In recognition of LGBT Health Awareness Week, CDPH hosted a community discussion on HIV and sexually transmitted infections (STIs) in the LGBT Community at Center on Halsted that included a keynote address from Commissioner Choucair, an overview of CDPH’s 2013 HIV/STI Surveillance Report from Nik Prachand and a panel discussion where local leaders including our own Tarek Mikati outlined how the community can use this information to combat the spread of HIV and STIs.

1. Chicago Department of Public Health
Commissioner Bechara Choucair, M.D.
City of Chicago
Mayor Rahm Emanuel
Current State of the HIV Epidemic
among MSM in Chicago
March 28, 2014
Center on Halsted
Nikhil Prachand, MPH
Director, HIV/STI Surveillance, Epidemiology and Research

3. Trends in HIV/AIDS Diagnoses in Chicago – 20 Years

4. Living with HIV in Chicago, 2011
Diagnosed (+ Undiagnosed)
City Total 21,555 (25,003)
MSM 12,610 (14,627)
Black MSM 4,862 (5,689)
White MSM 4,607 (5,205)
Latino MSM 2,348 (2,747)
Asian MSM 160 (185)

5. 1,008 Total HIV Diagnoses
(2011)
City Prevalence ~ 0.9%
MSM ~ 21%

6. HIV Infection Diagnoses by Select Characteristics,
Chicago, 2011
82%
18%
6%
33%
23% 22%
12%
3%
55%
20%
16%
9%
69%
7%
3%
21%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

7. Inclusion of Transgender in Surveillance Reporting
New HIV Diagnoses, 2011
81.0%
Male
17.7%
Female
1.3%
Transgender

8. Racial Disparities Persist
HIV Diagnoses, 2000-2011
0
200
400
600
800
1,000
1,200
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
Black White Hispanic Other

9. 2007 2011
35%
Recent Decreases among Black Women
New HIV Diagnoses, 2007 and 2011

10. 0
50
100
150
200
250
300
350
400
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
Black White Hispanic Other
Decreases Still Leave Huge Disparity in Females
FEMALE New HIV Diagnoses, 2000 - 2011

11. Little Decrease in Black or Latino Males in Past 5 Years
Male HIV Diagnoses, 2000-2011
0
100
200
300
400
500
600
700
800
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
Black White Hispanic Other

12. MSM continue to bear more of HIV burden
New HIV Diagnoses, 2011
60% in 2007 44% in 2000

13. Almost 90% Decrease in IDU Since 2000
CDPH – STI/HIV Surveillance, Epidemiology and Research Section – 03/2013
0
100
200
300
400
500
600
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis

14. Almost 50% decrease among HET
0
50
100
150
200
250
300
350
400
450
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis

15. 15% Decrease among MSM
0
100
200
300
400
500
600
700
800
900
1,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
MSM

16. 15% Decrease among MSM
0
100
200
300
400
500
600
700
800
900
1,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
MSM

17. 0
50
100
150
200
250
300
350
400
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
Black White Hispanic Other
HIV: MSM by Race

18. HIV: MSM by Age Group
0
50
100
150
200
250
300
350
400
450
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
13-19 20-29 30-39 40-49 50-59 60+

19. 0
20
40
60
80
100
120
140
160
180
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
13-19 20-29 30-39 40-49 50-59 60+
Black MSM:
2/3 New Diagnoses among Youth

20. White MSM: All Age Decline
0
20
40
60
80
100
120
140
160
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
13-19 20-29 30-39 40-49 50-59 60+

21. Latino MSM: Young Adults Increase
0
10
20
30
40
50
60
70
80
90
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NumberofDiagnoses
Year of Diagnosis
13-19 20-29 30-39 40-49 50-59 60+

22. 140 148
334
0
50
100
150
200
250
300
350
White MSM Latino MSM Black MSM
Emerging Patterns – MSM
New HIV Diagnoses, 2011

23. Syphilis in Young MSM Increasing
0
20
40
60
80
100
120
140
160
180
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
13-19 20-29 30-39 40-49 >=50
Numberofcases
2012: 43% Black; 33% White; 16% Latino 53% Syphilis Cases Co-Infected HIV

24. Behaviors
and Other Characteristics

25. Sex Behaviors – Young MSM (18-29)
HIV Behavioral Surveillance, 2011
Black White Hispanic Total
(%) (%) (%) (%)
Unprotected
anal sex
54 57 67 59
Unknown
status of
most recent
sex partner
34 29 51 38
Drug or
alcohol w sex 34 55 49 46
# Male sex
partners 3 4 3 3

26. National HIV Behavioral Surveillance 2011
Black White Hispanic
(%) (%) (%)
Lifetime Genital Herpes
2 4 3
Tested for STD
61 51 43
Diagnosed gonorrhea
5 3 8
Diagnosed chlamydia 4 4 6
Diagnosed syphilis
8 4 4
Other Sexually Transmitted Infections

27. National HIV Behavioral Surveillance 2011
Black White Hispanic
Most recent casual
partner was:
(%) (%) (%)
Younger than
respondent
31 47 32
Older than respondent 46 38 50
Same Race as
respondent
64 67 40
Sexual Network

28. Black White Hispanic
(%) (%) (%)
Most of the people in your
neighborhood would not accept
your sexuality
41 23 72
Go to another neighborhood to
feel accepted
55 40 55
Feel unsafe in your neighborhood
b/c you are an MSM?
12 7 17
Neighborhood has opportunities
for MSM to meet, socialize, etc.
44 74 46
Neighborhood Influences
Non-Boystown residents
Boystown = 60613, 60640, 60660, 60657

29. National HIV Behavioral Surveillance 2011
Black White Hispanic
(%) (%) (%)
Ever homeless
16 2 5
Ever held in prison or jail 29 9 14
Currently Unemployed 23 7 13
HS Grad or Less 32 9 31
Social Determinants

30. National HIV Behavioral Surveillance 2011
Black White Hispanic
(%) (%) (%)
Met HIV testing
guidelines
75 69 71
Received Free
Condoms
87 80 81
HIV Testing and Condoms

31. 64%
67%
70%
20%
30%
40%
50%
60%
70%
80%
90%
2004 2008 2011
MSM Testing Annually For HIV
HIV Behavioral Surveillance, 2011

32. National HIV Behavioral Surveillance 2011
Black White Hispanic
(%) (%) (%)
Ever heard of
PrEP
32 38 23
Taken PrEP
0 1 2
Willing to take
PrEP
58 50 53
PrEP

33. National HIV Behavioral Surveillance 2011
Black White Hispanic
(%) (%) (%)
Have Health
Insurance
53 82 57
Have Regular
Source of
Medical Care
81 82 70
Health Care and Access

34. More HIV+ MSM Taking HIV Medication
2008 to 2011
Chicago Department of Public Health, NHBS, 2012.
44%
84%
90%
100%
50%
82%
0%
20%
40%
60%
80%
100%
2008 2011
PercentonART
Years
Black
White
Hispanic

35. Continuum of Care

36. 1,011
78%
19,391
61%
11,823
90% 87%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV
Diagnoses
(2010)
% Linked to
Care within
3 months of
HIV
diagnosis
# Diagnosed
thru 2009
and living
w/HIV in
2010
% Retained
in Care (at
least 1 visit
in 2010)
# Retained
in Care
% on ART % Virally
Suppressed
(<200
copies/mL)
HIV Continuum of Care, Chicago, 2010
Linkage to Care Retention In Care ART and Viral Suppression

37. HIV Continuum of Care MSM by Race
275
77%
4,139
66%
2,747
90%
77%
175
85%
4,285
65%
2,797
88%
92%
116
84%
2,072
48%
999 100% 100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV
Diagnoses
(2010)
% Linked to
Care within 3
months of HIV
diagnosis
# Diagnosed
thru 2009 and
living w/HIV in
2010
% Retained in
Care (at least 1
visit in 2010)
# Retained in
Care
% on ART % Virally
Suppressed
(<200
copies/mL)
Black MSM White MSM Hispanic MSM

38. HIV Continuum of Care MSM by Race
275
77%
4,139
66%
2,747
90%
77%
175
85%
4,285
65%
2,797
88%
92%
116
84%
2,072
48%
999 100% 100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV
Diagnoses
(2010)
% Linked to
Care within 3
months of HIV
diagnosis
# Diagnosed
thru 2009 and
living w/HIV in
2010
% Retained in
Care (at least 1
visit in 2010)
# Retained in
Care
% on ART % Virally
Suppressed
(<200
copies/mL)
Black MSM White MSM Hispanic MSM

39. HIV Continuum of Care MSM by Race
275
77%
4,139
66%
2,747
90%
77%
175
85%
4,285
65%
2,797
88%
92%
116
84%
2,072
48%
999 100% 100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV
Diagnoses
(2010)
% Linked to
Care within 3
months of HIV
diagnosis
# Diagnosed
thru 2009 and
living w/HIV in
2010
% Retained in
Care (at least 1
visit in 2010)
# Retained in
Care
% on ART % Virally
Suppressed
(<200
copies/mL)
Black MSM White MSM Hispanic MSM

40. HIV Continuum of Care MSM by Race
275
77%
4,139
66%
2,747
90%
77%
175
85%
4,285
65%
2,797
88%
92%
116
84%
2,072
48%
999 100% 100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV
Diagnoses
(2010)
% Linked to
Care within 3
months of HIV
diagnosis
# Diagnosed
thru 2009 and
living w/HIV in
2010
% Retained in
Care (at least 1
visit in 2010)
# Retained in
Care
% on ART % Virally
Suppressed
(<200
copies/mL)
Black MSM White MSM Hispanic MSM

41. HIV Continuum of Care MSM by Race
275
77%
4,139
66%
2,747
90%
77%
175
85%
4,285
65%
2,797
88%
92%
116
84%
2,072
48%
999 100% 100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV
Diagnoses
(2010)
% Linked to
Care within 3
months of HIV
diagnosis
# Diagnosed
thru 2009 and
living w/HIV in
2010
% Retained in
Care (at least 1
visit in 2010)
# Retained in
Care
% on ART % Virally
Suppressed
(<200
copies/mL)
Black MSM White MSM Hispanic MSM

42. Envision a Plateau
275 100% 4,139 100% 2,747 100% 100%175 100% 4,285 100% 2,797 100% 100%116 100% 2,072 100% 999 100% 100%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# New HIV Diagnoses
(2010)
% Linked to Care
within 3 months of HIV
diagnosis
# Diagnosed thru 2009
and living w/HIV in
2010
% Retained in Care (at
least 1 visit in 2010)
# Retained in Care % on ART % Virally Suppressed
(<200 copies/mL)
Black MSM White MSM Hispanic MSM

43. What to Look For…
• 2012 Surveillance Data – Out in June
• Continuum Analysis
• Trends 2009 – 2011
• Mapping
• Data to Action
• Project CHAT – Behavioral Survey
• 4th MSM Cycle of HIV Behavioral Survey
• UIC- COIP (Jimenez, Ouellet)
• Young MSM (13 to 17 years) – Facebook Recruitment
• Northwestern (Mustanski, Newcomb)

44. facebook.com/ChicagoPublicHealth@ChiPublicHealth
312.747.9884
www.CityofChicago.org/Health
HealthyChicago@CityofChicago.org
Phone: 312-745-3204 Email: nik.prachand@cityofchicago.org