Northwest Region of Virginia

HIV/AIDS and STD TrendsData through 2006

Northwest Region

•ALBEMARLE•AUGUSTA•BATH•BUENA VISTA•CAROLINE•CHARLOTTESVILLE•CLARKE•CULPEPER•FAUQUIER•FLUVANNA•FREDERICK

•FREDERICKSBURG•GREENE•HARRISONBURG•HIGHLAND•KING GEORGE•LEXINGTON•LOUISA•MADISON•NELSON•ORANGE•PAGE

•RAPPAHANNOCK•RICHMOND CO.•ROCKBRIDGE•ROCKINGHAM•SHENANDOAH•SPOTSYLVANIA•STAFFORD•STAUNTON•WARREN•WAYNESBORO•WINCHESTER

Notes to Accompany Virginia HIV/AIDS TrendsAll data is reported as of December 31st, 2005 unless otherwise indicated.

HIV and AIDS reportingVirginia regulations require reporting of HIV and AIDS cases separately. As a result, a person canbe listed as either a Virginia HIV case, a Virginia AIDS case, or as both (HIV and AIDS). A personfirst diagnosed with HIV infection with no AIDS defining events will always be an HIV case. If at alater time, the patient is diagnosed as AIDS; the person will be listed as both an HIV and AIDScase. If a patient's initial diagnosis of HIV infection is accompanied with an AIDS defining event,the person will be listed as only an AIDS case.

UnduplicatedAs a result of Virginia reporting regulations for HIV and AIDS (see note above), an individualcould be reported twice, once as an HIV case and once as an AIDS case. An unduplicated reportwill count this individual only once. In the case of both HIV and AIDS diagnoses for one individual,age and place of residence at the time of diagnosis will derive from the HIV report. Unduplicated counts will be indicated.

LivingWhen active (e.g., review of charts at provider’s offices) or passive (e.g., receipt of death certificate from Division of Vital Records) surveillance indicates that a patient with HIV or AIDS has died, the reporting database is updated to reflect this information. Living counts will be indicated.

Notes to Accompany Virginia HIV/AIDS TrendsGeographyAll location information is based on the address that is reported to the Division at the time of report.

Report Date vs. Diagnosis DateTime frames are selected based on either the date of report or date of diagnosis. The report date is the date the morbidity is entered into the database. Diagnosis date is the date the disease was diagnosed by a health professional. Statistical reports prepared based on diagnosis dates are likely to change over time, given that disease reports sometimes involve time lags of varying degrees.

AIDS Case Definition ChangeOn January 1, 1993, the AIDS surveillance case definition for adolescents and adults was expanded to include three additional clinical conditions (pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer) as well as a laboratory marker of severeimmunosuppression in HIV-infected persons

HIV*/AIDS Trends Between 2005-2006, statewide increase (3%) in reported

HIV/AIDS Northwest Region saw a 24% decrease in reported

HIV/AIDS In the Northwest Region, Fauquier and Fluvanna each

showed the most notable decrease (88%) In 2006, 49% of reported cases of HIV/AIDS in the

Northwest region were White, 38% Black and 11% were Hispanic and 2% reported another race

Majority of the reported cases of HIV/AIDS were male (76%)

*Includes those that may have progressed to AIDS

VirginiaHIV*/AIDS Cases by Region (N=34,585**)

**Data through 2006

Northwest6.3%

Southwest8.3%

Central24.4%

Northern27.3%

Eastern33.7%

*Includes those that may have progressed to AIDS

Northwest Region of Virginia (N=1,286)Cases of HIV/AIDS* (1996-2006)

61

50 51

34

71

58

35

79

66

90

51

42

76 77

6154

61

5051

43

6659

0

10

20

30

40

50

60

70

80

90

100

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s_

Cases of HIV (n=576)

Cases of AIDS (n=710)

*Includes those that may have progressed to AIDS

People living with HIV(not AIDS)/AIDS Trends Number of people living with HIV(not

AIDS)/AIDS in Northwest Virginia at the end of 2006 ≈ 1217

7% of Virginia’s living total Most of cases are 35 years old 73% male 48% white

Number of People Living with HIV(not AIDS) or AIDS,

in Virginia, by Region, at the end of 2006 (N=18,119)

4379

58515263

1217 1409

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

5500

6000

6500

Rep

ort

ed L

ivin

g

Region

CentralEasternNorthernNorthwestSouthwest

Percentage of People Living with HIV (not AIDS), by Region (N=10,088*)

Northwest5.8%

Southwest7.6%

Central25.8%

Northern26.0%

Eastern34.8%

*Data through 2006

Percentage of People Living with AIDS, by Region, (N=8,031*)

Northwest7.9%

Southwest8.0%

Central22.1%

Northern32.8%

Eastern29.2%

*Data through 2006

Individuals Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia by Locality at the end of 2006 (N=1,217)

7363

5346 42

32 29 23 20 169 8 7 7 7 6 3

79

151621273137445056

86

156

88

67

0

50

100

150

200CH

ARLO

TTESVIL

LE

STAFFO

RD

CO

.SPO

TSYLV

AN

IACO

.W

INCH

ESTER

FRED

ERIC

KSBU

RG

ALB

EM

ARLE

CO

.

CU

LPEPER C

O.

HARRIS

ON

BU

RG

STAU

NTO

N

AU

GU

STA C

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FAU

QU

IER C

O.

FLU

VAN

NA C

O.

RO

CKIN

GH

AM

CO

.

CARO

LIN

E C

O.

WARREN

CO

.

ORAN

GE C

O.

LOU

ISA C

O.

FRED

ERIC

K C

O.

KIN

G G

EO

RG

E C

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WAYN

ESBO

RO

NELS

ON

CO

.

CLA

RKE C

O.

SH

EN

AN

DO

AH

CO

.

GREEN

E C

O.

MAD

ISO

N C

O.

RO

CKBRID

GE C

O.

BATH

CO

.

LEXIN

GTO

N

PAG

E C

O.

RAPPAH

AN

NO

CK

CO

.

BU

EN

A V

ISTA

Locality

Rep

orte

d L

ivin

g_

Individuals Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia, by Race, at the end of 2006 (N=1,217)

4

559

68

1 2

583

0

50

100

150

200

250

300

350

400

450

500

550

600

650

Report

ed L

ivin

g

Race

Asian/Pacific IslanderBlackHispanicMultipleUnknownWhite

Individuals Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia, by Risk at the end of 2006 (N=1,217)

5

239

178

490

53 4917 16

0

50

100

150

200

250

300

350

400

450

500

550

Report

ed L

ivin

g

Risk Factor

HemophiliaHeterosexual ContactInjecting Drug Use (IDU)Men Having Sex with Men (MSM)

MSM & IDUMultiple Heterosexual ContactsPediatricTransfusion

*170 cases unidentified risk or undetermined risk

Females Living with HIV(not AIDS)/AIDS in the Northwest Region of Virginia by Risk at the end of 2006 (N=331*)

165

219 7

57

0

50

100

150

200

HeterosexualContact

Injecting Drug Use(IDU)

MultipleHeterosexual

Contacts

Pediatric Transfusion

Risk Factor

Rep

orte

d L

ivin

g_ Females (n=331)

*72 cases unidentified risk or undetermined risk

Males Living with HIV(not AIDS)/AIDS in the Northwest Region by Risk at the end of 2006 (N=886*)

5

121

490

53

8 9

74

28

0

100

200

300

400

500

Hemophilia HeterosexualContact

Injecting DrugUse (IDU)

Men Having Sexwith Men(MSM)

MSM & IDU MultipleHeterosexual

Contacts

Pediatric Transfusion

Risk Factor

Rep

orte

d L

ivin

g_ Males (n=886)

*98 cases unidentified risk or undetermined risk

Total Early Syphilis* Trends Between 2005-2006, statewide increase (21%)

in reported syphilis Northwest Region had a 5% decrease in

reported syphilis In 2006, 72% of reported cases of Syphilis in the

Northwest region were white, 22% black Majority of the reported cases of Syphilis were

male (94%)

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis

or Early Latent Syphilis

Virginia

Total Early Syphilis* Cases by Region, 2006 (N=351)

Northwest5.1%

Southwest6.0%

Central17.1%

Northern26.8%

Eastern45.0%

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Northwest Health Region Cases of Total Early Syphilis* (1998-2006)

6

3

7 76

10

1918

11

0

2

4

6

8

10

12

14

16

18

20

1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ases

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Northwest Health Region, by locality in 2006 (N=18)

3

2 2

1 1 1 1 1 1 1 1 1 11

0

1

2

3

4

5SPO

TSYLV

AN

IA

AU

GU

STA

STAU

NTO

N

ALB

EM

ARLE

CH

ARLO

TTESVIL

LE

CU

LPEPER

FAU

QU

IER

FLU

VAN

NA

FRED

ERIC

K

KIN

G G

EO

RG

E

LEXIN

GTO

N

RO

CKIN

GH

AM

STAFFO

RD

WARREN

Locality

Rep

orte

d C

ases

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Northwest Health Region, by Race, in 2006 (N=18)

1

4

13

0123456789

101112131415

Report

ed C

ase

s

Race

Asian/Pacific IslanderBlackWhite

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Individuals Reported with Total Early Syphilis* in the Northwest Health Region, by age in 2006 (N=18)

1 1

4

2

4

0

4

2

0

1

2

3

4

5

13 - 1

9

20 - 2

4

25 - 2

9

30 - 3

4

35 - 3

9

40 - 4

4

45 - 4

9

50+

Age

Rep

orte

d C

ases

*Includes a diagnosis of Primary Syphilis, Secondary Syphilis or Early Latent Syphilis

Gonorrhea Trends Between 2005-2006, statewide decrease (22%) in

reported gonorrhea. 34% decrease in reported Hispanic cases.

Northwest Region saw a 23% decrease in reported Gonorrhea

In the Northwest Region, Charlottesville showed the most notable decrease (63%)

In 2006, 38% of reported cases of Gonorrhea in the Northwest region were White, 54% Black, and 4% were unknown

Majority of the reported cases of Gonorrhea were female (60%)

VirginiaGonorrhea Cases by Region, 2006 (N=6,474)

Northwest6.5%

Southwest15.1%

Central29.7%

Northern6.9%

Eastern41.8%

Northwest Health Region Cases Gonorrhea (1998-2006)

513

448 470 462441

629

546

422

487

0

100

200

300

400

500

600

700

1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s_

Individuals Reported with Gonorrhea in the Northwest Health Region, by Race, in 2006 (N=422)

1 2

226

10 417

162

0

50

100

150

200

250

Report

ed C

ase

s

Race

American Indian/AlaskanNativeAsian/Pacific Islander

Black

Hispanic

Multiple

Unknown

White

Individuals Reported with Gonorrhea in the Northwest Health Region, by locality in 2006 (N=422)

34 33 3128 28

25 2420 20 18 17

11 9 9 7 7 5 5 4 3 3 3 1 1 1

48

1611

0

10

20

30

40

50

60

STAFFORD

ALBEM

ARLE

SPOTSYLVANIA

FAUQUIE

R

FREDERIC

KSBURG

WIN

CHESTER

CHARLOTTESVIL

LE

CULPEPER

AUGUSTA

ORANGE

WARREN

CAROLIN

E

LOUIS

A

FREDERIC

K

WAYNESBORO

HARRIS

ONBURG

MADIS

ON

SHENANDOAH

STAUNTON

KIN

G G

EORGE

ROCKIN

GHAM

RAPPAHANNOCK

CLARKE

FLUVANNA

GREENE

NELSON

PAGE

ROCKBRID

GE

Locality

Rep

orte

d C

ases

Individuals Reported with Gonorrhea in the Northwest Health Region, by Age, in 2006 (N=422)

1

133

151

75

2411 13 6 8

0

50

100

150

200

0-1

2

13-1

9

20 - 2

4

25 - 2

9

30 - 3

4

35 - 3

9

40 - 4

4

45 - 4

9

50+

Age

Rep

orte

d C

ases

Chlamydia Trends Between 2005-2006, statewide increase (6%) in reported

Chlamydia and 26% increase in reported Hispanic Cases Northwest Region saw a 8% increase in reported

Chlamydia In the Northwest Region, Spotsylvania showed the most

notable increase (39%) In 2006 in the Northwest Region, 43% of reported cases

of Chlamydia were white, 34% black and 13% were unknown

Majority of the reported cases of Chlamydia were female (77%)

VirginiaChlamydia Cases by Region, 2006 (N=24,081)

Northwest11.5%

Southwest11.9%

Central22.5%

Northern13.4%

Eastern40.6%

Northwest Health Region Cases Chlamydia (1998-2006)

14911609

1859

21752070

22032416

25782777

0

500

1000

1500

2000

2500

3000

1998 1999 2000 2001 2002 2003 2004 2005 2006

Year of Report

Report

ed C

ase

s

Individuals Reported with Chlamydia in the Northwest Health Region, by Race, in 2006 (N=2,777)

2 30

931

234

23

354

1203

0

300

600

900

1200

1500

Report

ed C

ase

s

Race

American Indian/AlaskanNativeAsian/Pacific Islander

Black

Hispanic

Other

Unknown

White

Individuals Reported with Chlamydia in the Northwest Health Region, by locality in 2006 (N=2,777)

202186

159144 141 137 135 132

10885

68 66 63 63 53 48 36 33 28 26 22 21 15 9 7 7 5

311318

80 69

0

50

100

150

200

250

300

350

400

STAFFORD

SPOTSYLVANIA

CHARLOTTESVIL

LE

ALBEM

ARLE

HARRIS

ONBURG

WIN

CHESTER

FREDERIC

KSBURG

FREDERIC

K

AUGUSTA

CULPEPER

FAUQUIE

R

CAROLIN

E

ROCKIN

GHAM

WAYNESBORO

LOUIS

A

WARREN

ORANGE

STAUNTON

SHENANDOAH

KIN

G G

EORGE

PAGE

GREENE

FLUVANNA

ROCKBRID

GE

NELSON

CLARKE

MADIS

ON

BUENA V

ISTA

BATH

LEXIN

GTON

RAPPAHANNOCK

Locality

Rep

orte

d C

ases

Individuals Reported with Chlamydia in the Northwest Region, by age in 2006 (N=2,777)

6

10191099

417

13253 31 10 10

0

100

200

300

400

500

600

700

800

900

1000

1100

1200

1300

0-1

2

13-1

9

20 -

24

25 -

29

30 -

34

35 -

39

40 -

44

45 -

49

50+

Age

Rep

ort

ed C

ase

s

Prepared by:

Carrie Dolan, MPHEpidemiologist

Lindsey Matthews, MPH (updated)

Division of Disease PreventionJuly 2007carrie.dolan@vdh.virginia.gov

*Data accessed from HIV/AIDS Reporting System (HARS) and Sexually Transmitted Disease Management Information System (STDMIS) July 2007