Fewer Cleveland residents tested positive for HIV/AIDS in 2007

HIV incidence (new diagnoses) reported to health officials dropped 22% from 2006 to 2007 according to HIV/AIDS surveillance by the Cleveland Department of Public Health.

Cleveland, Sept. 5, 2008 - At a public panel organized by the AIDS Funding Collaborative, local health officials reported today that the number of new diagnoses of HIV among Cleveland residents decreased 22%, from 165 total cases in 2006 to 128 cases in 2007.

"Moving Beyond the HIV 'Care' and 'Prevention' Silos:  A Dialogue about Community Viral Load.", was held at Case Western Reserve University School of Medicine.

Cleveland Department of Public Health calculated that, of the 128 new cases, 92 were HIV-only and the other 36 were diagnosed with HIV, only to be diagnosed as having AIDS within the next 12 months. This latter group, they called 'doorstep AIDS' cases, seek medical care very late into their HIV infection. "Doorstep AIDS' cases are of great concern to public health and medical professionals since these persons form a pool of residents in a community that can potentially spread HIV. Fortunately, the number of these 'doorstep AIDS' case has dropped from 146 cases in 1995 to only 36 cases in 2007, the lowest number yet recorded by CDPH.

This staggering decrease in new HIV diagnoses for Cleveland comes on the heels of many new local campaigns and efforts to increase HIV awareness and testing in the community. CDPH reports that the number of persons tested for HIV at their two health centers (J. Glen Smith and the Thomas McCafferty Health Centers) is at an all time high. In addition, they have data from the Ohio Department of Health that suggests that HIV testing at other clinics in Cleveland has been increasing as well. 

David Bruckman, Biostatistician at CDPH, reported that there are additional trends noted in the data. Here is a summary of his findings presented at the event:

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HIV/AIDS Prevalence as of December 31, 2007:

• 3,723 persons are currently living with HIV/AIDS in the Greater Cleveland Area
• 2,678 are currently living with HIV/AIDS in Cleveland

• 58% have been diagnosed with AIDS

 Prevalence Rate: 596 per 100,000 population (living cases only)

• 32% are age 50 and over; 35% of people living with AIDS are age 50 and over
• Prevalence rates among those age 50 and over for Cleveland are much higher than national rates.
• 31% of Hispanic males diagnosed at age 50 and over report IDU as their primary risk of HIV exposure.
• 0.9% and 0.3% of the male and females populations, repectively, for Cleveland are reported to be HIV-positive.

Incidence of HIV in Cleveland, 2007:

• 128 new cases of HIV infection were reported in 2007, all having residence in Cleveland
• This is a 22% decrease from 2006 incidence
• 92 persons were HIV-only
• 36 were 'doorstep" AIDS cases

Incidence Trends - Race/ethnicity

• 71% of incidence cases are Black/African American (non-Hispanic). This is the highest annual percentage ever recorded for HIV/AIDS incidence in Cleveland.
• 21% White (non-Hispanic)
• 5% Hispanic
• 3% unknown race/ethnicity (not reported)

Other trends:

• More cases are occurring among Black/African American males age 20 to 29. 37% of incident cases diagnosed in Cleveland in 2007 were represented by these community.
• Fewer persons are being reported among incident cases having a history of injection drug use (4% for 2006-2007 incident cases.)
• 17 teens age 13 to 19 were diagnosed in 2007 with HIV for Cuyahoga County. 14 of these 17 were Cleveland residents.

Spotlight: Older persons with HIV

Increasing number of residents age 50+ are living with HIV/AIDS, due to

          1) better treatments

          2) newly diagnosed infections in people

 Of 860 persons age 50 and over living with HIV/AIDS in 2007, 27% were age 50+ when initially diagnosed & reported to health authorities

 Incidence: In Cleveland, persons age 50 and over account for:

• 16% (45/287) of new HIV/AIDS diagnoses made in 2006-2007

¨     Increase from 9% in 2001

¨     US: 15% in 2005

• 22% of new AIDS diagnoses made in 2006-2007

¨     Increase from 9% in 2001

• Exposure risk reported by older males differs from younger males (fewer MSM and more heterosexual contact reported.)
• Exposure risk reported by older females differs due to a higher incidence of injection drug use among females, especially Hispanic females.