Epidemiology of HIV and AIDSin the

Riverside/San Bernardino, Transitional Grant Area (TGA)

Compiled by: Riverside County Community Health Agency

Department of Public HealthEpidemiology and Program Evaluation Branch

With Data and Tables Provided by: San Bernardino Department of Public Health,

HIV and STD Surveillance Program

2007

Data Sources

Unless otherwise noted, all HIV/AIDS statistics come from HIV and AIDS cases reported to Riverside County or San Bernardino County Departments of Public Health as of December 31, 2006.

Inland Empire Demographic Profile

• The 4th and 5th most populous counties, combined population exceeds four million.

• Among the fastest growing counties in California.

• Metropolitan area fifth-fastest growing in nation, 14th largest nationwide.

• Area larger than the states of Connecticut, Delaware, Massachusetts, and New Jersey combined

• Increasing Hispanic/Latino population– Potential language barriers

AIDS Surveillance Summary

Riverside/San Bernardino CA,

TGACalifornia 1 United

States 2

Cumulative Cases 8,738 143,946 988,376

Cumulative Deaths 4,181 82,989 550,394

Living Cases 4,557 60,957 437,982Cumulative Case-fatality rate

48% 58% 56%

1 California Office of AIDS. AIDS Surveillance Report for California, December 31, 2006.

2 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report 2005

Names-based HIV Reporting

• Federal HIV/AIDS funding cuts to states without reliable HIV tracking systems.

• California Senate Bill 699 allowing name-based reporting signed April 2006.

• Names-based reporting will hopefully improve access to early interventions.

• 3,255 HIV positive cases reported in the TGA, with 98% living.

7/2002 – 3/2006: “No Name” reporting

4/2006 – : “Name” reporting (501 cases)

Profile of People Living with HIV/AIDS:Riverside/San Bernardino, California Transitional Grant Area

Gender, Race/Ethnicity, Age Group, and Mode of Transmission

Proportion of the Population, Proportion of Prevalent AIDS Cases, Proportion of Prevalent HIV Cases by Race/Ethnicity

0%

10%

20%

30%

40%

50%

60%

70%

80%

White Non-Hispanic

Hispanic/Latino AfricanAmerican

Asian/Pac.Islanders

NativeAm./Alaskan

Other/Multi-Race

Perc

ent

of Tota

l Population

Living AIDS Cases

Living HIV Cases

Prevalence Rate by Race/Ethnicity

0

50

100

150

200

250

White Non-Hispanic

Hispanic/ Latino AfricanAmerican

Asian/ Pac.Islanders

NativeAm./ Alaskan

Other/ Multi-Race

AIDS

HIV

N= 33

N= 713

N= 2,666

N= 1,082

N= 57

N= 6

Rate per100,000

TGA Medi-Cal (HIV) and ADAP Users by Race/Ethnicity, Fiscal Year 2004/2005

Unknown2%Other

5%

White63%Black

10%

Hispanic20%

ADAP N= 1,714

Other2% Unknown

13%

Hispanic17%

White50%

Black18%

Medi-Cal N=2,935

Proportion of Persons Living With HIV/AIDS by Gender

TGA AIDS Prevalence

TGA HIV Prevalence

12%

88%

Male

Female

84%

16%Male

Female

Proportion of Persons Living With HIV/AIDS by Age Group

TGA AIDS Prevalence

TGA HIV Prevalence

25%

70%

1% 4%

<1313-2425-4445+

1% 10%

25%

64%

<1313-2425-4445+

Proportion of Persons Living With HIV/AIDS by Mode of Transmission

TGA AIDS PrevalenceTGA HIV Prevalence

62%13%

9%

9%2% 5%

MSMIDUMSM/ IDUHeterosexualOtherN/ R

62%9%

5%

11%

2%11%

MSMIDUMSM/ IDUHeterosexualOtherN/ R

Epidemiology of HIV/AIDS:Riverside/San Bernardino, California Transitional Grant Area

Incidence, Prevalence, Evolving Trends, and Forecast

Percent of AIDS Cases by Race/Ethnicity and Year of Diagnosis

0%

10%

20%

30%

40%

50%

60%

70%

2000 2001 2002 2003 2004 2005 2006

Af. Am Hispanic White

Provisional

AIDS Incidence Rates by Race/Ethnicity and AIDS Incidence Rates by Race/Ethnicity and Year of DiagnosisYear of Diagnosis

0

5

10

15

20

25

30

2000 2001 2002 2003 2004 2005 2006

Af.Am Hispanic White

Provisional

Rate per100,000

Diagnosed AIDS Cases by Year2010 Projection

50

150

250

350

450

550

650

750

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

Year of Diagnosis

Nu

mb

er o

f In

div

idu

als

Dia

gn

ose

d w

ith

AID

S

200

Transitional Grant Area

Riverside

San Bernardino

R.C.

S.B.

200

Epidemiology of HIV/AIDS:Riverside/San Bernardino, California Transitional Grant Area

The Components: Profiles By County and Service Area

AIDS Prevalence by EMA Service Area of Residence

51.463.2

98.280.2

42.7

437.5

0

50

100

150

200

250

300

350

400

450

RC West RC Mid RC East SB West SB East SB Desert

Rate per100,000

Living AIDS Cases by Race/Ethnicity

0

50

100

150

200

250

300

White Af Amer/Black Hispanic Other/Unknown

Pre

va

len

ce

pe

r 1

00

,00

0 P

op

ula

tio

n

Riverside County San Bernardino County

N=267N=446

N=535N=547N=59

N=37

N=2,054

N=612

HIV Testing Risk Factors: July 1, 2005 to June 30, 2006

0%

10%

20%

30%

40%

50%

60%

MSM IDU

MSM/IDU

Heterosexual

Other

NIR/U

nk

Pe

rce

nt

of

Cli

en

ts

Riverside County San Bernardino County

TGA ADAP and Medi-Cal Users (HIV) by HARS Reporting County, Fiscal Year 2004/2005

San Bernardino21%

Riverside 49%

Other So.Ca.17%

San Francisco5%

Other4%

Unknown4%

ADAP

Riverside 27%

San Bernardino19%

Other So.Ca12%

San Francisco2%

Other3%

Unknown37%

Medi-Cal

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

HIV/AIDS Deaths

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

AIDS/ HIV Deaths, New Cases, and People Living with HIV/ AIDS Riverside/ San Bernardino Transitional Grant Area 1982-2006

By Year of Diagnosis

HIV/AIDS Deaths HIV/AIDS New Cases Living HIV/AIDS

7757

Aging Service Population: Riverside County Living AIDS Cases by Age at Report/Age Now

0

10

20

30

40

50

60

70

80

<13 13-24 25-44 45-64 65+

% o

f L

ivin

g R

epo

rted

AID

S C

ases AGE at Rpt

AGE Now

Summary

• Majority of incident and prevalent cases White, MSM

• Rates by race/ethnicity show disparity

African Americans have the highest rates

• AIDS case reporting (HARS) profile by race/ethnicity distribution similar to services utilization data.

Service use data (ADAP/Medi-Cal) show local users HARS reported in other counties

• Effective drug therapies have resulted in greater survival

Service population aging, chronic disease concerns

Acknowledgements

• Aaron Gardner

• Phill Coon

• Becky Nanyonjo

• Marshare Penny

Riverside County

San Bernardino County

Contact Information

Riverside County Department of Public HealthRiverside County Department of Public HealthEpidemiology and Program Evaluation BranchEpidemiology and Program Evaluation Branch(951) 358-5557(951) 358-5557

San Bernardino County Department of Public HealthSan Bernardino County Department of Public HealthAIDS, STD, & Reproductive Health ProgramsAIDS, STD, & Reproductive Health Programs(909) 383-3060(909) 383-3060

www.rivcohealthdata.org