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]Bcoamc. csf 1SXX eXWW 1"c0X-bn OT Co3nLt3VVL IIICoMtft ou .ty In the Mater of Resolution No, 2000/151 PROCLAIMING THE MONTH OF MAY 2000 "AIDS AWARENESS MONTH" in CONTRA COSTA COUNTY WHEREAS, there have been more than 2109 cases of AIDS and more than 1361 AIDS related 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 related infections may exceed 538,000 per person and $30 million throughout Contra Costa,and WHEREAS, the early deaths of Contra Costa residents from ADS represents a loss of more than 40,000 productive fife years and WHEREAS, no cure for AIDS exists an HIV education and prevention 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 NOW, THEREFORE, BE IT RESOLVED that the Board of Supervisors of the County of Contra Costa, California, does hereby proclaim May 2000 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 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. PASSED by unanimous vote of the Board Members present on the 2"`'day of May ��n eL /d.,vo o nGioia ist 'ct I 41Zayle B. Uiikema, District 11 j- V4WZ Donna District ill Mark Desaulnler, District IV� ABSENT Joe Canciamilla, District V Witness my hand and the Seal of the Board of Supervisors affixed this 2nd day May,2000. PHIL BATCHELOR,Clerk of the Board of Supervisors and County Administrator Deputy Clerk Introduced b a,District one .vf.•�n•.v`}.:n!.... r.i% ••f F:?.. +•:,4'r ifx;y.y.;:y;;�.y.; •.iS{:;>.} ,::ti.::>:.rh' :��:?��#:i:.+6: #;} ;;.};x4??:.3::rf, .},a• .•f.''.;�:}, f.?.; ../..r: .{l..}n. 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Of these, 2,109 (43.0%) have already been diagnosed with and reported to have AIDS and 1,361 of these people have died of AIDS. 47.6% HIV only 2331 200 1.0% Projected new AIDS 4.0% Never reported 210 diagnoses In 2000 748 4.3% HIV positive at death without AIDS 1361 15.3% Living with AIDS 27.8% Death due to AIDS Local estimate of the number of people living with HIVIAIDS: —3,500 Global View of the AIDS Epidemic Cases Deaths Contra Costa 2,109 1,361 (1131170) Bay Area* (State Once of AIDS) 40,824 26,550 (12131199) Californla (State Office of AIDS) 115,335 70,826 (12131199) U.S. (CDC&P) 664,921 410,800 (12131199) World (WHO)' 47,300,000 13,900,000 (12131199) !Pay Area Counties:Alameda,Contra Costa,Marin,Napa,San Francisco,San Mateo,Santa Clara,Solano,Sonoma Cumulative estimate of persons with HIV/AIDS t� February 2000 2 Recently Detected HIV Infections January 1999 - December 1999 Clients tested for HIV at county Anonymous Test Sites'without prior positive test(tested+/total tested) Men Race Gay/ Gay/ Heterosexual Heterosexual Health Total bisexual bisexual IDU IDU partner Care worker White 0/90 0/14 0/83 0/365 0/16 0/568 African American 0/14 0/6 3/34 1/254 0/1 4/309 Latino 0/34 0/2 0/27 11248 0/4 1/315 Asian 0/4 0/1 0/3 0/48 0/0 0/56 Native American 0/0 0/0 0/2 0111 0/0 0/13 Other 0/7 0/0 0/3 0/50 1/1 1/61 Total 0/149 0/23 3/152 2/976 1/22 6/1322 Women Race Heterosexual IDU Heterosexual Health Care worker Total partner White 1/73 1/285 0111 2/369 African American 2129 1/194 0/4 3/227 Latina 0/8 1/245 0/8 1/261 Asian 0/0 0148 0/0 0/48 Native American 0/1 0/5 0/0 0/6 Other 0/3 0/20 0/2 0/25 Total 3/114 3/797 0/25 6/936 "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 info call : 1-800-287-0200 Free -donations accepted 3 Contra Costa County HIVIAIDS Epidemiology 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 occurs: either the patient's CD4 count drops below 200 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 those diagnosed with HIV/AIDS*. Cumulative Cases' Diagnosis Category Adult Pediatric Total Cancer or Opportunistic Infection 1388 12 1400 Immunological (CD4<200 or 14%) 709 0 709 Total 2097 12 2109 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 146 Primary lymphoma in brain 8 Coccidioidomycosis 6 Mycobacterium avium complex or M. kansasll 239 Cryptococcosis 64 M. tuberculosis, pulmonary 74 Cryptosporidiosis 37 M. tuberculosis, disseminated or extrapulm. 31 Cytomegalovirus disease 58 Mycobacterium, of other species 11 Cytomegalovirus retinitis 64 Pneumocystis carinii pneumonia 621 HIV encephalopathy(dementia) 105 Recurrent bacterial pneumonia within 12 mos 1 Herpes simplex (> 1 month) 39 Progressive multi focal ieukoencephalopathy 16 Histoplasmosis 4 Salmonella septicemia, recurrent 0 Isosporiasis (> 1 month) 2 Toxoplasmosis of brain 38 Kaposi's sarcoma 215 Wasting 194 Burkitt's lymphoma 8 Lymphold interstitial pneumonia 2 *Individual patients may have contracted more than one of the above listed opportunistic infections/conditions. 6Cumulative cases reported from 2/1/82 to 1131/00. February 2000 4 2,109 CONTRA COSTA COUNTY RESIDENTS DIAGNOSED WI:reported S Through January 31, 2000, a cumulative total of 2,109 cases of AIDS we to the Public Health Department. This represents a cumulative incidence er 100,000 population using 1999 population projection data from the Califate Department of Finance. Total AIDS cases reported through 1/31/00 Mode of infection and gender distribution Adult and adolescent cases (n=2,097) Mode of HIV infection Male (%) Female (%) Total Gay/bisexual 1,262 (70.9) 0 (0) 1,262 (60.2) Heterosexual injection drug use 303 (17.0) 160 (50.5) 463 (22.1) Gay/bisexual injection drug use 112 (6.3) 0 (0) 112 (5.3) Hemophilia 16 (0.9) 0 (0) 16 (0.8) Heterosexual contact 11 (0.6) 123 (38.8) 134 (6.4) Transfusion with blood/blood product 28 (1.6) 16 (5.0) 44 (2.1) Disk under investigation 48 (2.7) 18 (5.7) 66 (3.1) Total 1,780 (100) 317 (100) 2,097 (100) Pediatric cases (n=12) Mode of HIV infection Male (%) Female (%) 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) 5 (100) 12 (100) 5 Contra Costa County HIV/AIDS Epidemiology Report Total AIDS Cases Reported in Contra Costa through 1/31/00 Race/Ethnicity Distribution Race/ethnicity Adultladolescent cases {%} Pediatric cases (%) Total White 1204 (57.4) 4 (33.3) 1208 (57.3) African American 621(29.6) 4 (33.3) 625(29.6) Latino 222 (10.6) 4 (33.3) 226 (10.7) Asian/Pacific Islander 41 (2.0) 0 (0) 41 (2.0) Native American/Alaskan 9 (0.4) 0 (0) 9 (0.4) Total 2097 (100) 12 (100) 2109 (100) Age Distribution Year of Diagnosis (Age at time of diagnosis) (New diagnoses) Age Total (%) 250 Groups 231 <5 8 (0.4) 223 221 5-12 4 (0.2) 13-19 8 (0.4 181 183 20-29 256 (12.1) 30-39 880 (41.7) 147 40-49 652 (30.9) 132 50-59 197 (9.4) 105 101 60-69 76 (3.6) 82 >69 28 (1.3) 64 69 Total 2109 (100) 53 39 Ll Li Ll 15 0 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 A) February 2000 6 People in Contra Costa Living with AIDS as of 1131/00 (n=748) Mode of Infection and Gender Distribution Mode of infection Male (%) Female {%) Total (%) Gay/bisexual 413 (70.1) 0 (0) 413 (55.2) Heterosexual injection drug user 109 (18.5) 80 (50.3) 189 (25.3) Gaylbisexual injection drug user 34 (5.8) 0 (0) 34 (4.6) Hemophilia 4 (0.7) 0 (0) 4 (0.5) Heterosexual contact 5 (0.8) 63 (39.6) 68 (9.1) Transfusion with blood/blood product 1 (0.2) 5 (3.1) 6 (0.8) Parents at risk for HIV 2 (0.3) 2 (1.3) 4 (0.5) Risk under investigation 21 (3.6) 9 (5.7) 30 (4.0) Total 589 (100) 159 (100) 748(100) Race/Ethnicity Race/Ethnicity Adult/Adolescent cases Pediatric cases Total {%) White 388 0 388 (51.9) African American 249 2 251 (33.5) Latino 85 2 87 (11.6) Asian/Pacific Islander 20 0 20 (2.7) Native American/Alaskan 2 0 2 (0.3) Total 744 4 748 (100) 7 Contra Costa County HIV/AIDS Epidemiology Report California Counties with Highest Cumulative Incidence of AIDS Cases per 100,000 population using 1999 population projection data from California State Department of Finance,as of 1131100 San Francisco ,016.5 Marin lillJM79.5 Los Angeles JIM23.2 Alameda IlMO3.6 Sonoma 64.2 San Diego 63.6 Solano wak99 Riverside M76 San Mateo 53.9 Sacramento M41.7 Contra Costa t., 30.1 Contra Costa Cities with Highest Cumulative Incidence of AIDS Incidence per 1,000 population using 1999 population projection data from California State Department of Finance;reported for cities with>50 cases,as of 1/31/00 Richmond L .2 San Pablo .5 Pittsburg .4 Walnut Creek .0 Martinez .5 Concord .5 Pleasant Hill .2 Antioch .5 February 2000 8 Contra Costa Residents with AIDS by city of residence as of 1131100 Bethel Island() 114 Byron a 412 Brentwood 5114 Oakley 15!14 Bay Point 21143 Chart includes only cities with 5 or more Antioch 1� X50169 reported cases. four additional cities Pittsburg 751105 have reported a total of 9 cases Pacheco fl 114 Alamo[@ 318 Clayton Ej 3/13 Moraga M 3114 San Ramon 11127 Danville 11127 Lafayette 16122 Living Orinda 8129 Pleasant Hill 30141 Deceased Martinez, x '45158 (LivinglDeceased) Walnut Creek 821127 Concord ; � -W ' .0- 951192 Crockett[J315 Rodeo 0]219 Kensington®418 Hercules 11118 EI Sobrante 18121 North Richmond 12125 Pinole X9(29 EI Cerrito 13138 San Pablo x ¢ - 37184 Richmond 1 179/307 9 Contra Costa County HIVIAIDS Epidemiology Report Modes of infection by year of AIDS diagnosis (as of 1/31/00) 2000 1999 1998 1997 1998 1996 1994 1993 1992 1991 1990 1989 1988 1987 1988 Gay/bisexual men 1986 Injection drug users 1984 ® Gaylbisexual male IDUs 1983 Heterosexual Contact 1982 Other` 0 50 100 150 200 250 300 'Hemophilia,transfusion recipient,maternal exposure,no risk identified Deaths among people diagnosed with AIDS By year ofdeath, as of 1131100(n=1,361) 184 151 150 156 137 111 102 73 61 60 51 39 31 ® MCS � � 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 February 2000 10 Heterosexual, Gay, and Female Injection Drug Users Diagnosed with AIDS Since the first years of the AIDS epidemic in the county so- an increasing number of AIDS Heterosexual male IDU cases are injection drug users 5a — Gay/bisexual male IDU (IDUs). Presently, IDUs make . . . . . • Female IDU up 27.31 (n=575*) of all the 4a AIDS cases diagnosed in the county. The data represented in this chart and the table 3a directly below reflect AIDS cases diagnosed through 20 - January 0 January 31, 2000. 4r r •• •,,, , "This number also includes 10 - of !� %000 gaylbisexual IDUs (n=112) as of • �`"' '■�• 1/31!00. a 83 84 85 88 87 88 89 90 91 92 93 94 95 96 97 98 99 Corresponding Data 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Heterosexual(303) 1 0 1 1 8 16 17 14 37 52 34 34 32 19 21 8 8 Caylbisexual (112) 0 1 2 5 6 6 9 7 16 18 8 11 8 6 4 3 2 Female (1 60) 0 0 0 1 0 1 0 1 4__L12 12 12 15 24 16 19 16 13 11 11 Race/Ethnicity of Injection Drug Users Diagnosed with AIDS (as of 9/31100) Race/Ethnicity Male IDUs Female IDUs Total White 151 30 181 (.31.5) African American 216 122 338 (58.8) Latino 42 7 49 (8.5) Asian/Pacific Islander 4 1 5 (0.9) Native American 2 0 2 (0.3) Total 415 1 160 1 575 (100) 1 Contra Costa County HIV/AIDS epidemiology Report AIDS among Gay/Bisexual Men (as of 1131/00) Gay and bisexual men (n=1,374*), constitute the group from which 65.11 of 83.3%8.7 84.8% a5.4% all cases have been 81.1% reported in the county and 75.5%x4.8% the largest group from 7,.4% 71.4% 89.5% which new cases are 85.8% a3.8% emerging. Nevertheless, a 59.3% 57.8% declining trend is observed 54.8% in the proportion of AIDS 47.5 49.3% cases from this group. 45.3% (The actual number of cases is shown inside the bars.) *This number includes both IDU gaylbisexua/ men (n=112) and non-IDU gaylbisexua/ men (n=1,262) 5 L5] 13 33 43 70 75 11 1,3 15 16 L37'11 41 00 76 1 48 t2sj 134 1982 1983 19B4 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1998 1997 1998 1999 HIV Prevalence among Non-IDU Gay/Bisexual Men (Voluntarily tested at the publicly funded county clinics, Jan 1985- Dec 1999) 18.8% 15% 10.9% 9.8% 7.9% 8.1% 7.4% 6.4% 4.8% 3.3% 1-70 0� 0010 1985-871988-89 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 1965-99 (tested+ltotal tested) 1985-87 1988-89 1990 1991 1992 1993 1994 1995 1996 1997 1 1998 1 1999 1985-99 1481786 1401933 51/46945!570 311643 301466 30/370 25/338 7/215 51193 1/120 0/149 513/5252 18.8% 15.0°l0 10.9°l0 7.9% 4.8% 6.4% 8.1% 7.4% 3.3°l0 2. % 0.8% 0% 9.8% February 2000 - 12 AIDS among Men & Women Infected through Heterosexual Contact excluding IDUs (as of 1/31/00) AIDS diagnoses among heterosexual men and women by year of diagnosis 20 female male 16 15 13 12 9 9 9 6 2 t ;r 2 2 2 1 "M111", 1,,::: 0 _0 0 mar0 0 0 1985 1988 1987 1968 1969 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 Summary of AIDS patients infected through heterosexual contact by mode of infection of their infected partner, as of 1/31/00 Women constitute Heterosexual contact with: Male(%) Female(%) Total(%) 91.8% of those diagnosed with AIDS Injection drug user 6 (54.5) 62 (50.4) 69 (50.7) who were infected Bisexual male - 26 (21.2) 26 (19.4) through heterosexual contact. The mode of Hemophiliac 0 1 (0.8) 1 (0.8) infection of the heterosexual partner is Transfusion recipient 0 2 (1.6) 2 (1.5) most often injection HIV+and risk under investigation 5 (45.5) 32 (26-0) 37 (27.6) drug use (50.7/). Total 11 (100) 123 (100) 134(100) 13 Contra Costa County HIVIAIDS Epidemiology Report AIDS Epidemic among Females Females with AIDS by year of diagnosis as of 9/31/00 47 43 36 29 30 26 24 22 22 22 11 6 ®0® a 1985198619871988198919901991199219931994199519961997199819992000 Race/Ethnicity distribution of females diagnosed with AIDS Number of cases and percentage 1985-871 2 Race/Ethnicity # (%) 2 19$8-89 White 100(31.1) 14 3 1990-911 301 African American 187 (58.1) 1992-93 - -----------____47 29 Latino 30 (9.3) 1994-951 491 Asian/Pacific Islander 5 (1.5) 1996-971 43 13, Total 322 (100) 1998-99 --3-77-77 1985-99' 222 1 !00 U Females of color White Females February 2000 - 14 Children with HIV/AIDS 12 Contra Costa children (1-12 years) have been diagnosed with AIDS 92 Contra Costa children have tested positive for HIV Children's Hospital Oakland Pediatric AIDS/HIV Program has evaluated, cared for and monitored 92 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. The mode of exposure of one child is still under investigation. Of the 86 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 1986 . . . . . . . . . . . . . . . . . . 3 Gender(%) 1987 . . . . . . . . . . . . . . . . . . 4 Male . . . . . . . . . . . . . . . . . 46 (50) 1988 . . . . . . . . . . . . . . . . . . 3 Female . . . . . . . . . . . . . . 46 (50) 1989 . . . . . . . . . . . . . . . . . . 6 1990 . . . . . . . . . . . . . . . . . 11 Race/Ethnicity (%) 1991 . . . . . . . . . . . . . . . . . 10 White . . . . . . . . . . . . . . . . 26 (28) 1992 . . . . . . . . . . . . . . . . . . 3 African American . . . . . . . 52 (57) 1993 . . . . . . . . . . . . . . . . . 12 Latino . . . . . . . . . . . . . . . . 14 (15) 1994 . . . . . . . . . . . . . . . . . . 2 1995 . . . . . . . . . . . . . . . . . . 9 Maternal Infection through (%) 1996 . . . . . . . . . . . . . . . . . . 7 Injection drug use . . . . . . 53 (62) 1997 . . . . . . . . . . . . . . . . . . 2 Heterosexual contact . . . 25 (29) 1998 . . . . . . . . . . . . . . . . . 12 Undetermined . . . . . . . . . . 8 (9) 1999 . . . . . . . . . . . . . . . . . . 8 HIVIAIDS in Teenagers (13-19) Only 8 of the 2,109 AIDS cases in the county reported since the beginning of the epidemic were teenagers at the time of their diagnosis. A total of 8 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 eight 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 1999: Year Teens tested Idly± 1992 951 0 Of the six who tested positive all were female; 1993 840 2 two were 16 and the other four were 19 years 1994 730 0 old; one was an injection drug user and the 1995 790 1 other five were infected through heterosexual 1996 607 1 contact with HIV infected men. 1997 254 0 1998 458 1 1999 399 1 Contra Costa County HIVIAID.S 4piderniology Report HIV Related Services Provided in Contra Costa County During the period of January through June 1999, the following partial list of services have been reported by community-based organizations and agencies serving people with HIV/AIDS in Contra Costa County. Data is not available from many organizations and individuals assisting those affected by the epidemic but not funded by the CARE Act or HOPWA: 244 people received transportation and/or gasoline to attend health and support services 110 people received transportation van services 12 people received 653 home-delivered meals 302 people received food vouchers 329 people received 8,639 bags of groceries 125 people received direct emergency assistance to pay for utilities and other bills 552 people received case management services 130 people received services at a day support center in Richmond 144 people received counseling to assist them in applying for benefits 105 people received housing advocacy assistance 25 people received 1,582 hours of home care so that they could remain in their homes 51 people received HIV-related legal services Who is Receiving Services in Contra Costa County In the six month period January 1, 1999-June 30, 1999 demographic data was collected from 568 individuals (unduplicated)who received services from agencies/programs funded by the federal government under Ryan White CARE Act and Housing Opportunities for People with AIDS(HOPWA). Income information available on 498(87.791o)clients n % Less than$600 per month 153 30.7 Between$601 and$900 per month 263 52.8 Between$901 and$1200 per month 50 10.1 Over$1200 per month 32 6.4 HIV/AIDS Status serostatus known of 562(98.9916)clients n % AIDS 350 62.3 Symptomatic HIV 99 17.6 Non-Symptomatic HIV 113 20.1 Demographic Data of Services Recipients (n=566) Gender n % Primary Language(n=565) n % Male 384 67.8 English 525 92.9 Female 182 02.2 Spanish 34 6.0 Race/Ethnicity(n=565) n !o Other 6 1.1 White 180 31.9 African American 295 52.2 Current Living Situation (n=506) Latina 75 13.3 (varies throughout year) Asian/Pacific islander 9 1.6 Homeless in emergency shelter 29 Native American 2 0.3 Homeless on streets 8 Unknown 4 0.7 Hospital or medical facility 1 Mode of transmission(n=545) n % Hotel/motel 2 Men having sex with men 172 31.6 Jail/prison 4 MSM/IDU 20 3.7 Living with friends/relatives 157 Injection drug user 182 33.4 Owned housing 19 Blood product recipient 5 0.9 Psychiatric Facility 0 Sex Partner of IDU 23 4.2 Rental Housing 272 Heterosexual contact 108 19.8 Substance abuse treatment facility 3 Pediatric 15 2.7 Transitional Housing 8 Other/unknown 20 3.7 Other 3 ......... ...::.......::........:.;.......:.:...::..:...: y 4 rro ?idtfwfd��4 f?g r 4 F 4 { � yc f f Y Y q{ { f it k f 4 f :Ff •:/.v•.q ?•:.{•ry :}:::::f•:::r.•::::::::::::::::r: nv},{{}v.�rv. /,({.��, r+r ?;.$'.,, .�},'{i?.F.. }•}fF 4v.,�F.?$$t$,4, ••,,},}'{•f$,;+,:•$S%$r,;+{:?{{::}r•:x:.{ vr:•,• ^.�:::nv::::x:: f}}•{.}:?4}}:•}Y •}i'f.•:}K•F.j:.,v,.}T'f•••f'k${Y{{xr ��>> +' •r:};.: {4:r• f:•%•}:0:4:•}' •' ii .+v:r.r{ $..+'>rtn?•fOr .}r. ...�. $}:yr.}}:.}:4:4Y4:?CO:4:•$$$$$$$$$$$'i$$$....v ':ii}, /:$:; %f vr�. ?•$%•.^}:4:•}:O:O:•.+•:•}:4:4:•}:•}:•}}}::::::. ++?�(4. v..+�•.+• ..Fr �:. v.4{:$i$ir.+•. rv:•.... ...�.. 4:vh}.. yv� ../...v? it '�C•r ...�........ $$:iY: ? 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