV � lv J � 1 61 3 1 r ,. 44"'.c G r pa e k s 39 � � 49 ` 20 12 r �. 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1995 1997 Draft HIV/AIDS Treatment Guidelines for Adults and Adolescents The Panel on Clinical Practices for Treatment of HIV in pregnant women who do not require HIV Infection, convened jointly by the Department of antiretroviral drugs for their own treatment. Health and Human Services and the Henry J. Kaiser The guidelines relied in part on the companion Family Foundation, has issued draft Guidelines for the document Report of the NIH Panel to Define Use of Antiretroviral Agents in HIV-Infected Adults and Principles of Therapy for HIV Infection, which Adolescents. The guidelines recommend that all provides the scientific rationale for therapeutic individuals with CDC-defined AIDS should receive strategies. combination antiretroviral therapy, preferably with three Both documents were subject to a 30-day drugs including a protease inhibitor. The guidelines public comment period, which has now closed. further recommend that treatment be guided by regular After reviewing the comments, the panel will monitoring of the patient's viral load and CD4+count. publish final versions of both documents in the At least two drugs in a three drug regimen should be Morbidity and Mortality Weekly Report. Until then, changed when there are indications (such as an the drafts remain available from the National AIDS increase in viral load) that treatment is failing. Clearinghouse at 800-458-5231 and their Web site Treatment with only two drugs is considered less than at www.cdonac.org or from the HIV/AIDS optimal and treatment with only one drug is not Treatment Information Service at 800-448-0440 recommended. An exception is made for the use of and their Web site at www.hivatis.org. AZT monotherapy to prevent vertical transmission of Source:HHS News, June 19, 1997 White House Abandons Medicaid Pian for HIV The Clinton administration has abandoned an renew hope and ensure that good people are not attempt to use Medicaid to ensure that tens of priced out of live-saving medicine." thousands of poor, HIV-infected Americans who are The department had hoped to cover the drugs by still healthy get new therapies that may prolong their expanding Medicaid, the federal health insurance lives, according to federal health officials, who program for the poor and disabled. But by law, concluded the drugs were too expensive. Medicaid can only start innovative experiments if it The decision comes eight months after Vice can prove that they will not add to the programs President Al Gore announced to AIDS activists that expenditures. he had directed the Department of Health and Human Services to explore ways to"ease suffering, SF Chronicle,Friday, December 5, 1997,A 12 January 1998 10 Contra Costa Residents with AIDS by city of residence as of 12131197 Byron 4/2 Brentwood M 3/12 Oakley E 9/13 Bay Point 18142 Antioch (_ 39/67 Pittsburg 67191 Pacheco 1 114 Alamo [5 3111 Moraga [M 4113 Clayton CN 6/10 San Ramon E 9125 Danville E� 11127 Lafayette EIN 150 Orinda 9/28 Living Pleasant Hill 28143 Deceased Martinez i 40153 walnut Creek 571119 (Living/Deceased) Concord 821187 Crockett 11214 Rodeo Z2/9 Kensington ]IJ 418 Hercules X711)118 El Sobrante CM 13121 North Richmond EM 10123 Pinole JM 6/29 El Cerrito DM 14134 San Pablo iir 30178 Richmond A 1581282 Chart includes only cities with 5 or more reported cases. Four additional cities also reported=cases. THE HIVIAIDS EPIDEMIC 11 What is the problem? • AIDS stands for Acquired Immune Deficiency Syndrome, a condition that destroys the body's defenses against certain infections and cancers. Although, there is presently no cure for AIDS, the latest treatments available are allowing those infected with HIV to live longer. • AIDS results from infection with 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 who are 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. • AIDS can be avoided, but risky behaviors are difficult to change even when people know the facts about transmission. Who is being affec ed by HWIDS? • Since 1982, 1,538 cases of AIDS have been reported in Contra Costa County. At least 1,282 persons have died. At the present time the number of Contra Costa residents estimated infected with HIV is approximately 4,000. To date 1,668 men, 258 women, and 12 children have been diagnosed with AIDS. The majority of people with AIDS are gaytbisexual men (61%) and gay/bisexual men who inject drugs (5%), although increasing proportions of people with AIDS are heterosexual injection drug users, women, African Americans and Latinos. These numbers are disproportionate to the size of the racial/ethnic populations in the county. • Heterosexual injection drug users account for 21% of the AIDS cases. If the spread of HIV among injection drug users is not dramatically curtailed, this population could soon reach the levels of infection found in some areas of the East Coast of the United States (60-70%). Currently the rate of infection among African American injection drug users in Contra Costa is 30.6°/x. • At least 0.5% of the general population, 10% of all drug injectors, 11% of gay and bisexual men, and one per thousand women delivering babies in Contra Costa are estimated to be HIV infected. • AIDS has put an increasing burden on the public health care system. IN CONTRA C 0 S T A C 0 U N T Y 12 What are the soci l and economic costs of HIVIAIDS? • AIDS is largely a disease of the young. Already, the known early deaths of Contra Costa County residents from AIDS represents a loss of 37,285 potential years of productive life. If all HIV-infected Contra Costa residents die from AIDS, our communities could lose an additional 70,000 potential productive years of life. • The estimated potential earnings lost by Contra Costa residents who have died of AIDS total $700 million. Using the same rates for all persons living with HIV, the potential lost earnings could amount to an additional $1.37 billion. • The yearly cost of treating AIDS related opportunistic infections can reach $38,000 per person per year. Combination therapies using protease inhibitors may cost as much as $18,000 per year. The use of protease inhibitors may reduce the cost of treating AIDS related infections by $3,000. During the next few years, treating people with AIDS in Contra Costa could cost as much as $30 million a year and treating people with HIV in Contra Costa could cost up to another$30 million, if all the 1,640 individuals estimated to be infected were to receive protease inhibitors. What needs to be done? • Learn as much as possible about HIV and AIDS. Inform family and friends and encourage 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 to 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. 13 Contra Costa County HIV/Aim Epidemiology Report How Residents Were Infected with HIV Modes of infection by year of AIDS diagnosis 160 f i 140 120 , i 100 - 80 i Q(� f € I 60 ♦♦ �'► 40 ,♦� ��, E ,■r 20 ♦1r Q982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 Gay/bisexual men ----- Injection drug users Gay/bisexual male IDUs --- - — Heterosexual Contact Other* *Hemophilia,transfusion receipt,maternal exposure,no risk identified Men having sex with men continues to be the largest group from which new diagnoses of AIDS emerge, followed by injection drug users. The gap between these two groups is closing with each passing year. The following pages will go into greater detail regarding the populations affected. January 1998 14 HIV/AIDS Among Gay/Bisexual Men Gay and bisexual man (n=1,288*), constitute the group from which 68.5% of $5.2% $4.3% all cases have been 76 % reported in the count and M 73 7% , p Y 71 8!. the largest group fromWRNIO which new cases are n ' Nk 82.5% 5$.9% emerging. Nevertheless a ��� � � 4 ��� �� declining trend is observed r ° �� �_ 5a s% � �� rla'i p r S #$ 'fir in the proportion of AIDS '�� " � A cases from this group. r t, R w og (The actual number Of �"a N; � � cases is shown inside the x� bars.) 4V, 01 *This number includes both 117U iJcaylbiseXual filen (n=104) and non-IDU C-aylbisexual mel? (n-1,184) 1982-93 1984-86 1986-87 1988-89 1890-91 1992-93 1994-95 1996-97 HIV Prevalence Among hlon4DU Gay Bisexual Men (Voluntarily tested at the publicly funded county clinics, 1985-June 1997) 15% 18.9% 10.4% Ot @ i x a r q d , pglfi t � 4% 4.8% 1 ^�t I' �� 3 3% 3% �� E `g 1985-87 1988-89 1998 1991 1992 1993 1994 1995 1996 1987 1985-97 (tested+/total tested) 1985-87 1988-89 1990 1981 1992 1893 1994 1995 1996 1997 1985-97 1481766 1401933 511469 451570 311643 301466 301370 251338 71215 31101 51014891 18.8% 15.0% 10.9% 7.9% 4.60!0 6.4% 8.1% 7.4% 3.3% 3% 10.4% 15 Contra Costa County HIVIAIDS Epidernio%gy Re rt Heterosexual, Gay, and Female Injection Drug Users Since the first years of the AIDS epidemic in the county eo an increasing number of AIDS Heterosexual mate IOU cases are injection drug users so Gay/bisexual male ID.0 (IDUs). Presently, IDUs make . . . . . . Female IOU up 26.6% of all the AIDS 40-1 cases diagnosed in the county. The data represented 30 in this chart and the table directly below reflect AIDS cases diagnosed through 20 1997. Of the 514*IDUs over .00ft half of them are African 10 American. ;L r-- --7-- T 1 *This number also incfudes 198319841985198619871988198910901901199219931904 logs 19961997 gaylbisexual IDUs (n=104) as of 12/31/97, 1995 1997 en 1987 ��11980k 1991 IM993 14 4 7 16 .14�11� 37 34 33 HOW'' Gaylblsexual 104 0 2 5 6 16 17> 8 11 7 7 < 2 FernaMe0 0 13 24 0 7 12 18 15 7 Race/Ethnicity of Injection Drug Users (as of 12131197) Race/Ethnicity Male IDUs Female IDUs Total White 137 26 163(31.7) African American 201 98 299(68.2) Latino 40 6 46 (8.9) Asian/Pacific Islander 4 0 4 (0.8) Native American 2 1 0 1 2 (0.4) Total 384 130 314 (100) Janus 1998 16 H1VlAIDS News... Women Who Obtain Multiple HIV Tests Have Higher Levels of Risky Behavior In a recent study of inner-city women sex with an injection drug user, or sex with an at high risk for HIV infection, L. Solomon, et al. HIV positive partner, were significantly more found that 75% of study participants had likely to have received a prior test and also previously been tested for HIV infection and more likely to have failed to return for test 62% of these women had multiple prior tests. results. Of the women who had been tested HIV testing behaviors in a population of inner-city previously, 13% failed to return for their test women at high risk for HIV infection. J Acquire results. Women participating in particularly Immune Defrc Syndr Hurn Retravirol 1996;13.267- high-risk activities such as injection drug use, 272 Study Sheds New Light on Mother-to-Infant HIV Transmission In Oobstetrical Factors and the obstetricians should consider caesarean Transmission of Human Immunodeficiency section delivery for women who have not used Virus Type I from Mother to Child,"Sheldon H. AZT or show evidence of AZT resistance, if Landesman ;M.D., 'et al; report that HIV- the duration of ruptured membranes appears infected women who give birth more than four likely to exceed four hours. However, the hours after rupture of the fetal membranes are effectiveness of caesarean section delivery in nearly twice as likely to transmit the virus to preventing perinatal transmission has not their infants, compared with women who been demonstrated and the procedure may be deliver within four fours of membrane rupture. associated with increased risk of infectious Illicit drug use during pregnancy, low prenatal complications i nl severely CD4+ lymphocyte count, and low birth weight immunocompromised HIV infected women. were also associated with increased risk of NEJM 1996;334:1617--1623 transmission. The authors state that Two Drugs Better than One for Treating Children with Symptomatic HIV Infection A large multi-center study supported by Based on a review of preliminary the National Institutes of Health suggests that results of the study, an independent Data and initial therapy using zidovudine (AZT) Safety Monitoring Board recommended that combined with either lamivudine (3TC) or enrollment in the study (known as AIDS didanosine (ddl) is more effective at delaying Clinical Trial Group (ACTG 300) be stopped disease progression or death in children with early and the study closed due to the obvious symptomatic HIV infection than using ddl improvement in clinical benefits conferred by alone. the combination regimens. The board found Preliminary results of the study indicate the AZTI3TC combination treatment that combination antiretroviral therapy should decreased the risk of death by 80 percent be the preferred initial treatment for relative to ddl treatment alone. symptomatic HIV-infected children, particularly those under three years of age, who have Source.NIH News Release, June 26, 1997. never been treated with anti-HIV drugs. 17 Contra Costa County HIVIAIDS Epiderniokqqy Report AIDS among Heterosexual Men & Women in Contra Costa County AIDS diagnosis among heterosexual men and women by year of diagnosis, as of 12131197 female male 1 16 3 6 4 1985 1986 1987 1988 1989 1900 1991 1992 1993 1994 1995 1996 1997 Summary of AIDS patients infected through heterosexual contact by mode of infection of their infected partner, as of 12/31/97 Women constitute 92.51 of those diagnosed with AIDS Heterosexual contact with: Male- Female Total who were infected through heterosexual contact The Injection drug user 5 46 51 (47.7) mode of infection of the Bisexual male 0 23 23(21.6) heterosexual partner is most - often injection drug Use Hemophiliac 0 1--- 1 (0.9) (47.7%). Transfusion recipient 0 2 2(1.9) HIV+and risk under 3 27 30(28-0) investigation January 1998 18 AIDS Epidemic among 'V omen Women with AIDS by the year of diagnosis as of 12/31197 47 43 N 36 M". P awh 3 n�2 a 2929 a 2 w' F„ 22 f 12 ( '1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 '1996 1997 Race/Ethnicity distribution of females diagnosed with AIDS 1985-86 Number of cases and percentage Race/Ethnicity # (%) 1987-i38 1 White 86(32.7) 1989-90 African American 150(57.1) 1991-92 20 Latino 24(9.1) 1993-94 31 Asian/Pacific 1995-97 2s! Islander 1995-97 MEIN= a Total 263(100) Women otCalor 0 White Women ......... _. ............... _ ._ ................. .............................. ............... ................ Contra Costa County HIVIA IDS Epidemiology Report Children with HIVIAiDS 12 Contra Costa children (1-12 years) have been diagnosed with AIDS 67 Contra Costa children have tested positive for HIV Children's Hospital Oakland Pediatric AIDS/HIV Program has evaluated, cared for and monitored 72 patients under the age of eighteen with residence in Contra Costa who at sometime presented antibodies against HIV. Five of these patients have been infected from blood products. Of the 66 who were exposed to HIV maternally, an estimated one-third were infected with HIV, while the transient maternal antibodies present in the other two-thirds will disappear by the second year of life. Demographic characteristics of the above patients Year of referral to Children's Hospital Gender(%) Male . . . . . . . . . . . . 37 (51) 1986 . . . . . . . . . . . . . . . 3 Female 35 (49) 1987 . . . . . . . . . . . . . . . 4 1988 . . . . . . . . . . . . . . . 3 Race/Ethnicity (%) 1989 . . . . . . . . . . . . . . . 6 White . . . . . . . . . . . . . 23 (32) 1990 . . . . . . . . . . . . . . 11 African American . . . . 40 (56) 1991 . . . . . . . . . . . . . . 10 Latin . . . . . . . . . . . . . 9 (12) 1992 . . . . . . . . . . . . . . . 3 1993 . . . . . . . . . . . . . . 12 Maternal infection through (%) 1994 . . . . . . . . . . . . . . . 2 Injection drug use . . . 47 (71) 1995 . . . . . . . . . . . . . . . 9 Heterosexual contact . 13 (20) 1996 . . . . . . . . . . . . . . . 7 Undetermined . . . . . . . 6 (9) 1997 . . . . . . . . . . . . . . . 2 HIVIAIDS in Teenagers (13-19) Only 6 of the 1938 AIDS cases in the county reported since the beginning of the epidemic were teenagers at the time of their diagnosis. A total of 7 young adults (13-19) from the county have been cared for and followed-up at Children's HospitalOakland Pediatric AIDS/HIV Program. Five of the seven cases are hemophiliacs or transfusion recipients. The following statistics represent the teenagers who voluntarily presented themselves for HIV testing at publicly funded clinics in the county between 1992 and 1997: Year Teens tested HIV+ 1992 951 0 Of the four who tested positive all were female; 1993 840 2 one was 18 and the rather three were 19 years 1994 730 0 old; one was an injection drug user and the 1995 790 1 other three were infected through heterosexual 19-96 607 1 contact with HIV infected men. 1997 254 0 .. ........................................................................................................................................................................................................ ........................................................................................................................................................................................................................... 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Ml� 1, III , '.X"m .... - � , ,�,;`�'.MINI :. � : I/. � �,/�&///;/�Y/l/�l�/y//ll -, -,.," ,-,""',,MK*',.:K,X .I. �.**l:..l.,--,l'..-... . , rg I �;:-,-. ...,-11-. :'- , ......................I..,..............................................................I......... .................................................................... ............... 0 401 have A Contra Costa AIDS Awareness Campaign 597 Center Ave. Suite 200 Martinez, CA 94553 tel: (925) 313-6776, FAX: (925)313-6798 May is AIDS Awareness Month in Contra Costa For more information on community events to kick-off the 1998 Contra Costa"You Have the Power to Stop AIDS" Campaign, please contact Nancy Puttkammer, tel: (925) 313-6776. May 2: Cinco de Mgyo Celebration Free HIV testing and AIDS information Richmond Civic Center Plaza, Noon - 6 p.m. Sponsored by Familias Uniclas May 9: WOAH: Workshop Organized 6gainst Homophobia _ Workshops and dance for gay youth and their allies Las Lomas High School, Walnut Creek, Noon - I I p.m. Sponsored by the Center for Human Development and the Mariposa Coalition May 30:AIDS Intervention Basketball Tournament 3-on-3, HIV information, and fun forthe whole family Hillview Junior High School, Pittsburg, 10:30 - 5 p.m. Sponsored by the Pittsburg Pre-School Coordinating Council May 30: "it Takes a Village toStopthe Virus" A community forum with barbecue, music and door prizes Shields-Reid Community Center, North Richmond, 1 1:30 -4 p.m, Sponsored by Center for Health, Unity Church, Neighborhood House, Project Pride May-3 1: Recognizing Volunteer Leaders A celebration honoring small business owners and teen peer educators Sponsored by Planned Parenthood: Shasta-Diablo Planned Parenthood, Richmond, 3 - 6 pm r �&: gi;. AF' Contra Costa County AIDS Program in partnership with members of the HIV Education and Prevention Network 1998 Contra Costa AIDS Awareness Month WHEREAS,there have been more than 1,938 cases of AIDS and more than 1,282 AIDS deaths reported among Contra Costa residents, since the first AIDS case was diagnosed in Contra Costa in 1982; WHEREAS,more than.4,000 Contra Costa residents are estimated to have been infected with HIV since the start of the AIDS epidemic; WHEREAS,women,teenagers and young adults (including gay youth), and people of color are at increasing risk for HIV infection; WHEREAS,the annual cast of treating HIV disease and AIDS-related infections may exceed $38,000 per person and$30 million throughout Contra Costa; WHEREAS,the early deaths of Contra Costa residents from AIDS represents a loss of 37,285 productive life years; "WHEREAS,some members of the public assume that new HIV treatments represent a cure for HIV/AIDS and that the epidemic is waning; WHEREAS,no cure for AIDS exists and HIV education and prevention remains the most effective means of limiting the impact of the epidemic; WHEREAS,the Contra Costa County AIDS Program in partnership with members of the HIV Education and Prevention n=etwork is coordinating an AIDS Awareness Month in May; NOW,THEREFORE,BE IT RE-SOLVED,that the County Board of Supervisors does hereby proclaim that May 1998 is AIDS Awareness Month in Contra Costa County. As members of the Contra Costa County's Board of Supervisors, we also call upon all citizens,parents, governmental agencies, elected officials,businesses,public and private institutions, religious communities, hospitals and schools to use our power to stop HIV/AIDS by encouraging dialogue about HIV/AIDS, supporting community efforts at HIV prevention, providing comprehensive HIV/AIDS education, and responding compassionately to people living with HIV and AIDS. ..... .............. ...7777777 . ........... ... ...... .......... .. . ....... .. .. ..... MEMO----1 0- 11110 "MIN WN 111111 Mon' gE mum"u'll All no dw 11 NUNN .............. - --------- a ..... I I I....... 10 MON .......... .... ........... .......... mmml X0 ai .1g 1 10 ........................ --------------- . .... ............ Nis Nis 11 . ....... ..... mol ----- ..... - W�a� x�i.�'g M�ii. I'M JIM Rill ...... .... ........... 115-7 iiiiiili"ii�";iiii,�,��i,�,;"Ff IS ou.......... ... ..... .. ----------- mill ...1. . .... ...... .. oo/�'"NO."I""'I"11". ..... ...... ............. ..... ............. . ---------- oil ------------- . . ..... ... ---------------- ---------- 11------------- pt� n �kC �les HOW TO REPORT 1�IH''� REP'QMNC [ NECESSARY , >:ty establishing active AIDS surveillance in your To plan forfuture It�Ith rare needs artd services 1edicsl tecllity "1"aritor trends in H1V nteCtian By own*tiq.a Candentl Morbidity report card To project#afore nurniaer of AIDS cases 5 By telep#rone TO provide'IrT Wn bon ort the history df H1V HTc vtOMcJ Td3 URVEIL.L.ANCE It�the law Gail either F,bli Health Advisor. Rise Ft000ti t llA 313, 73 Ha�ieftah 313-879C? All heaft cam, providersare required to Contra Costa Hem Services report AIDS cis 16their I+ I heWM Public Health Division departrnertt. AIDS erp Eplderrtiolgy,Serve trancealfomia`s Ccsde of Reguietiorts, T"rtfe 17, &Health Date Unit Health Se tion 25M. Gaiter Ave,Suite 350, Martinez,CA 94553 ReportinAI S SUMM' ry cif L Inti n Caiifornia Administrative Code, rifle 17 (Section 1f>03..01 {previous numer tin}) "—a Wgpitsf Mag rorrt`the nom, date cOFtxi►tfi, ad�> snela/seourr*hcrr��ier, r r�of OS €�l, the date trf hc3sp r afrotrl anti any other inform- iort required cin slf or fhrrred oe�es of AIDS, tothe State L1ear ent&H�ee�tfi andt�trt�tYheir Caii#ornfa AdmirnEtrave bode, 11tt$ 7 (Section 10175 1105 "Evdry peen Must repay frx the{ eaith >•any diagX#osed or suspeet6, case a�f arm cal the fofltwr�rrg di�ea des yr condi tia w-Acquka fry►rrl modeefraierrcy yndrrzrrxe..." Ca##ornia Adminitrafive bode,Titte'17(Batt1.on 291 2.):fiItows health.officers to irnrestiget+s �ornm�nicab�disees. pati#arriva M alt#i a& #sty,Code (Seefilon:19 � rabi � � tC� Itrcal health acrtttoriti as part of an AIDS diagnosis. Catifornia Hoaith&Safety Codi,{�e+ �ion 'I��.�'1 18�. ,anti 1�I��.�}��4cr closut�: to public health,uthorities cif resin of HIV't performed€in cadavers. Allows for HIV test to be pe awned on c lavers wlthbtd wrl#ten cor ser t a part tsf an a utopsy or in conjun Won with anatornicat gets. atifornira Heaifttr&Safely Code,(Section 199.27}:Allows for voluntary contact.tracing with the written consent of theMV seropositive individual, _..... ......_.. ......... ......... ......... ......... .......... Tab b�nosing A�I35 oases R Fr gt#er c es f a p rt r stic.... r s a mon, .d��tgno ed uses ,'; M11t Test�n r#t d�t�oted � ect�o�s , . Tte uses rport+ c� . ; :e 1.0. �endec d�s#r�b�t��n K #s#r�but�on: {� f Ade �f#Str#�3utlt�� K i 4 K V y 1� r C AIDS n�S�s ... = >.. _ ; Res#t�er��s I#v ., �sttate d�resldex�ts.1i`lfeC�e�,�f#th M�� - . - . - ♦: ♦ '•. < . . <. �,. nc�den�ce�f A��3� � dal#�rsrrr�a oOut�t#es nth the h# fiest cumulative i .. �C es with tt a h#ghe t curr#u at ve .... r�+ a of D ( z�ntra costa t ♦ K K �t�sths amc�r�g ��d�agnc�se�w� � a � frett S::. T eatr e t Gu le i�te dor Adults and Adolescents . � �thite E�ot#se;Ab�rr�(ons '#oOFcl mMiff ..: � !< Git�ririvar�of All „ des - .... . % xl K Kd H������� ���d��� H{ "� �`rt'�$ �r�LI1'1t,'�. �� �'►��4'�S Y Y Y i Y a IY ♦ Y �� aY . K � rr.. n eottQn d o users :. K x H!'�llA1S n�Ws 1� AIQS a# o#� rosexual . � �I��among vs/omen 1 Ft ;MIS#I�tt?S � ; . _ .K. ♦ x ;ti x . x K 1 T�enag�rs #h H1 '#�li�� M�� related Baty#o+�;s prom#ded �n �©#�tra este e,r�d�av�ta reeves hemi K For copies of this report call: 313-6323 ................................................................ ............................................................................... ........................................................ Contra Costa County HIV/AIDS gpideMi2l Report Diagnosing AIDS cases In California HIV infection without AIDS is not a reportable communicable disease and as a result, only diagnosed AIDS cases are reported to the Health Department. An individual who has tested HIV positive is diagnosed with AIDS when one of two events occur: either the patient's CD4 count drops below 200 cells//J (or <14%); or the patient is diagnosed with one of 26 AIDS defining cancers or opportunistic infections . Below is a table indicating frequencies of how individuals in Contra Costa are diagnosed with AIDS and a frequency list of cancers and opportunistic infections or conditions reported by those diagnosed with HIV/AIDS*. Cumulative Casesi Diagnosis Category Adult Pediatric Total Cancer or Opportunistic Infection 1323 12 1335 Immunological(CD4<200 or 14%) 603 0 603 Total 1926 12 1938 Frequency of Occurrence of Cancers, Opportunistic Infections or Conditions among Contra Costa residents diagnosed with AIDS* Cancer, infection or condition* frequency Cancer,infection or condition* frequency Candidiasis, bronchi, trachea or lungs 22 Immunoblastic lymphoma 29 Candidiasis, esophageal 143 Primary lymphoma in brain 6 Coccidioidomycosis 6 Mycobacterium avium complex or M. kansasfi 232 Cryptococcosis 58 M. tuberculosis, pulmonary 67 Cryptosporidiosis 37 M. tuberculosis, disseminated or extrapulm. 29 Cytomegalovirus disease 57 Mycobacterium,of other species 11 Cytomegalovirus retinitis 60 Pneumocystis carinii pneumonia 584 HIV encephalopathy (dementia) 103 Recurrent bacterial pneumonia within 12 mos 1 Herpes simplex(> I month) 36 Progressive multi focal leukoencephalopathy 14 Histoplasmosis 4 Salmonella septicemia, recurrent 0 Isosporiasis (> 1 month) 2 Toxoplasmosis of brain 38 Kaposi's sarcoma 208 Wasting 185 Burkitt's lymphoma 8 Lymphoid interstitial pneumonia 2 *Individual patients may have contracted more than one of the above listed opportunistic infections/conditions. sCumulative cases reported from 2/1/82 to 12/31/97. ...............-............ Janua�ry_1998 2 Global Summary of the HIV/AIDS Epidemic as of December 1997 Adults 5.2 million People newly infected with Women 2.1 million HIV in 1997 Children < 15yrs 590,000 Total 5.8 million Adults 29.5 million People living with HIVIAIDS Women 12.1 million Children 1.1 million Total 30.6 million Adults 1.8 million AIDS deaths in 1997 Women 820,000 Children < 15yrs 4610,000 Total 2.3 million AIDS deaths since the Adults 9.0 million beginning of the epidemic Women 4.0 million Children 2.7 million Total 11.7 million AIDS orphans since the beginning of the epidemic 8.2 million Source: UNAIDS and WH©, Report on the Global HIVlAIDS Epidemic, December 1997 I-IIV as, n, Recently the Testrng team has adopted C3rasure as opt,0n'in HIV tesking aloe- with tietaradlydIodd test: ThsIas .done :be+ use It:prouided! better �iccess ir► ort�rmcritty based #estng and;at is IriOreeadiiy>acep#ed arn0ng!the injection drug `, ussrrg pc p €la:ion.