Pediatric HIV/AIDS Cases* in Florida, through 2003

1
Pediatric HIV/AIDS Cases in Florida, through
2003

• Bureau of HIV/AIDS
• HIV/AIDS Surveillance Section
• [phone] or SC 205-4430

HIV/AIDS cases infected UNDER 13 years of
age. Includes adult HIV/AIDS cases, diagnosed
with a pediatric risk AFTER 12 yrs of age. Data
as of 07/31/04.
2
Pediatric AIDS Cases by Age Group and Year of
Diagnosis, Florida, 1990-2003
N1,233
These data represent an 89 decline in pediatric
AIDS cases diagnosed from 1992 (N178) to 2003
(N22). Include cases in persons aged gt12
yrs. at AIDS diagnosis with a ped risk aged lt12,
(N108). 2003 data are provisional. Data as
of 07/31/04.
3
Pediatric AIDS Cases, By Age Group and Year of
Diagnosis, Florida, 1990-2003
N1,233
Include cases in persons aged gt12 yrs. at AIDS
diagnosis with a ped risk aged lt12,
(N108). 2003 data are provisional. Data as of
07/31/04.
4
Percent of Pediatric AIDS Cases, By Age Group
and Year of Diagnosis, Florida, 1990-2003
N1,233
Include cases in persons aged gt12 yrs. at AIDS
diagnosis with a ped risk aged lt12,
(N108). 2003 data are provisional. Data as of
07/31/04.
5
Cumulative Reported Pediatric AIDS CasesBy
County, Florida, Reported through 2003
N1,584
Includes 111 adult AIDS cases, ages 13 yrs,
with pediatric risks (data as of 03/01/04).
6
Cumulative Reported Pediatric HIV (not AIDS)
CasesBy County, Florida, Reported through 2003
N307
HIV reportable July 1, 1997.
Includes 4 adult HIV cases, ages 13 yrs, with
pediatric risks (data as of 03/01/04).
7
(No Transcript)
8
Pediatric AIDS CasesBy Year of Report, By State
9
United States
Ages lt13 2000 Population By Race/Ethnicity
(N52,190,294)
Pediatric (Ages lt13) AIDS Cases By
Race/Ethnicity Diagnosed through 2002 (N9,300)
These numbers do not represent actual cases in
persons with a diagnosis of AIDS. Rather,
these numbers are point estimates of cases
diagnosed that have been adjusted for reporting
delays. The estimates have not been adjusted for
incomplete reporting.
10
FLORIDA
2000 Population By Race/Ethnicity (Ages
lt13) (N 2,620,799)
Pediatric HIV/AIDS Cases By Race/Ethnicity Repor
ted through 2003 (N1,897)
Include cases in persons aged gt12 yrs. at HIV or
AIDS diagnosis with a ped risk aged lt12,
(N115). 2003 data are provisional. Data as of
07/31/04.
11
Cumulative Pediatric (lt13 yr.) HIV/AIDS Cases By
Exposure Category, Reported through 2003
United States (thru 2002) (N9,074)
Florida (N1,897)
N1,797
Other Pediatric Risk includes sex with male or
receipt of blood products.
12
Cumulative Pediatric HIV/AIDS Cases By
Expanded Exposure Category Florida, Reported
through 2003 (N1,897)
Note 6 (exploded pieces) are NOT perinatal
transmission cases
13
Pediatric HIV/AIDS Cases by Mode by Race
Florida, Data through 2003
14
Prevalence of AIDS-Defining Conditions Most
Commonly Reported Among Pediatric Cases
Florida, Reported through 2003, (N1,584)
Note data are NOT mutually exclusive, many
cases have more than 1 disease.
Include cases in persons aged gt12 yrs. at AIDS
diagnosis with a ped risk aged lt12,
(N115). 2003 data are provisional. Data as of
07/31/04.
15
Perinatal HIV/AIDS Cases
16
Perinatal HIV/AIDS CasesBy Reporting Area of
Diagnosis
17
Perinatal HIV/AIDS Cases by Year of
Birth Florida, 1978-2003 (N1,829)
These data represent a 93 decline in
HIV-perinatally infected births from 1992 (N169)
to 2003 (N11). 83 perinatal AIDS and 5
perinatal HIV cases were diagnosed after age
12. Note HIV Infection Reporting Began
7/97. 2003 Data are provisional, data as of
07/31/04
18
Perinatal AIDS Cases by Age Group and Year of
Diagnosis, Florida, 1990-2003
N1,167
These data represent an 88 decline in pediatric
AIDS cases diagnosed from 1992 (N170) to 2003
(N20). Include cases in persons aged gt12
yrs. at AIDS diagnosis with a ped risk aged lt12,
(N78). 2003 data are provisional. Data as of
07/31/04.
19
Mothers Exposure Category by Year of Childs
Birth for Perinatally Acquired HIV/AIDSFlorida,
Born through 2003 (N1,829)
2003 data not complete due to reporting lag.
83 perinatal AIDS and 5 perinatal HIV cases were
diagnosed after age 12. Note HIV Infection
Reporting Began 7/97.
20

Mothers Exposure Category for Perinatally
Acquired HIV/AIDS (N1,829) By Year of Childs
Birth, Florida
Born 1978-1990 (N 950)
Born 1991-2003 (N 879)
83 perinatal AIDS and 5 perinatal HIV cases were
diagnosed after age 12. 2003 data not complete
due to reporting lag.
21
FLORIDA
2000 Population By Race/Ethnicity (Ages
lt13) (N 2,620,799)
Perinatal HIV/AIDS Cases By Race/Ethnicity Repor
ted through 2003 (N1,829)
Include cases in persons aged gt12 yrs. at HIV or
AIDS diagnosis with a ped risk aged lt12,
(N88). 2003 data are provisional. Data as of
07/31/04.
22
Perinatally Acquired AIDS Cases by Age at
Diagnosis (N1,515)Florida, Born through 2003
Number of Cases
(lt2 yrs,N864)
Age in Years
Age in Months
Cases in persons aged gt12 yrs. at AIDS diagnosis
that were perinatally acquired (N83).
23
Perinatally Acquired HIV (not AIDS) Cases by Age
at Diagnosis (N314)Florida, Born through 2003
Number of Cases
(lt2 yrs,N113)
Age in Years
Age in Months
Cases in persons aged gt12 yrs. at HIV diagnosis
that were perinatally acquired (N5).
24
Current Age Distribution Of Persons Presumed to
be Living With Perinatal HIV/AIDS Reported
through December 2003, Florida, (N995)
Current age as of 07/31/04 of presumed living
HIV/AIDS cases reported through 2003. Note Of
these living cases, 66 AIDS and 5 HIV cases were
not reported until after age 12.
25
Prenatal HIV Testing Among Women Delivering a
Live Birth, Florida, 1996-2002
95 C.I.
Comment Floridas percentage of childbearing
women tested prenatally for HIV is the highest
in the U.S., which has probably contributed to
the continued decline in pediatric AIDS cases.
Source Pregnancy Risk Assessment Monitoring
System (PRAMS).
26
Percent of Mothers of Perinatal HIV/AIDS Cases
Who Were Known to be HIV Positive Prior to
Birth By Year of Birth 1996-2003, Florida (167 of
268 births)
2003 data not complete due to reporting lag.
27
Percent of Perinatal HIV/AIDS Cases Born
1996-2003 Whose Mothers Knew They Were Infected
Prior to Birth And Received ZDV and/or Other
Antiretroviral Therapies By Year of Birth,
Florida (N167 of 268 births)
2003 data not complete due to reporting
lag. The same mother can be in multiple
categories
28
Percent of Perinatal HIV/AIDS Cases Born
1996-2003 Who Received ZDV and/or Other
Antiretroviral Therapies By Year of Birth,
Florida (N268)
2003 data not complete due to reporting
lag. The same child can be in multiple
categories
29
Possible Missed Opportunities to Prevent
Perinatal Transmission of HIV Among HIV/AIDS
Cases Born 2000-2003, Florida (N92)
30
Time of Maternal HIV TestingAmong Perinatal
HIV/AIDS CasesBorn 2000-2003, Florida (N92)
Note 69 (75) of the 92 moms knew they were
infected prior to birth.
2003 data not complete due to reporting lag.
31
Percent of Perinatal HIV (not AIDS) and
AIDS Cases Born 2000-2003 By Age of Diagnosis,
Florida
HIV (not AIDS) Cases (N72)
AIDS Cases (N20)
32
Nationality of Mother and Child of Perinatally
HIV-Infected Cases Born 2000-2003 (N92),
Florida
Mother
Child
There was no opportunities for Florida
interventions prior to birth for children born
outside the U.S.
33
Mothers of Perinatally HIV-Infected
Cases According to Receipt of Prenatal Care,
Prenatal ART, Or ART at Delivery Born
2000-2003 (N92), Florida
Prenatal Care Prior to end of 6th month
Prenatal ART
ART at Delivery
Yes
No
ART Antiretroviral Therapy
2003 data not complete due to reporting lag.
34
Percent of Mothers of Perinatally HIV-Infected
Cases Who Abused Drugs or Had an STD During
Pregnancy Born 2000-2003 (N92), Florida
Abused Drugs
Had an STD
2003 data not complete due to reporting lag.
35
Perinatally HIV-Infected Cases Status of
Receiving Neonatal Drugs and Breast feeding Born
2000-2003 (N92), Florida
Received Neonatal Drugs
Breastfed
2003 data not complete due to reporting lag.
36
AIDS-Defining Conditions for Perinatally
Acquired AIDS Cases (aged lt2 yr.)by Age at
Diagnosis for Florida, Reported through 2003
(N862)
Number of Cases
Other AIDS defining conditions
37
HIV/AIDS Pediatric Cases By Expanded Mode of
Exposure for Selected Counties in Florida Born
1996 through 2003
Miami-Dade (N91)
Broward (N44)
Palm Beach (N24)
Mom IDU
Mom-Sex Risk
Moms Risk-Other/Unkn.
Peds Risk-Other/Unkn.
2002 data not complete due to reporting lag.
38
HIV/AIDS Pediatric Cases by Age at Diagnosis
Selected Counties in Florida Born 1996 through
2003
Miami-Dade (N91)
Broward (N44)
Palm Beach (N24)
2002 data not complete due to reporting lag.
39
HIV/AIDS Pediatric Cases by Race/Ethnicity
Selected Counties in Florida Born 1996 and
through 2003
Miami-Dade (N91)
Broward (N44)
Palm Beach (N24)
2002 data not complete due to reporting lag.
40
Steps to Prevention Success
Client accepts test returns for results
Provider and clients adherence to
regimen antenatal, intrapartum, and neonatal.
If HIV positive, prophylactic treatment is
offered and accepted
Follow-up care, avoidance of breastfeeding
41
(No Transcript)
42
New CDC Initiative Advancing HIV Prevention

• Four key strategies
• Make HIV testing routine part of medical care,
• Implement new models for diagnosing HIV
  infections outside medical settings,
• Prevent new infections by working with persons
  with HIV and their partners,
• Further decrease perinatal HIV transmission.

43
Strategy 4 Further Decrease Perinatal HIV
Transmission

• Work with partners to promote routine, voluntary
  prenatal testing, with right of refusal
• Develop guidance for using rapid tests during
  labor and delivery or post partum, for women with
  unknown HIV status
• Provide training in conducting prenatal testing
• Monitor integration of routine prenatal testing
  into medical practice.
• Ensure appropriate antiretroviral treatment and
  comprehensive follow-up care for HIV-infected
  pregnant women and their infants.

44
Team 4 Frances Walker

• Ana Rua-Dobles - HUG Me Program
• Amy Kaye University of Miami
• Lorene Maddox - Bureau of HIV/AIDS, DOH
• Jody Bryan Infant, Maternal and Reproductive
  Health, DOH
• Mittie Moffett - Childrens Medical Services, DOH
• Deadra Green - Minority AIDS Coalition of
  Jacksonville, Inc.
• Amy Saulsby - AIDS Healthcare Foundation
• Martha Kennedy - Title II Nurse, DOH
• Shalewa Noel Florida/Caribbean AETC
• Dr. Andrew Helfgott Sacred Heart Hospital

45

• The Targeted Outreach for Pregnant Women Act
  (TOPWA) program.
• The Florida/Caribbean AIDS Education and Training
  Center project conducts trainings of perinatal
  service providers.
• The University of Florida project evaluates the
  perinatal HIV prevention program and conducts
  chart reviews.
• Collaboration with state agencies and
  organizations to ensure that perinatal HIV issues
  are addressed.
• Perinatal social marketing campaign.
• Women and Children The Perinatal HIV Program
  is located on the Bureau of HIV/AIDS internet
  site

Perinatal Programs
46
(No Transcript)
47
Florida/Caribbean AETC Perinatal Training by
Professional Discipline, 2000 - 2003
 
 
 
 
48
Florida/Caribbean AETC Perinatal Training by
Employment Setting, 2000 - 2003
49
PRAMS Healthcare Provider Discussions About HIV
Testing, and Pregnant Women Tested for HIV in
Florida, 2000-2002
50
Proportion of Women Screened and Enrolled in
TOPWA by Race/Ethnicity, 1999-2003
Enrolled (N 13,695)
Screened (N 95,828)
51
Proportion of Women Screened and Enrolled in
TOPWA by Age, 1999-2003
52
Reasons for No/Inadequate Prenatal Care Among
Women Enrolled in TOPWA, 1999-2003 (N 13,695)
53
Targeted Outreach for Pregnant Women Act (TOPWA)

• 12 programs in 12 counties (3 jail programs)
• Conducts outreach to high-risk pregnant women and
  actively links them with services
• Offers on-site pregnancy and HIV testing.

54
Targeted Outreach for Pregnant Women Act
(TOPWA) Contract Providers
HOLMES
ESCAMBIA
SANTA ROSA
Minority AIDS Coalition of Jacksonville, Inc.
JACKSON
OKALOOSA
WALTON
WASHINGTON
NASSAU
GADSDEN
HAMILTON
JEFFERSON
CALHOUN
LEON
MADISON
BAY
DUVAL
BAKER
SUWANNEE
LIBERTY
WAKULLA
COLUMBIA
TAYLOR
UNION
BRADFORD
CLAY
LAFAYETTE
GULF
ST JOHNS
FRANKLIN
GILCHRIST
ALACHUA
PUTNAM
DIXIE
FLAGLER
LEVY
MARION
Farmworkers Association of Florida
VOLUSIA
TOPWA FUNDING 1,195,000
LAKE
CITRUS
SUMTER
SEMINOLE
HERNANDO
ORANGE
BREVARD
Tampa Hillsborough Action Plan Outreach, Jail
and Pinellas Programs
HUG-Me Program Outreach and Jail Programs
PASCO
OSCEOLA
PINELLAS
HILLSBOROUGH
POLK
Healthy Start Coalition of St. Lucie County, Inc.
INDIAN RIVER
MANATEE
OKEECHOBEE
HARDEE
ST LUCIE
HIGHLANDS
SARASOTA
DESOTO
MARTIN
CHARLOTTE
GLADES
Childrens Case Management Organization, Inc.
Source of Light Hope Development Ctr., Inc.
PALM BEACH
HENDRY
LEE
Planned Parenthood of Collier County, Inc.
Minority Development Empowerment, Inc.
BROWARD
COLLIER
Christ Crusaders, Inc.
MONROE
DADE
Mount Bethel Human Services Corp, Inc.
Teen Pregnancy Prevention Center, Inc. Outreach
and Jail Programs
Updated July 2003
55
HIV/AIDS Cases Among Women of Childbearing Age
(Ages 15-44) By Race/Ethnicity and Year of
Report Florida, 1998-2003
56
HIV/AIDS Cases Among Women of Childbearing Age
(Ages 15-44) By Age of Diagnosis and Year of
Report Florida, 1998-2003
57
HIV/AIDS Cases Among Women of Childbearing Age
(Ages 15-44) By Mode of Exposure and Year of
Report Florida, 1998-2003
58
For Florida HIV/AIDS Surveillance Data Contact
[phone] Lorene Maddox, MPH Ext.
2613 Linda Friedlander, MS Ext. 2614
Tracina Bush Ext. 2612 Internet
http//www.doh.state.fl.us/disease_ctrl/aids/index
.html Intranet http//dohiws.doh.state.fl.us