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2018 STD/HIV Surveillance Report State of Louisiana Department of Health Office of Public Health

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2018 STD/HIV Surveillance Report State of Louisiana Department of Health Office of Public Health 2018 STD/HIV Surveillance Report State of Louisiana Department of Health Office of Public Health Louisiana Department of Health Office of Public Health STD/HIV/Hepatitis Program 1450 Poydras Street, Suite 2136 New Orleans, LA 70112 (504) 568-7474 http://ldh.louisiana.gov/hiv www.louisianahealthhub.org Louisiana Office of Public Health STD/HIV/Hepatitis Program DeAnn Gruber, PhD, LCSW Director, Bureau of Infectious Diseases Sam Burgess, MA, MSHCM Director, STD/HIV/Hepatitis Program Anthony James, MS, MA, MSHCM Deputy Director - Programs Chaquetta Johnson, DNP, MPH, APRN, WHNP-BC Deputy Director - Operations Tsegaye Assefa, MBA Financial Operations Manager Jacquelyn Naomi Bickham, MPA Prevention Manager Javone Charles, MPH Field Operations Manager Joy Ewell CDC Lead Public Health Advisor Julie Fitch, MA Capacity Building and Community Mobilization Manager Jessica Fridge, MSPH Surveillance Manager Will F. Henderson III, MSIS Health Systems Manager Billy Robinson, PhD Evaluation Manager Erika Sugimori, MPH Care and Services Manager Debbie Wendell, PhD, MPH Data Management/Analysis Manager Graphic Design Jim McGowan with Complete Communications, Inc. Editor/Production Jessica Fridge, MSPH Antoine Brantley, MPH Jacob Chávez, MSAS Dhara Dangar, MPH Justice King, MSPH Ashley Hoover, MPH Lauren Ostrenga, MPH Acknowledgements Thank you to the STD/HIV/Hepatitis Program staff who worked tirelessly to collect the data used within this report and ensured the quality and consistency of the data. Thank you for your input, editorial cor- rections, and time in creating this Annual Report to encompass all aspects of SHHP’s continued effort to prevent the transmission of STDs, HIV, and Hepatitis B & C, to ensure the availability of quality medical and social services, and to track the impact of the STD, HIV, and Hepatitis B & C epidemics in Louisiana. In addition, we wish to acknowledge the contribution of persons with STD diagnoses, persons living with HIV and/or Hepatitis B & C, STD/HIV and Hepatitis health care providers, community groups, researchers, and members of the community. Publication of this report would not have been possible without their coopera- tion, dedication, and hard work. Table of Contents List of Figures ..................................................................................................................................................... iv ii List of Tables ..................................................................................................................................................... vii Louisiana Office of Public Health, STD/HIV/Hepatitis Program Overview ......................................................1 Executive Summary ............................................................................................................................................ 2 Geographic Guide to Louisiana’s Public Health Regions and Metro Areas .....................................................4 Louisiana’s Population and Healthcare Environment ...................................................................................... 5 Break Out: National HIV/AIDS Strategy ............................................................................................................ 6 Understanding HIV Disparities in Louisiana ...................................................................................................... 8 CHAPTER 1 – PROFILE OF THE HIV EPIDEMIC IN LOUISIANA Introduction to HIV Surveillance ................................................................................................................. 19 10-Year Trends in New HIV Diagnoses (2009-2018) ...................................................................................20 Late HIV Testing in Louisiana ....................................................................................................................... 30 HIV Rates in the United States, 2018 .......................................................................................................... 31 Break Out: HIV Among Gay, Bisexual and Other Men Who Have Sex With Men (GBM) .........................32 Break Out: HIV Among Youth in Louisiana .................................................................................................33 Break Out: HIV Among Blacks in Louisiana ................................................................................................34 Break Out: HIV Among Transgender Persons in Louisiana ........................................................................35 10-Year Trends in New AIDS Diagnoses (2009-2018) .................................................................................36 AIDS Rates in the United States, 2018 ........................................................................................................38 HIV and AIDS In the South ........................................................................................................................... 40 Persons Living in Louisiana with HIV (Prevalence) .....................................................................................42 National HIV Behavioral Surveillance Survey (2016-2018) ........................................................................45 CHAPTER 2 – LINKAGE AND RETENTION IN HIV CARE Linkage to HIV Medical Care ....................................................................................................................... 49 Unmet Need: Percentage of Persons out of HIV Medical Care .................................................................50 Louisiana’s HIV Care Continuum ................................................................................................................. 52 Viral Suppression Trends ............................................................................................................................. 53 Visualizing Disparities with the HIV Care Continuum ................................................................................54 Table of Contents CHAPTER 3 – PERINATAL HIV EXPOSURE AND CONGENITAL SYPHILIS Perinatal HIV Exposure ................................................................................................................................ 55 Congenital Syphilis ....................................................................................................................................... 63 CHAPTER 4 – PROFILE OF STDs IN LOUISIANA iii Introduction to STD Surveillance ................................................................................................................ 69 Chlamydia..................................................................................................................................................... 70 10-Year Trends in Chlamydia Diagnoses ....................................................................................................70 Chlamydia Diagnoses by Sex at Birth, Race/Ethnicity, and Age at Diagnosis ...........................................71 Chlamydia Diagnosis Rates in the United States, 2018 ..............................................................................77 Gonorrhea .................................................................................................................................................... 78 10-Year Trends in Gonorrhea Diagnoses ....................................................................................................78 Gonorrhea Diagnoses by Sex at Birth, Race/Ethnicity, and Age at Diagnosis ..........................................79 Gonorrhea Diagnosis Rates in the United States, 2018 .............................................................................85 Primary & Secondary Syphilis ..................................................................................................................... 86 10-Year Trends in P&S Syphilis Diagnoses .................................................................................................86 P&S Diagnoses by Sex at Birth, Race/Ethnicity, and Age at Diagnosis ......................................................87 P&S Syphilis Diagnosis Rates in the United States, 2018 ...........................................................................93 Early non-Primary non-Secondary Syphilis ................................................................................................94 10-Year Trends in Early non-P&S Syphilis Diagnoses .................................................................................94 Early non-P&S Diagnoses by Sex at Birth, Race/Ethnicity, and Age at Diagnosis .....................................95 CHAPTER 5 – HIV CO-INFECTION WITH STDs AND HEPATITIS C STDs and Hepatitis C with HIV Co-Infection ...............................................................................................97 Syphilis and HIV Co-Infection ...................................................................................................................... 98 Gonorrhea and HIV Co-Infection ..............................................................................................................102 Chlamydia and HIV Co-Infection ...............................................................................................................106 Hepatitis C and HIV Co-Infection...............................................................................................................110 APPENDICES HIV and STD Tables ...................................................................................................................................
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