HIV Diagnoses, Prevalence and Outcomes in Nine Southern States

Abstract

A group of nine states in the Southern United States, hereafter referred to as the targeted states, has experienced particularly high HIV diagnosis and case fatality rates. To provide additional information about the HIV burden in this region, we used CDC HIV surveillance data to examine characteristics of individuals diagnosed with HIV in the targeted states (2011), 5-year HIV and AIDS survival, and deaths among persons living with HIV (2010). We used multivariable analyses to explore the influence of residing in the targeted states at diagnosis on deaths among persons living with HIV after adjustment for demographics and transmission risk. In 2011, the targeted states had a higher HIV diagnosis rate (24.5/100,000 population) than the US overall (18.0/100,000) and higher proportions than other regions of individuals diagnosed with HIV who were black, female, younger, and living in suburban and rural areas. Furthermore, the targeted states had lower HIV and AIDS survival proportions (0.85, 0.73, respectively) than the US overall (0.86, 0.77, respectively) and the highest death rate among persons living with HIV of any US region. Regional differences in demographics and transmission risk did not explain the higher death rate among persons living with HIV in the targeted states indicating that other factors contribute to this disparity. Differences in characteristics and outcomes of individuals with HIV in the targeted states are critical to consider when creating strategies to address HIV in the region, as are other factors identified in previous research to be prominent in the region including poverty and stigma.

Prevalence and Predictors of Substance Use Disorders Among HIV Care Enrollees in the United States

“…With respect to age, available CNICS data precluded examination of SUD chronicity in this cohort. Nevertheless, persistent substance abuse among aging HIV+ persons is a progressive risk for mortality (63, 64). While improved clinical management of HIV infection has contributed to domestic decline in deaths due to AIDS-related causes, substance-related causes of death (i.e., drug overdose, mental disorders resulting from substance abuse) continue to increase among HIV+ persons of all ages (65).…”

Human Immunodeficiency Virus Testing Practices and Interest in Self-Testing Options Among Young, Black Men Who Have Sex With Men in North Carolina

“…YBMSM in areas not covered by existing surveillance systems represent a major gap, especially in the Southeast US. This region suffers from extremes of poverty, discrimination, health disparities, and HIV-related stigma 9 – all of which may have a deeper impact on young people of color and restrict their access to HIV testing. 10 …”

Use and Predictors of End-of-Life Care Among HIV Patients in a Safety Net Health System

“…For instance, recent data has revealed that in the Southern United States, which are disproportionally affected by HIV, the death rate among persons living with HIV was higher than in any other region of the country. 7 These states share other characteristics, including high poverty rates and overall poor health of the population. 8 …”