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i HIV Surveillance 2010 Annual Data Report i Virgin Islands Department of Health Communicable Disease Division STD/HIV/TB Program HIV Surveillance Unit To Our Readers: All US states and territories have implemented HIV Surveillance to monitor the HIV epidemic. The Virgin Islands Department of Health HIV Surveillance program is one of 45 areas that have had long term confidential name-based HIV infection reporting to monitor the patterns of HIV and AIDS diagnosis, mortality, and modes of exposure. The HIV Surveillance Annual Data Report is prepared by the Virgin Islands HIV Surveillance program in partial fulfillment of the cooperative agreement (5U62PS001040) between the Centers for Disease Control and Prevention (CDC) and the Virgin Islands Department of Health. The data in the 2010 Annual Data Report provide a picture of the HIV/AIDS epidemic in the Virgin Islands and the need for prevention and care services. The HIV Surveillance program has addressed the need for trend data by many data users in the 2010 report. Additionally, tables were added to include STD data. We hope to provide data from the other units that comprise the STD/HIV/TB program in the 2011 report. All data in this report were generated from the Virgin Islands HIV Surveillance Progam’s enhanced HIV/AIDS Reporting System (eHARS). All information about HIV/AIDS patients is confidential and is collected specifically for epidemiologic purposes. The CDC and the Virgin Islands Department of Health has implemented policies and procedures to assure the confidentiality and security of HIV and AIDS data. Data release policy regulates the release of HIV Surveillance reports, which ensure that HIV data are not presented in such a manner as to potentially identify any individual with HIV/AIDS. This report was produced by Annette Gumbs Hobson, HIV Surveillance Coordinator. Assistance was provided by Katy Sanon, UVI intern, and Karissa Cave, Data Entry Clerk. Data on STDs were furnished by Jasper Lettsome, St. Thomas Clinic Administrator. HIV Surveillance 2010 Annual Data Report ii For Inquiries about this report, write to or contact: The Virgin Islands Department of Health Surveillance Program 1303 Hospital Ground Suite 10 Old Municipal Hospital Bldg. I St. Thomas, VI 00802 Telephone: 340-774-9000 ext. 4667 or 340-774-0127 Fax: 340-715-1589 The HIV Surveillance 2010 Annual Data Report is not copyrighted and may be used and copied without permission. However, citation of the source is appreciated. This publication was supported by a cooperative agreement (5U62PS001040-03) from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. HIV Surveillance 2010 Annual Data Report iii Contents To Our Readers .......................................................................................................................................... i CONCEPTS ................................................................................................................................................. 1 Table 1. HIV and AIDS cases by year reported and selected characteristics of persons, 2010 United States Virgin Islands…………………………………………………………………………………………….3 Table 2. New HIV Infections by sex and year reported, 2006 to 2010 - USVI………………………………..4 Table 3. Cumulative AIDS and HIV Infection cases reported by sex and race/ethnicity, 2010 - USVI…………………………………………………………………………………………………………………….5 Table 4. Cumulative AIDS and HIV Infection cases reported by sex and exposure category, 2010 - USVI…………………………………………………………………………………………………………………….5 Table 5. Cumulative AIDS and HIV Infection cases reported by sex and age, 2010 - USVI…………….6 Table 6. Cumulative AIDS and HIV Infection cases reported by sex and vital status, 2010 - USVI…………………………………………………………………………………………………………………….6 Table 7. Cumulative HIV cases reported by race/ethnicity and exposure category, 2010 - USVI…………………………………………………………………………………………………………….………7 Table 8. Cumulative HIV cases reported by race/ethnicity and age, 2010 - USVI……………….…………7 Table 9. Cumulative HIV cases reported by race/ethnicity and vital status, 2010 - USVI………………7 Table 10. Cumulative AIDS cases reported by race/ethnicity and exposure category, 2010 - USVI………………………………………………………………………………………………………….…………8 Table 11. Cumulative AIDS cases reported by race/ethnicity and age, 2010 - USVI………………..………8 Table 12. Cumulative AIDS cases reported by race/ethnicity and vital status, 2010 - USVI………….…8 Table 13. AIDS and HIV cases by sex and year reported, 1993-2010 - USVI……………..…………………….9 Chart 1. AIDS Cases reported by Sex, Virgin Islands………………………………………………………….……....10 Chart 2. HIV Cases reported by Sex, Virgin Islands………………………………………………….…….…...……..10 Table 14. Cumulative Pediatric cases reported by island and selected variables -2010, USVI……………………………………………………………………………………………………………….…………….11 Chart 3. St. Thomas/St. John HIV Pediatric Status…………………………………..………………………………….12 HIV Surveillance 2010 Annual Data Report iv Chart 4. St. Croix HIV Pediatric Status………………………………………………………………………………………..12 Table R1. Adults and adolescents living with a diagnosis of HIV infection by year-end 2008, United States and 5 U.S. dependent areas.……………………………………………………….………….13 Map 1. St. Thomas and St. Croix HIV/AIDS Cases by residence at diagnosis………………………………16 Table S1. Gonorrhea Cases reported by sex, age and race, 2005 to 2010 - USVI……………………..…..17 Table S2. Chlamydia Cases reported by sex, age and race, 2005 to 2010 - USVI……………………..…..18 Chart 5. Gonorrhea vs Chlamydia……………………………….……………………………………………………………..18 HIV Surveillance 2010 Annual Data Report 1 CONCEPTS HIV Surveillance – The continuous, systematic collection, analysis, and interpretation of HIV/AIDS data. Epidemiology – The study of incidence and distribution and control of a disease in a population. Epidemic – A disease that spreads rapidly through a defined demographic segment than would normally be expected. Case – A condition, such as HIV or AIDS according to a standard definition (ex. HIV Case) Cumulative Cases – The total number of cases of a disease reported or diagnosed during a specified time. Rate – The frequency of a disease compared to the number of persons at risk for the disease. X 100,000 # of reported HIV infection cases for specific year(s) Virgin Islands Population during the same year(s) Trend – A long-term pattern in the progression of the disease. Pediatric – Persons that are less than 13 years of age at the time of diagnosis. Adult/Adolescent – Persons that are 13 years of age or older at the age of diagnosis. Prevalence – The total number of persons living with HIV or AIDS in a population over a period of time. Incidence – The total number or rate of new cases of a disease over a period of time. Prevalence rate – The percentage of the population living with HIV. X 100,000 Total number of living HIV cases for specific year Virgin Islands Population during the same year Incidence rate – The total number of new cases in a specific area during a specific time period among the population at risk in the same area and time period. X 100,000 # of new cases for specific year Virgin Islands Population during the same year Risk factor – individual routes of HIV exposure/transmission: MSM, IDU, heterosexual contact, blood transfusion, Perinatal exposure, etc. HIV Surveillance 2010 Annual Data Report 2 MSM (men who have sex with men) – A risk factor to describe male-to-male sexual contact which includes penis-to-mouth, penis-to-anus, or mouth-to-anus. It does not include mouth-to-mouth contact. Gay, bisexual, and other men who have sex with men fall within this category. IDU (Injection Drug User) – A risk factor to describe individuals that use syringes, needles, or cookers to Inject illicit drugs used for producing euphoria. NIR (No identified risk) –Cases in which risk information cannot be identified or confirmed. Reported – The date on which an adult or pediatric HIV/AIDS case report form is entered into the HIV/AIDS reporting database. Diagnosed – The date on which laboratory test confirmed a disease or a physician having determined or analyzed a patient's condition by evaluating signs and symptoms through diagnostic analysis. HIV (Human Immunodeficiency Virus) – The retrovirus that causes AIDS by infecting the T-helper cells. AIDS (Aquired Immune Deficiency Syndrome) – A result of Human Immunodeficiency Virus (HIV) infection, which disables the immune system from effectively fighting numerous opportunistic infections and cancers. Serorevert – the change in serostatus from positive to negative. Seroreversion occurs in infants whose antibody status changes once they have lost maternally transmitted antibodies. Seroconvert – the development of detectable specific antibodies to microorganisms in the blood serum as a result of infection or immunization. Perinatal Exposure – A risk factor that describes the possible spread of HIV/AIDS from a mother to her baby that can occur during pregnancy, labor, delivery or breastfeeding. HIV Surveillance 2010 Annual Data Report 3 Table 1. HIV and AIDS cases by year reported and selected characteristics of persons, 2010 - United States Virgin Islands HIV AIDS HIV AIDS Total Cases 296 632 15 16 Adult 290 617 15 16 Pediatric 6 15 0 0 Living 252 281 15 14 Deceased 44 351 0 2 Under 13 6 15 0 0 13-14 2 0 0 0 15-24 41 26 4 0 25-34 101 168 4 4 35-44 87 228 6 5 45-54 37 140 1 3 Over 54 22 55 0 4 Black 174 426 6 10 White 23 50 2 1 Hispanic 93 154 7 5 Other 6 2 0 0 Males 160 395 9 11 Male-to-male sexual contact (MSM) 36 130 5 2 Injection drug use (IDU) 15 64 0 1 MSM & IDU 2 16 0 0 Heterosexual contact 30 91 0 1 Blood transfusion/hemophiliac 0 2 0 0 Perinatal transmission 4 6 0 0 Risk not reported/other 73 86 4 7 Females 135 209 6 5 Injection drug use (IDU) 10 29 1 0 Heterosexual contact 62 109 2 2 Blood transfusion/hemophiliac 1 0 0 0 Perinatal transmission 2 8 0 0 Risk not reported/other 60 63 3 3 (CUMULATIVE) 2010 HIV Surveillance 2010 Annual Data Report 4 Table 2. New HIV Infections by sex and year reported, 2006 to 2010 - USVI Year No. % No. % No. % 2010 15 62.5 9 37.5 24 100.0 2009 18 60.0 12 40.0 30 100.0 2008 14 63.6 8 36.4 22 100.0 2007 22 57.9 16 42.1 38 100.0 2006 23 62.2 14 37.8 37 100.0 Males Females Total Over the past five years, the number of new HIV infections reported has fluctuated. Despite a fluctuation in the total cases reported, males account for approximately 60% of new HIV infections (regardless of the stage of the disease). HIV Surveillance 2010 Annual Data Report 5 Table 3. Cumulative AIDS and HIV Infection cases reported by sex and race/ethnicity, 2010 - USVI Race/ethnicity No. % No. % No. % No. % Total 422 100.0 158 100.0 210 100.0 135 100.0 Black, not-hispanic 279 66.1 98 62.0 147 70.0 73 54.1 White, not-hispanic 41 9.7 17 10.8 9 4.3 6 4.4 Hispanic 100 23.7 40 25.3 54 25.7 53 39.3 Other 2 0.5 3 1.9 0 0.0 3 2.2 Males AIDS HIV Females AIDS HIV Table 4. Cumulative AIDS and HIV Infection cases reported by sex and exposure category, 2010 - USVI Exposure Category No. % No. % No. % No. % Total 422 100.0 158 100.0 210 100.0 134 100.0 Male-to-male sexual contact (MSM) 130 30.8 36 22.8 Injection drug use (IDU) 64 15.2 15 9.5 29 13.8 10 7.5 MSM & IDU 16 3.8 2 1.3 Heterosexual contact 91 21.6 30 19.0 109 51.9 62 46.3 Blood transfusion/hemophiliac 2 0.5 0 0.0 0 0.0 1 0.7 Perinatal transmission 6 1.4 4 2.5 8 3.8 2 1.5 Risk not reported/other 113 26.8 71 44.9 64 30.5 59 44.0 Males Females AIDS HIV AIDS HIV Non-Hispanic black males and females account for the majority of HIV and AIDS cases reported in the Virgin Islands. Among all males, blacks account for 66% of AIDS cases and 62% of HIV Cases reported. Among all females, blacks account for 70% of AIDS cases and 54% of HIV Cases reported. This is mainly due to the predominance of African descent in the US Virgin Islands population. Obtaining risk factor information continues to be a major setback in assessing how individuals may have been exposed to the virus. Most males contracting the virus were exposed through male-to- male sexual contact, while females were exposed through heterosexual contact. HIV Surveillance 2010 Annual Data Report 6 Table 5. Cumulative AIDS and HIV Infection cases reported by sex and age, 2010 - USVI Age at diagnosis No. % No. % No. % No. % Total 422 100.0 158 100.0 210 100.0 135 100.0 Under 13 7 1.7 3 1.9 8 3.8 3 2.2 13-14 0 0.0 1 0.6 0 0.0 1 0.7 15-24 16 3.8 19 12.0 10 4.8 21 15.6 25-34 100 23.7 48 30.4 68 32.4 52 38.5 35-44 158 37.4 47 29.7 70 33.3 39 28.9 45-54 102 24.2 26 16.5 38 18.1 11 8.1 Over 54 39 9.2 14 8.9 16 7.6 8 5.9 Males Females AIDS HIV AIDS HIV Table 6. Cumulative AIDS and HIV Infection cases reported by sex and vital status, 2010 - USVI No. % No. % No. % No. % Total 422 100.0 158 100.0 210 100.0 135 100.0 Adults 415 98.3 155 98.1 202 96.2 132 97.8 Pediatric 7 1.7 3 1.9 8 3.8 3 2.2 Living 174 41.2 130 82.3 107 51.0 119 88.1 Deceased 248 58.8 28 17.7 103 49.0 16 11.9 Males Females AIDS HIV AIDS HIV Very few pediatric exposures to HIV seroconvert. Therefore, the majority of HIV and AIDS cases in the Virgin Islands are among adults. Since the HIV Surveillance program began accounting for the HIV and AIDS cases, approximately 59% of males and 49% of females reported with an AIDS diagnosis have died. HIV Surveillance 2010 Annual Data Report 7 Table 7. Cumulative HIV cases reported by race/ethnicity and exposure category, 2010 - USVI Exposure Category No. % No. % No. % No. % Total 171 100.0 23 100.0 93 100.0 6 100.0 Male-to-male sexual contact (MSM) 15 8.8 11 47.8 8 8.6 2 33.3 Injection drug use (IDU) 12 7.0 2 8.7 10 10.8 1 16.7 MSM & IDU 1 0.6 1 4.3 0 0.0 0 0.0 Heterosexual contact 44 25.7 6 26.1 41 44.1 1 16.7 Blood transfusion/hemophiliac 1 0.6 0 0.0 0 0.0 0 0.0 Perinatal transmission 5 2.9 0 0.0 1 1.1 0 0.0 Risk not reported/other 93 54.4 3 13.0 33 35.5 2 33.3 Black White Hispanic Other Table 8. Cumulative HIV cases reported by race/ethnicity and age, 2010 - USVI Age at diagnosis No. % No. % No. % No. % Total 171 100.0 23 100.0 93 100.0 6 100.0 Under 13 5 2.9 0 0.0 1 1.1 0 0.0 13-14 2 1.2 0 0.0 0 0.0 0 0.0 15-24 18 10.5 2 8.7 17 18.3 3 50.0 25-34 55 32.2 11 47.8 33 35.5 1 16.7 35-44 52 30.4 5 21.7 28 30.1 1 16.7 45-54 22 12.9 3 13.0 11 11.8 1 16.7 Over 54 17 9.9 2 8.7 3 3.2 0 0.0 Black White Hispanic Other Table 9. Cumulative HIV cases reported by race/ethnicity and vital status, 2010 - USVI No. % No. % No. % No. % Total 171 100.0 23 100.0 93 100.0 6 100.0 Adults 166 97.1 23 100.0 92 98.9 6 100.0 Pediatric 5 2.9 0 0.0 1 1.1 0 0.0 Living 143 83.6 19 82.6 82 88.2 5 83.3 Deceased 28 16.4 4 17.4 11 11.8 1 16.7 Black White Hispanic Other Blacks are most unlikely to provide a risk factor to determine mode of exposure. However, approximately 26% of Blacks and 44% of Hispanics have reported being exposed to the virus through heterosexual contact. 47% of whites have contracted the virus through male-to-male sexual contact. Among all races and ethnicities, the majority of HIV cases reported was among persons 25 – 34 years of age. HIV Surveillance 2010 Annual Data Report 8 Table 10. Cumulative AIDS cases reported by race/ethnicity and exposure category, 2010 - USVI Exposure Category No. % No. % No. % No. % Total 426 100.0 50 100.0 154 100.0 2 100.0 Male-to-male sexual contact (MSM) 85 20.0 27 54.0 17 11.0 1 50 Injection drug use (IDU) 43 10.1 4 8.0 46 29.9 0 0 MSM & IDU 10 2.3 4 8.0 2 1.3 0 0 Heterosexual contact 151 35.4 6 12.0 42 27.3 1 50 Blood transfusion/hemophiliac 2 0.5 0 0.0 0 0.0 0 0 Perinatal transmission 8 1.9 0 0.0 6 3.9 0 0 Risk not reported/other 127 29.8 9 18.0 41 26.6 0 0 Black White Hispanic Other Table 11. Cumulative AIDS cases reported by race/ethnicity and age, 2010 - USVI Age at diagnosis No. % No. % No. % No. % Total 426 100.0 50 100 154 100.0 2 100.0 Under 13 9 2.1 0 0.0 6 3.9 0 0.0 13-14 0 0.0 0 0.0 0 0.0 0 0.0 15-24 15 3.5 0 0.0 11 7.1 0 0.0 25-34 103 24.2 15 30.0 49 31.8 1 50.0 35-44 156 36.6 19 38.0 52 33.8 1 50.0 45-54 101 23.7 10 20.0 29 18.8 0 0.0 Over 54 42 9.9 6 12.0 7 4.5 0 0.0 Black White Hispanic Other Table 12. Cumulative AIDS cases reported by race/ethnicity and vital status, 2010 - USVI No. % No. % No. % No. % Total 426 100.0 50 100.0 154 100.0 2 200.0 Adults 417 97.9 50 100.0 148 96.1 2 100.0 Pediatric 9 2.1 0 0.0 6 3.9 0 0.0 Living 185 43.4 24 48.0 72 46.8 0 0.0 Deceased 241 56.6 26 52.0 82 53.2 2 100.0 Black White Hispanic Other Of cumulative AIDS cases reported, 35% of Blacks were exposed through heterosexual contact, 54% of Whites were exposed through male-to-male sexual contact and almost 30% of Hispanics were exposed through Injection drug use. Among all races and ethnicities, the majority of AIDS cases reported was diagnosed at 35 – 44 years of age. HIV Surveillance 2010 Annual Data Report 9 Table 13. AIDS and HIV cases by sex and year reported, 1993-2010 - USVI Year AIDS HIV AIDS HIV AIDS HIV 2004 12 9 5 11 17 20 2005 6 7 4 8 10 15 2006 11 13 7 6 18 19 2007 14 7 5 11 19 18 2008 7 8 4 4 11 12 2009 5 11 2 11 7 22 2010 11 9 5 6 16 15 Males Females Total While HIV was first noted in the United States in the early 1980s, the Virgin Islands law did not mandate HIV and AIDS reporting by physicans until 1994. The law was revised in 1998 to include confidential name-based reporting. HIV Surveillance 2010 Annual Data Report 10 Males, 11 Females, 5 0 2 4 6 8 10 12 14 16 2004 2005 2006 2007 2008 2009 2010 Number of Cases AIDS Cases reported by Sex Virgin Islands Males, 9 Females, 6 0 2 4 6 8 10 12 14 2004 2005 2006 2007 2008 2009 2010 Number of Cases HIV Cases reported by Sex Virgin Islands Over the past seven years, more males were reported with AIDS than females. There has been no steady trend with the number of HIV cases reported between males and females. The numbers continue to fluctuate from year to year. HIV Surveillance 2010 Annual Data Report 11 Table 14. Cumulative Pediatric cases reported by island and selected variables - 2010, USVI Selected Variables Virgin Islands St. Croix St. Thomas/ St. John Total 83 39 44 Deceased 13 10 3 Perinatally HIV Exposed 26 6 20 Seroconverted 13 7 6 Seroreverted 31 16 15 Of the 83 perinatally exposed cases to HIV, approximately 16% (13) have died. Majority of the deceased cases were on St. Croix. About 31% remain perinatally exposed due to several factors, which include parental relocation and not retesting. The HIV status of pediatric cases exposed to HIV is reassessed at 18 to 24 months of age. Approximately 77% of pediatric cases with a perinatally exposed status were on St. Thomas/St. John. About 16% of pediatric cases born to HIV infected mothers seroconvert (contracted the virus). 37% of pediatric cases born to HIV infected mothers serorevert (did not acquire the virus). HIV Surveillance 2010 Annual Data Report 12 Deceased 7% Perinatally HIV Exposed 45% Seroconverted 14% Seroreverted 34% St. Thomas/St. John HIV Pediatric Status Deceased 26% Perinatally HIV Exposed 15% Seroconverted 18% Seroreverted 41% St. Croix HIV Pediatric Status HIV Surveillance 2010 Annual Data Report 13 Table R1. Adults and adolescents living with a diagnosis of HIV infection by year-end 2008, United States and 5 U.S. dependent area Area of residence Number Number Rate Rank Total 850,136 679,590 337.5 Alabama 10,366 10,316 266.5 18 Alaska 615 607 108.5 31 American Samoa 2 2 4.7 44 Arizona 11,492 11,815 225.7 20 Arkansas 4,896 4,976 211.1 22 California 103,073 Colorado 10,650 10,678 263.7 19 Connecticut 10,365 10,930 372.6 8 Delaware 2,938 District of Columbia 14,329 Florida 92,149 90,909 586.2 3 Georgia 33,282 35,220 450.0 6 Guam 96 100 75.1 38 Hawaii 2,188 Idaho 739 744 60.8 40 Illinois 31,889 32,962 312.0 14 Indiana 8,279 8,109 154.6 26 Iowa 1,554 1,549 62.3 39 Kansas 2,596 2,597 113.4 30 Kentucky 4,416 4,403 123.7 29 Louisiana 16,262 16,210 444.3 7 Maine 1,024 1,098 97.2 36 Maryland 28,448 Massachusetts 13,739 Michigan 13,827 14,122 169.4 24 Minnesota 6,094 6,086 140.6 27 Mississippi 7,864 7,761 324.9 10 Missouri 11,189 11,137 225.7 21 Montana 335 Estimated* HIV Surveillance 2010 Annual Data Report 14 Table R1. Adults and adolescents living with a diagnosis of HIV infection by year-end 2008, United States and 5 U.S. dependent area continued Area of residence Number Number Rate Rank Nebraska 1,548 1,553 106.6 34 Nevada 6,759 6,692 315.9 13 New Hampshire 1,125 1,196 106.9 33 New Jersey 35,176 36,974 513.2 5 New Mexico 2,272 2,252 139.0 28 New York 128,143 135,018 826.7 1 North Carolina 22,746 22,369 294.0 15 North Dakota 167 167 30.9 43 Northern Mariana Islands 13 1 2.5 45 Ohio 16,081 16,283 169.7 23 Oklahoma 4,683 4,740 158.8 25 Oregon 4,846 Pennsylvania 31,773 31,220 294.0 16 Puerto Rico 17,887 18,828 575.4 4 Rhode Island 1,770 South Carolina 13,839 13,700 367.1 9 South Dakota 390 387 58.4 41 Tennessee 14,631 14,530 281.0 17 Texas 61,872 61,595 319.0 11 U.S. Virgin Islands 560 598 663.9 2 Utah 2,237 2,245 107.6 32 Vermont 403 Virginia 19,896 20,477 316.4 12 Washington 10,127 West Virginia 1,423 1,416 91.9 37 Wisconsin 4,871 4,814 102.5 35 Wyoming 202 205 46.5 42 Source: Centers for Disease Control and Prevention. HIV Surveillance Report, 2009; vol. 21. Table 21. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Published February 2011. Accessed March 8, 2011. Note: Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis * Includes data from areas with confidential name-based HIV infection reporting since atleast January 2006. Estimated numbers resulted from statistical adjustment that accounted for reporting delays but not for incomplete reporting. Rates are per 100,000 population. Estimated* HIV Surveillance 2010 Annual Data Report 15 Table R1 shows persons in the United States and U.S. dependencies living with HIV infection. It illustrates each state and U.S. dependency rank in the HIV epidemic by per 100,000 population. Only states that have had confidential HIV name-based reporting since at least January 2006 can be statistically adjusted for reporting delays and included in the ranking. However, all areas were reporting HIV data to CDC by 2008 and reported the number of persons living with a diagnosis of HIV infection at the end of 2008. While the Virgin Islands have a relatively low number of cases living with HIV infection compared to other areas, the Territory is number two when ranked by rate. New York ranks number 1 in rate of persons living with HIV infection. HIV Surveillance 2010 Annual Data Report 16 HIV Surveillance 2010 Annual Data Report 17 Table S1. Gonorrhea Cases reported by sex, age and race, 2005 to 2010 - USVI 2010 2009 2008 2007 2006 2005 Total cases 136 115 118 72 45 73 Males 49 25 27 19 13 24 Females 87 90 91 53 32 49 Under 10 0 0 0 0 0 0 10-14 1 2 1 3 1 3 15-19 38 31 49 22 10 27 20-29 82 68 62 41 30 36 30-39 12 6 3 5 3 3 40-44 1 6 2 1 1 0 Over 44 2 2 1 0 0 4 Black 110 98 87 56 34 49 White 2 0 10 4 2 6 Hispanic 23 17 19 11 9 2 Other 1 0 2 1 0 16 Between 2005 and 2010, 72% of cases reported with gonorrhea were females. Approximately 57% of gonorrhea cases were in the age group of 20 to 29. The 15 to 19 age group accounted for 31% of cases. The majority of gonorrhea cases were among Blacks. HIV Surveillance 2010 Annual Data Report 18 Table S2. Chlamydia Cases reported by sex, age and race, 2005 to 2010 - USVI 2010 2009 2008 2007 2006 2005 Total Cases 615 488 587 347 267 464 Males 179 53 138 81 62 95 Females 436 435 449 266 205 369 Under 10 0 0 0 0 0 0 10-14 3 7 4 4 5 13 15-19 195 190 194 117 78 143 20-29 331 254 338 190 146 259 30-39 46 30 38 25 32 42 40-44 5 6 10 6 4 1 Over 44 7 1 3 5 2 6 Black 460 384 442 274 206 346 White 10 14 27 9 10 16 Hispanic 115 88 111 61 50 89 Other 2 2 5 3 1 13 0 100 200 300 400 500 600 700 2010 2009 2008 2007 2006 2005 Number of Cases Years Gonorrhea vs Chlamydia GONORRHEA CHLAMYDIA Between 2005 and 2010, 78% of Chlamydia cases reported was females. The 20 to 29 age group accounted for 55% of the cases. This group was followed by the 15 to 19 age group that accounted for 33% of chlamydia cases. The highest reported cases of chlamydia were observed in African American/blacks. HIV Surveillance 2010 Annual Data Report 19 Virgin Islands Department of Health 2010 HIV Surveillance Data Report Feedback The purpose of this form is to provide the individual(s) responsible for preparing this report feedback from end-users regarding the ease of use and relevance of the data report for planning and educational activities. We would like to know what you think. Please call, e-mail, or fax your comments to: Annette Gumbs Hobson Surveillance Coordinator Telephone: (340) 774-9000 ext. 4667 Fax: (340) 715-1589 Email: annette.gumbs@usvi-doh.org 1. Were the tables easy to understand? Yes No Somewhat 2. Were the data useful for your planning, grant-writing, or educational activities? Yes No Somewhat 3. What specific purpose do you have for using HIV/AIDS data? (ex. Grant writing) 4. What specific data would you like included in the next annual data report? 5. What other suggestions do you have for improvement? (ex. Graphs, analysis, etc.) Mailing List To be added or removed from the HIV Surveillance Annual Data Report mailing list, please contact Gritell Martinez, Territorial Director or Annette Gumbs Hobson, Surveillance Coordinator. Contact numbers are (340) 774-0127 and (340) 774-9000 ext. 4667. You may send us a fax at (340) 715-1589 or email us at gritell.martinez@usvi-doh.org or annette.gumbs@usvi-doh.org . We welcome any comments and constructive criticism that you may have. HIV Surveillance 2010 Annual Data Report 20 The Virgin Islands Department of Health Communicable Disease STD/HIV/TB Program Staff Management Staff Gritell C. B. Martinez, MPA – Territorial Director Annette Gumbs Hobson, MBA – Territorial Surveillance Coordinator Lavida Joseph-Brown – Territorial Prevention Coordinator Lauris Harley – Territorial TB Elimination Specialist Diane Henry Malone – Program Administrator Ryan White Part D Rashida Francis, MEd – Ryan White Part B Grant Monitor Jasper Lettsome – St. Thomas Clinic Administrator Barbara Francis, MS – St. Croix Clinic Administrator Medical Staff Barbara Douglas, MD, AAHIVS, Public Health Physician - St. Thomas/St. John District Richard Olans, MD, FIDSA, AAHIVS, Medical Director, Infectious Disease Director - St. Croix District Rita Olans, NP - Territorial Nurse Practitioner Jocelyn Murray, RN - St. Thomas/St. John District HIV Surveillance Staff Monifa Carrillo - St. Croix HIV Surveillance Field Investigator Karissa Cave - Data Entry Clerk Katy Sanon - UVI Intern HIV and STD Prevention Staff Joan Brown - Disease Intervention Specialist II Adrian Edwards - Disease Intervention Specialist I Jasmin Cintron - Disease Intervention Specialist I Aminata Nicholas - Health Outreach Worker Nicole Swan, Disease Intervention Specialist II Neikia Brathwaite, Disease Intervention Specialist I Eboni Brathwaite, Disease Intervention Specialist I Case Management Staff Ruth Richardson - Ryan White Case Management Planner Dorothy James, RN - Ryan White Case Management Planner Melissa Parry - Ryan White Case Management Planner Marcus Bailey, LSW - Ryan White Case Management Planner Administrative Support Staff Francine Penn-Scipio - Administrative Assistant Angela Browne - Administrative Officer III Ebony Potter, MBA - Administrative Officer III Ellarine Batiste - Senior Office Support Iris Smith - Senior Office Support Laura James - Senior Office Support The Virgin Islands Department of Health Communicable Disease STD/HIV/TB Program PROGRAM OVERVIEW The Virgin Islands Department of Health (VIDOH) Communicable Disease STD/HIV/TB Program is responsible for the containment and prevention of sexually transmitted disease, including HIV/AIDS and TB through disease intervention, education, screening, diagnostic and treatment activities, and coordinating the TB and HIV prevention programs. Risk reduction methods and cost effective screening sites are provided throughout the Territory. The program also monitors disease trends, and collaborates with other health agencies and programs. The main objective of the program is to decrease the incidence of STD, HIV and TB by providing education, counseling, testing and treatment for these commonly occurring infections in the community. The Communicable Disease STD/HIV/TB Program is 95% federally funded. Grantors include the U.S. Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) and Health Resources Services Administration (HRSA). The table below illustrates the program funding for year 2010. Federal Funding Grant Cycle Amount Awarded Ryan White Part B 4/1/10-3/31/11 $1,268,387.00 Ryan White Part D 8/1/09-7/31/10 $246,837.00 HIV Prevention 1/1/10-12/31/10 $641,688.00 STD Prevention 1/1/10-12/31/10 $193,222.00 TB Elimination 1/1/10-12/31/10 $86,938.00 HIV Surveillance 1/1/10-12/31/10 $205,621.00 TOTAL FEDERAL FUNDS $2,642,693.00 Local Funding 10/1/09-9/30/10 $145,177.00 TOTAL PROGRAM FUNDING $2,787,870.00