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MINUTES - 05041999 - P3
�.�►�'" t�ts�:'�Ittr�. �rt7►'l�ti�. �+c�►�tx.�t In the Meter of Resolution No. 99/204 PROCLAIMING THE MONTH OF MAY 1999 "AIDS AWARENESS MONTH" in CONTRA COSTA COUNTY WHEREAS, there have been rnore than 1,998 cases of AIDS and more tl gar; 1.,305 AIDS re€ated deaths reported among Contra Costa residents since the first AIDS case was diagnosed in Contra Costa County in 1982; and WHEREAS, it is estimated that more than 4,900 Contra Costa residents have been infected with HIV since the start of the AIDS epidemic,and WHEREAS, women, teenagers,young adults,and people of color(especially African- Americans) are at increasing risk for HIV infection;and WHEREAS, the annual cost of treating HIV diseases an AIDS-re#ated infections may exceed $38,000 per person and $30 million throughout Contra Costa,and WHEREAS, the early deaths of Contra Costa residents from AIDS represents a loss of 40,000 productive life years;and WHEREAS, no cure for AIDS exists an - HIV education and prevention i remains the most effective means of limiting the impact of the epidemic;and WHEREAS, the Contra Costa County AIDS Program in partnership with members of the HIV education and Prevention Network is coordinating an AIDS Awareness Month in May,and 10W,THEREFORE, BE IT RESC'VED, *that the Contra Costa County Board of Supervisors does hereby proclaim May 1999 as AIDS Awareness Month in Contra Costa County, and hereby calls upon all citizens, parents,governmental agencies, elected officials, businesses, private institutions, non-profits agencies, religious communities, hospitals and schools to use our collective powers to stop HIV/AIDS by encouraging dialoque about HIV/AIDS, supporting community efforts at H€V prevention, providing comprehensive H#V/A€DS education,and responding compassionately to people living with HIV and AIDS. PASSED by unanimous vete of the Board Members present on the 4t"day of May. Jo �#o#a, Di �t ayie B. Ui' ma, Distrrict ll onna Gerbe , Istria III Mark Desau#Hier, District IV roe anciamilla, District V Witness my hand and the Sea?of the Board of Supervisors affixed this 4"'day of May PHIL BATCHELOR,Clerk of the Board of Supervisors and Cour yAdm nistrator /} Introduced by Supervisor john C�!oia,D:StrtCt One t�eputy T eek RESOLU"TTON NO. 99/204 U. rz- x . Lu c, U.i 100 '.d /uj�j. % fir/ V) � CC L. }" UJ AXI k yty' i' {: } q V t S > V c{©3� •�a C�i' ;C it-J i � O it � 0 lei t"* 0 1. ti1aL '00C t 'a $ + CS t t Q .0 LL trS 4- 41 p 4 14 ro- +- c c c Eta ._' o -913, _ _ CL v uVA ro - a 4- CRJa Vf p fa u t3 V- d `C7 V�1 N r Ol 40 pU o o tg� te} u CC Z &. 00 00 o sOIN ' g d c� mm try c W :03 + -a y Ch s C3 " «C3 a i �y L� C a+ t3 a a t+i t3 rn #- 6i +- N tY cv rn c, c 0 rz °' ° i d ,v cxj v i- ri iC'. o� > � rn a. +b L � r V u t; 9 as cx - 0 0 ' w x ` -i � 0 r. � S f4n L S100. 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Hlil tfCtions , .. `. 3iagnosed A3DS oases .: Frecuer�ces'afccsrtrst i'nfec#i emerg �ecrese Al ?S;cases 3 Total AIDS oases repp�ed 4: Mode. infect€"on: gender �€str�b�tscn ,.a 4 Race/ethnicity distrib #�cn F Age distributtcn Fear of Al DS;diagnc sis residents lingtb AI alifc rr count e with tl�e highest cumulatiVe incidence.cf Al€ 's 7 Cites vt�tth ti e h g est cumulative-i c der ce:ofAIDS LConfra Dr sta fid ) 7` ,ity distribuiti' D cf<AI ;case .... iS E.. l4�1a41LS: �dtl� �n'Gortte Dcssta C�aurtty::Facf' heets 910 ' l-lc res c er is Mere infeoted €deaths amcrtg peo pJ agno ed r r€th AI,f Abstract sub"missions for i AJPI H NciV`.1097; i AIDS arnon . n ection drd users J . . 9 13 HIVIAlDS:'among qty/bisexual mer:, . . . . . . . . . . . . . SIDS arno'rq, etero:sej�u of rr;or'and'.w r i n AIDS.6monfemales . hildren wit,, HMAIDS 1 . eena er vv tl l lVfAl a 7 ESII'+/ r�ieted SerLrtcs proVdedrttr Costa andhc receives therri 1 , . For copies of this report call: (925) 313-6323 1 Contra Costa County HIVIAIDS Epidemiology Report ESTIMATE OF CONTRA COSTA COUNTY RESIDENTS INFECTED WITH HIV Based on back calculations and more recent estimates by the State Office of AIDS a total of approximately 4,900 Centra Costa County residents are estimated to have been infected with HIV. Of these, 1,998 (40,5%) have already been diagnosed with and reported to have AIDS; 1,305 people have died of AIDS. 50.1%HIV only 2472 i� 1.0%Projected new AIDS 4.1%Never reported orfed diagnoses In 9898 4.3%HEV positive at 6$3 / death without AIDS \\\ I `1305 Nis 14..0%Living with AIDS 26.5%Death due to AIDS Local estimate of the number of people living with I MAIDS: -3,500 :Glbb6l VreW of the AIMS Epidemic 'Cases Deaths ContrI.a'ICasta 1,998 '!,305 ( 01s�sj' l3ay Area . (State:©ffrCe of AIDS) 39;054 25,570 (9130/98) Calrfornra (State ©ice ofAlt7S) 108,814 67,953 (9!30198} US (CCC&P) 641.,086 390,692 (113719 } UVorld (wtici 30,6;00,00,0 11,700,000 (1213:: ay Area,counties:.Alameda contra Costa;M rin Napa San Francisco,:soo;San Nateo,Santa Clara,SaEano,Sonoma Gummu ative'es#!mate of Persors.wth HIVlAID5 ................................. ............................................................................._........ ._..................................................................................................................._ ......... .._...... ......... ......... ......... ......... ......... ......... ... _........ ......... ......... ......... ......... ................ ........ ......... ......... ......... ......... ......... .............. ................._ October 199£ 2 Recently detected HIV Infections July 1997 - June 1998 Clients tested for HIV at county Anonymous Test Sites"without prior positive test(tested+/total tested) Men Race � Gayl Gay/ Heterosexual i Hetero- ' Blood/ Health Total bisexual bisexual IDU IDD, sexual blood Care partner product worker White 1/109 0/16 3/126 3/401 0/7 0/15 71�T4 African American 0/20 0/2 : 4/72 2/291 0/6 0/5 61396 Latino1 2/25 0/5 0/44 01253 0/4 0/5 2/336 Asian 0/3 1 0/0 0/4 0/13 0/0 0/2 0/22 Native American 0/3 0/0 0/4 0/13 0/0 0/0 Ol20 Other 0/3 0/1 0/1 0/33 0/0 0/0 iJ138 Total3/163. . 0/24': 71251' 51004 �' 0/17 3 {3/27: 15/1466 Women Race Heterosexual Lesbian/ Heterosexual Lesbian/ Health Blood/ Tota' lou bisexual IDU partner bisexual j Care blood € ' worker product White 2/77 1 0/20 0/311 0/57 0/10 0/6 2/481 African American 2/34 0/12 4/323 1/40 0/8 0/7 71424: Latino 0/9 1/3 1/273 0/7 0/7 0/7 x/306 Asian 0/2 0/1 0/38 0/7 0/2 0/1 0/51 ?native American 1 014E 0/1 0/17 0/2 0/2 0/0 Other 0/2 0/2 0/17 0/2 0/0 0/0 4023 . Ttfal. 4/1 Z8 . 1/39. 5/979 1/115 019 0/21;: 111(:311 : Locations and schedules of ATS: Concord Pittsburg Richmond 2355 Stanwell Circle 550 School Street 100 39th Street Tuesday Wednesday Thursday 5:00- 8:00 P.M. 5:00- 8:00 P.M. 5:00- 8:00 p.m. For more into call ; 1-804-287-0200 Free -donations accepted 3_ Contra Costa County HIV/AMS 4pidemio169y Report Diagnosed AIDS Cases In California HIV infection without AIDS is not reportable. 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 2003 cells/,ul (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 these diagnosed with HIV/AIDS*. Cumulative Cases Diagnosis Category Adult Pediatric Total Cancer or Opportunistic Infection 1342 12 1354 Immunological (C04 <200 or 14%) 644 0 844 Total 1888 12 1998 G 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 23 Immunoblastic lymphoma 29 Candidiasis, esophageal 144 Primary lymphoma in brain 6 Coccidioidomycosis 6 Mycobacterium avium complex or M. kansasii 235 Cryptococcosis 59 M. tuberculosis, pulmonary 70 Cryptosporidiosis 37 M. tuberculosis, disseminated or extrapulm. 31 Cytomegalovirus disease 57 Mycobacterium, of other species 11 Cytomegalovirus retinitis 61 Pneumocystis carinii pneumonia 598 HIV encephalopathy (dementia) 104 Recurrent bacterial pneumonia within 12 mos 1 Herpes simplex (> 1 month) 38 progressive multi focal leukoencephalopathy 15 Histoplasmosis 4 Salmonella septicemia, recurrent 0 Isosporiasis (> 1 month) 2 Toxoplasmosis of brain 38 Kaposi's sarcoma 211 Wasting 186 Burkitt's lymphoma 8 Lymphoid interstitial pneumonia 2 *Individual patients may have contracted more than one of the above listed opportunistic infections/conditions. §Cumulative cases reported from 2/1/82 to 10/6/98. .................................... .............. .... _..........._.... __ October 1998 4 99.CONTRA':COSTA COUNTY RESIDENTS'DIAGNOSEDWITH AIDS'! T# �'c3tt l�}ctesber 6Y198, cur0ulat� re Intal of 'l x998a�es af.AICS were -ep;srted tc tl P pltc Heait l lepartment This represents a cumuiative incidence cat 22 1 per 1 Q"O' 0: c ul i tion`us�n 1996.pcipulati-on',pro'dc bh date from the Calsfic�ni� State Department°cf P#nance.: Total AIDS cases reported through 1016/98 Mode of infection and gender distribution Adult and adolescent uses (n=1,986) 3 Mode of HIV infection Male (%) i Female (%) Total Gay/bisexual 1206 (7(3.7) ' 0 (0) 1206 (60.7) Heterosexual injection drug use 290 (17.0) 142 (50.9) 432 (21.8) Cay/bisexual injection drug use 108 (6.3) 0 (0) 108 (5.4) Hemophilia 16 (1.0) 0 (0) 16 (0.8) Heterosexual contact 8 (0.5) 108 (38.7) 116 (5.9) Transfusion with b€oodlblood product 28 (1.6) 16 (5.7) 44 (2.2) Risk under investigation 51 (2.9) 13 (4.7) 64 (3.2) Total 1707 (100) 279 (1008) � 1986 (100) Pediatric cases (n=12) Meade of HIV infection Male (%) Female (°Oce) Total Parent at risk or has HIV/AIDS 4 (57.1) 5 (100) 9 (75.0) Transfusion with blood/blood product 3 (42.9) 0 (0,) 3 (25.0) Total 7 (100) i 5 (100) 12 (100) 5 Centra Costa Count HMAIDS Epidemiology Report Race/Ethnicity Distribution Race/ethnicity Adultladolescent cases (°lo) Pediatric cases Total White 1165 (58.7) 4 (33.3) °1169(58.5) African American 570 (28.6) 4 (33.3) 574 (28.7) Latino 206 (10.4) 4 (33.3) 210 (10.5) Asian/Pacific Islander 36 (1,8) 0 (c) 36 (1.8) Native American/Alaskan 9 (0.5) 0 (0) 9 (0.6) Total 1985 (100) 12 (100) 1998 (100) Age Distribution Year of Diagnosis (Age at tune of diagnosis) (New diagnoses) Age Total (%} Groups 5Q 231t�qA <6 8 (O.4) 223 222 6- 4 (0.2) 4 ( 13-19 7 (0.4) ii "> 183 20-29 241 (12.1) 30-39 846 (42.3) 147133 40-49 612 30.6 3}'y -59 1883 .4 105 04 60.69 69 (3.4) 92 >69 23 (1.2) Total 1998 (140) 30 53 27 s i5 7 S a 4982 1983 1984 1995 1986 1997 1988 '1989 '19916 1901 1992 1993 4994 095 1966 1397 ^#988 October 1998 S Residents Living with AILS as of 1016/98 (n=693) Mode of Infection and Gender Distribution Mode of infection Male (°/a} � Ferrule Total (%) Gay/bisexual j 388 (69.2) 0 (0) 388 (56.0) Heterosexual injection drug user 107 (19.1) 66 (50.0) 173 (25.0) Gaylbisexual injection drug user 33 (5.9) 0 (+3) 33 (4.7) Hemophilia 4 (0.7) 0 (0) 4 (0.6) Heterosexual contact 2 (0.3) 52 (39.4) ! 54 (7.8) `transfusion with blood/blood product i (0.2) 7 (5.3) 8 (1.1) Parents at risk for HIV 2 (0.3) 2 (1.5) (0.6) Risk under investigation 24 (4.3) 5 (3.8) 29 (4.2) Total 561 (100) 132 (100) 693 (100) Race/Ethnicity Race/Ethnicity 1 Adult/Adolescent cases (%) Pediatric cases (°la) Total White 374 (54.3) 0 (0) 374 (54.0) African American i 225 (32.6) 2 (50.0) 227 (32.8) Latino 73 (10.6) 2 (50.0) 75 (10.8) Asian/Pacific Islander 15 (2.2) 0 (0) 15 (2.1) Dative AmericanlAlaskan 2 (0.3) 0 (0) I 2 (0.3) Total 689 (100) 4 ('100) 693 (100) 7 Contra Costa County HIVIAIDS Epidemiology Report California Counties with Highest Cumulative Incidence of AIDS Cases per 101),001?population using 1998 population projection data from California State Department of Finance,as of 10/6/98 San Francisca ::'.:s;:<.::::: 912.6 Marin `'`" u.<..° ... -- Los Angeles 399.1 Alameda Sonoma ' ''''> '< i53 Sar+. Diego X39.3 i> `:'.:!' ` 68.2 Solana :-"::<: Riverside x ' 53.2 San Mateo L, i242.5 Contra Costa Contra Costa Cities with Highest Cumulative Incidence of AIDS Incidence per 1,000 population using 1998 population projection data from California State Department of Finance;reported for cities with>50 cases,as of 1016198 Richmond San Pablo { .. _ .2 Pittsburg Walnut Creek Martinez r Concord _ •5 Pleasant Hill �_._..__. _.x.__.2.2 Antioch1 _..._......_. ...._.................................................................................................. .................................................................................................................................................................................................................................................................................................. .......... .......................................................... .. ........... ... ....... ...... _........ _ _ _ _.. . .................. _ __ _ October 7998 8 Centra Casts Residents with AIDS by city of residence as of 1016196 Bethel Island 914 Byron 1412 Brentwood N 3/13 Oakley EM 12/43 Bay Point EDEM 18142 Antioch 41167 Pittsburg 69186 Pacheco 114 Alamo 00 318 Moraga IM 4113 Clayton EN 6/10 San Raman 10126 Danville L ' 11/27 Lafayette 16122 Living Cr€nda L= 9/28 Pleasant Hill E� " 29/41 Deceased Martinez ..::' <44153 Walnut Creek __F27,01,W1501 ' vi' 51132 (i.l�, nlieceaSed} Concord L _ _�._ _�h....•>.<�5.',.., ;,_. : t•.; .: •., .,.;_«:•:..::.,•.: 911188 Crockett 111 314 Rodeo 32,19 Kensington A 4/8 Hercules Em 10118 El Sobrante 34,121 North Richmond E3M 10124 Pinole t.M. 6129 El Cerrito F--N=- 95134 San Pablo = MS" .0 31!40 Richmond 1631294 Chart includes only cities with 5 or more reported cases. Three additional cities also reported cases. THE HI V ,/ AI D S EPlt) EMI 9 What is the probiem? « 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. LALho iq being affected by HIV/AIDS « Since 1982, 1,998 cases of AIDS have been reported in Contra Costa County. At least 1,505 persons have died. At the present time the number of Contra Costa residents estimated infected with HIV is approximately 4,900. To date 1,797 men, 279 women, and 12 children have been diagnosed with AIDS. « The majority of people with AIDS are gay/bisexual men (60.4%) and gay/bisexual men who inject drugs (5.4°!%), although increasing proportions of people with AIDS are heterosexual injection drug users (21.6%), women(14.0%), African Americans (28.7%), and Latinos(10.5°gym). These numbers are disproportionate to the size of the racial/ethnic populations in the county. « Heterosexual injection drug users account for 21.E% 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 28.7%. « 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. I N C 0 N T R A C 0 S T A C0 U N T Y 10 What are the social 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 some 40,000 potential years of productive life. If all HIV-infected Contra Costa residents die from AIDS, our communities could lose an additional 100,000 potential productive years of life. 9 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 $2 billion. 0 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 per year. During the next few years, treating people with AIDS in Contra Costa could cost as much as $30 million a year. Treating people with HIV in Contra Costa could cost up to another $45 million, if all of the 2,472 individuals estimated to be infected were to receive protease inhibitors. What needs to be done? 0 Learn as much as possible about HIV and AIDS. Inform family and friends and encourage them to adopt healthy behaviors. a 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. 0 Protect people living with HIV infection from discrimination. 0 Provide testing, counseling, medical care and support to all people infected with HIV. Increase HIV/AIDS prevention efforts by county, city and community agencies. 0 Reach the populations most at risk with concentrated prevention messages and innovative programs. 0 Expand efforts to involve city, community and church leaders in delivering HIV prevention messages in the most affected areas of the county. 17 Contra Costa County HIVIAtDS Epidemiology Report How Residents Were Infected with HIV Modes of infection by year of AIDS diagnosis 1997 1996 1995 r 1994 • �"�" 1991 1990 A u 1989 1988 1987 . . %ZE 1985 ``;': _' its 1984 1983 1982 ' 0 s0 100 1s0 200 260 Gay/bisexual men Injection drug users Gay/bisexual male ICUs Heterosexual Contact ■ tither` 'Hemophilia, transfusion receipt, maternal expo Deaths among people diagnosed with AIDS By year of death, as of 1016199 (n-1,306) ISO 151 i50 1156 137 111 is is 89 1 t 20 12 1982 1983 1984 1985 1986 1987 1989 1989 1990 1991 1992 1993 1994 1996 1996 1997 1998 October 1998 12 Abstract submissions for the American Journal of Public Health Nov. 1997 126'hAPHA Annual Meeting Theme: "Public Health and Managed Care" Washington, DC - November 15-19, 1998 Factors associated with syringe sharing among injection drug users (IDUs) following the implementation of a medium-sized syringe exchange program (SEP) Bluthenthal, R.N., Erringer, E. A., Kral, A. H., Edlin, S. R. Urban Health Study, UC San Francisco Objective: To determine factors associated with syringe sharing in a cross-sectional study of IDUs in a cornmunity with a medium size (between 10,000-55,000 syringes exchanged/year) SEP. Rationale: As of 1996, most SEPs (59%) in the United States exchanged fewer than 55,000 syringes per year. All published studies of SEPs have examined large and extra-large volume (>55,000 syringes exchanged per year) programs. Methods: Using targeted sampling methods, IDUs were recruited from streets settings in Richmond, California in 1996 and 1997 following the initiation of the SEP in Sept. 1995. IDUs received HIV testing and were interviewed regarding HIV risk behaviors, drug use, sexual practices, medical and criminal histories, and contact with outreach services including SEP use. !DUs who reported SEP use in the past 30 days and said SEP was their main source of syringes were classified as SEP users. Results: Of the 340 IDUs, 64% were African American, 26% were white, 8% were Hispanic; 32% were female 76% were 40+ years old, 22% were homeless; 17% tested positive for HIV; and 44% were SEP users. Factors associated with syringe sharing in bivariate analysis or in previous studies were analyzed for independent association with syringe sharing- In logistic regression analysis, SEP users were less likely than non-SEP to share syringes(adjusted odds ratio[A.O.R.10,38; 95%confidence interval [CI)=0.16-0.92) as were African American respondents (A.O.R-=0.2; 95% CI=0.09-0.47). Syringe sharing was associated with injecting >3 per day (A.O.R.=2.95; 95% C1-1.09-8.01) and having a steady sex partner who is an IDU [A.O.R.=4.00; 95%CI=1.86-8.62). Conclusion: Use of this medium sized SEP was associated with lower rates of syringe sharing. Study results suggest that use of medium sized SEPs can be associated with lower rates of syringe sharing among Qis who use them. "Doctors" & "Patients" - Why are injection drug users injecting each other? Kral,A. H,, Biutheinthal, RX, L mick J, Erringer, E. A.,Gann, Jr. D., Edlin, B. R. Urban Health Study, UC San Francisco Purpose:To assess why injection drug users(IDUs)give injections to and receive Injections from other drug users. Background: Video-taped injection episodes of IDUs have shown that giving and receiving injections often involve blood contact (Flynn et a!, 1995). After a review of the literature, we found no studies on the prevalence of these activities or the reasons why IDUs engage in these activities. Methods: IOUs were recruited using targeted sampling methods in San Francisco,Oakland, and Richmond, CA in 1996 and 1997. "Doctors" are defined as IDUs who reported having given injections to other IOUs in the past month. Patients"are defined as IOUs who reported having received injections from other people in the past month. Results: Of 1,166 IDUs interviewed, 283 (24%) reported being patients and 427 (37%) reported being doctors, of whom 132(11%) reported being both. Reasons for receiving injections included: I)not knowing how to inject themselves (were new initiates or never learned how); 2)no easily accessible veins; 3)hands too shaky at time of Injection,4)veins too flat during first morning Injection; 5)relinquishing power to another IDU(e.g. a sex partner); and 6)neck as preferred injection site. Doctors mentioned altruistic reasons as well as incentives(money, drugs, sex) for giving injections to other IOUs. Conclusions: Giving and receiving injections are common among IOUs in the SF Say Area. Reasons ranged from inexperience to physical problems to power dynamics. Interventions need to address these key issues and provide practical solutions, including teaching IDUs to avoid blood contact when giving and receiving injections and how to better inject themselves. 13 Contra Costa Cotntj HIVIAIDS Epidemiology Report Heterosexual, Gay, and Female Injection Drug Users Diagnosed with AIDS Since the first years of the AIDS epidermic in the county 60 an increasing number of AIDS _ _ Heterosexual mate IDU cases are injection drug users 507 - �- G�ylt>isexua# male #�� (Ws). Presently, IDUs make . . . . . Female IOU up 27.0% (n=540) of all the 40 AIDS cases diagnosed in the county! The data represented 30 in this chart and the table directly below reflect AIDS 20 +� g cases diagnosed through October 9998. 10 '7'his number also includes gaylbisexual IDUs (n=1018) as of a -�r— $. 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 corresponding Data 87 88 ; 89 9tt .: 91 92 93 94'. 95 96 97 98 Heterc5exuas 20 # ::'.ff'; # E, 6 :`i 5 ' 17 S d 37 3 3434 32 .`':"! #9 Cayttssex�sal(1�}8) 't 2 female (142} ....:... Q Q 4, 7 1 12 1 ': 24 1 19 Dace/Ethnicity of Injection Drug Users Diagnosed with AIDS (as of 90/6/98) Race/Ethnicity Wale IDUs Female IDUs Total White 145 28 173 (32.0) African American 205 108 313 (58.0) Latino 42 6 48 (8.9) Asian/Pacific Islander 4 0 4 (0.7) Native American 2 0 2 (0.4) Total 398 142 540 (100) October 1998 14 AIDS among Gay/Bisexual Men Gay and bisexual then (n=1,314*), constitute the group from which 65.8 of 85.2% 83.7% all cases have been 9 <<< reported in the county and :: .::::::::::>>::::> 73.8% 71.8% e largest group from 6 . g � k' 4 2 to which t7� cases are 59.3% eme PNevertheless,�• a F F sm.8 �decPinin trend is observed in the proportion of AIDS PLS ;:A:::<:::fi::;::::;:::::::::i<�:t;i::::;>i:: :sis;:::>;ii;i.r;5�:<:tit.;:. .::�:R%k::<t:::i<fi::: ::.;;::;'ts::d'i::ii:r:;i::::i:;::;;:: i::i:.:;:;5;;>12:'+:.1�::::<:5::::>:::1;:. :i:5•r:::i•s:o-:;>:::•%;::<•>r::•::::: .� cases from this group. he actual number of : #>a cases is shorn inside the =i : :::: >:::<:> bars. *This number tn.tudas both / DU 9 �' a lbisaxuaf mar; n-908and _ fsaxuat ma non-IDU s•Y!b rs :a €' +'c?�ii?"i<'?c% i� '3i`�f»i»:•: E�:::•:::y;::�;:•:;>� f•p>::x:•::;;� 1....•.:::..:,..:i ....,.......,.:.:. ................ ......._........ 1982-83 1984-85 1986-87 1988-89 1990-91 1992-93 1994-95 1996-98 HIV Prevalence among Non-IDU Cay/Bisexual Alen (Voluntarily tested at the publicly funded county clinics, Jan 1985 -June 199$) 18.8% 15% :'. 10.9% 113.1% '• <> _ >` ° 1 _ 7.9% 8. fo ? 7.49'0 ............. 6.49'0 ;::<i:>:::::::. I 4,fi°la ...1 6 E isi s» ?P j .•t c%j?I 3 3.3 1:1 2.6°f0 >:a 'i #<a i 1.3% i .......... <i i:::`'':.: is .. .. :;f i,fi:4U.`F:.. �;:• •' �% 1985-871988-89 1990 1991 1992 1993 1994 1995 1996 1997 1998 1985-98 (testedtftotal tested) r 1985-87 1988-89 1990 1991 1992 1993 1994 1995 1996 1997 9998 1985-98 148178E 140/933 51/469 45/573 31/643 30/466 30/379 25/338 � 7/295 5/193 1/75 513/5058 18.8% 16.0% 10.9% 7.9% 4.8% a 6A% $.1°!0 7.4% § 3.3% 2.6% 1.3% 10.1% 15 Contra Costa County HtVJAIDS Epidemiology Report AIDS among Men & Women Infected through Heterosexual Contact (excluding IDUs) AIDS diagnosis among heterosexual men and women by year of diagnosis, as of 10/6198 IMfemale male oil <' sit IM ME Nii No low Aso i Ft? t%''zi'':'•i%: i�i'i�i >3:J 3i :-r 11 p #El €�i?icfi? i7 f l ff :•i:� G p itiaiiii# '3:t1 ii`3 :SolI ssa too :zi 2 r:2 E q 1 t 'a. %3f C: 3i :'si fi3 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Summary of AIDS patients inflected through heterosexual contact by mode of infection of their infected partner, as of ITS98 Amen constitute Heterosexual contact with: Male(%) I Female(%) Total (%) 93.1% of those diagnosed with AIDS injection drug user 5(62.5) 53(49,1) 88 (50.0) who were infected Bisexual male 0 23(21.3) 23 (19.8) through heterosexual contact. The mode of Hemophiliac o 1 (o.g) 1 (0.9) infection of the heterosexual partner is Transfusion recipient o 2(1.8) 2 (1.7) most often injection drug Use {5(1.(7°/a). HIV+ and risk under I 3(37.5) 29(27-6) 32 (27.6) investigation Total ' 8 108 116 (100) ............................................................................................................................................................................................................................................................................................................................. ............................................................................................................................................................................................................................................................................................................................ October 1998 16 AIDS Epidemic among Females Females with AIDS by the year of diagnosis as of 1016198 47 43 33 29 30 24 22 <a21 <i 2{iiia ii .1 • iii:i:`•'ii y >3x L? .... C" i <'7 :% :: LLL 99$8 9988 998 499£ "989 1flt3f3 1591 1992 9553 1994 9955 1598 9597 999$ Race/Ethnicity distribution of females diagnosed with ,AID 9983- :>r::ws >>>ew s.'::' Number of cases and percentage «: _ RacelEthnicity # N � � ti::.'•::iv���{r''.`xt CS':>:`;?:`sY2v���,':r;}�'iz32�"�.;�sw',.•_�•.```�'�.`.. '� White 92 (32.4) 20>,. ..:,;,{;: •.; African American 163 (87.4) .:::' v ';�7 ;z• : ik:.,> ,wu$v,, •; 39 Latino 8 (8.8) Asian/Pacific !slander 4 (1,4) 1997-98 . � �. � sTotal 284 (100 ) fi7G �0 } �h21M.-Of 3L Females of Color White Females 17 Contra Costa Coup fy Kt 'lA1DS fpidemiology Report Children with HIMIDS 12 Contra Costa children (1-12 years) have been diagnosed with AIDS 69 Contra Costa children have tested positive for HIV Children's Hospital Oakland Pediatric AIDS/HEV Program has evaluated, cared for and monitored 75 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 69 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 39 (52) 1986 . . . . . . . . . . . . . . . . . 3 Female 36 (48) 1987 . . . . . . . . . . . . . . . . . 4 1988 . . . . . . . . . . . . . . . . . 3 Race/Ethnicity (%) 1989 . . . . . . . . . . . . . . . . . 6 White . . . . . , . . . . . . . 23 (31) 1996 . . . . . . . . . . . . . . . . . 11 African American . . . . 43 57 1991 . . . . . . . . . . . . . . . . . 10 ( ) 1992 . . . . . . . . . . . . . . . . . 3 Latino 9 (12) 1993 . . . . . . . . . . . . . . . . . 12 1994 . . . . . . . . . . . . . . . . . 2 Maternal infection through 1995 . . . . . . . . . . . . . . . . . 9 Injection drug use . . . 48 (69) 1996 . . . . . . . . . . . . . . . . . 7 Heterosexual contact 15 (22) 1997 . . . . . . . . . . . . . . . . . 2 Undetermined . . . . . . , 6 (9) 1993 . . . . . . . . . . . . . . . . . 3 HIV/AIDS in Teenagers (13-19) Only 7 of the 1$998 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 Hospital Oakland 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 1998: Year Teens tested HIV+ 1992 951 0 Of the five who tested positive all were female, 1993 840 2 one was 16 and the other four were 19 years 1994 730 0 old; one was an injection drug user and the 1995 790 1 other four were infected through heterosexual 1996 607 1 contact with Klll infected men. 1997 254 0 1998 240 1 ..............................................................................................................................................�................ ................................................................................................ ................. 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''I'll'',........... I -,''''I'll'''',....I..,................................................ - "I . ---,''''I'll Overview of Contra Costa County You Have the Power to Stop AIDS Campaign Canoun160,000 per year CDtn .ct Period,October 1, 1998 - June 30, 2001 (3 years) Pro dGoals: Goal 1) Safer,sex Promotion among Youth • To more widely disseminate existing youth-oriented field-tested materials from the CDC, the State Office of AIDS, etc.; To develop and disseminate Contra Costa-specific social marketing materials to augment existing materials; To engage local youth in a creative process to develop peer-oriented materials. We propose holding a contest or series of contests involving visual art(such as posters, hats, condom packet designs), theater pieces, music, or use of other creative media; To foster youth-lead advocacy that encourages local institutions,including schools, to adopt policies supporting safer sexual behaviors among youth. We propose allocating$24,000- 35,000 per year to a CBO for a youth advocacy;project. Goal 2) Safer Sex Promotion among Young MSMslQueer Youth To more widely disseminate existing materials on HIV risk reduction and countering homophobia for weer youth; To develop and disseminate Contra Costa-specific materials to counter homophobia; • To engage local youth in a creative process to develop peer-oriented materials. Possibilities include a video project, a condom package/safer sex kit design contest,photo exhibit, etc., = To faster youth-lead advocacy that encourages local institutions,including schools,to adopt policies that counter homophobia and reduce discrimination,harassment and isolation among queer youth. We propose allocating$24,000-35,000 per year to a CBO for a queer youth advocacy project. ,{mal 3) Safer Sex Promotion among Communities of Color 6 To review and disseminate existing social marketing materials(such as pasters,PSAs,point- of-sale displays from the SOA, COC and other organizations)which are judged to be culturally appropriate. Q To develop neve Contra Costa social marketing materials which promote safer sexual behaviors among local communities of color, To further encourage local businesses owned by and serving communities of color(such as barber shops,beauty salons,bars,billiard rooms,restaurants)to become community partners in the social marketing campaign. These businesses will display campaign materials,participate in local campaign events and distribute free condoms and other risk reduction materials to their customers. To promote involvement among churches and ether religious institutions serving local communities of color. Goal 4)HIV Counseling and Testing Promotion for Women of Child-bearing Age To promote clinic-based and:;mobile HIV testing services to women of child-bearing age through the development of culturally and linguistically-appropriate materials(such as outreach packets, radio and television PSAs, and flyers that health care providers can distribute).