Epidemiological Profile of HIV/AIDS in Minnesota
Jessica Brehmer, MPH — Surveillance Epidemiologist
Allison La Pointe, MPH — HIV Surveillance Coordinator
Julie Hanson Pérez, MSW — Planning and Evaluation Coordinator
AIDS – Acquired Immune Deficiency Syndrome
ADAP – AIDS Drugs Assistance Program
CCCHAP – Community Cooperative Council on HIV/AIDS Prevention
CD4 – Cluster of Differentiation 4
CDC – Centers for Disease Control and Prevention
CTR – HIV Counseling, Testing and Referral
DIS – Disease Intervention Specialist
eHARS – Enhanced HIV and AIDS Reporting System
HBV – Hepatitis B Virus
HCV – Hepatitis C Virus
HIV – Human Immunodeficiency Virus
HRSA – Health Resources and Services Administration
IDU – Injection Drug Use(r)
MDH – Minnesota Department of Health
MSM – Men Who Have Sex with Men
PLWHA – People Living with HIV/AIDS
STD – Sexually Transmitted Disease
STI – Sexually Transmitted Infection
TB – Tuberculosis
TGA – Transitional Grant Area
VL – Viral Load
The epidemiological (epi) profile presents data on the HIV epidemic in the state of Minnesota. The profile is intended to give the Community Cooperative Council on HIV/AIDS Prevention (CCCHAP) and the Minnesota HIV Services Planning Council (Planning Council) a thorough understanding of the epidemic in our state. By showing who is becoming infected and who is living with the disease, the epi profile helps identify the people who are in need of prevention and care services, both those who are infected and those at risk. The epi profile serves as a starting point for the CCCHAP and the Planning Council in their consideration of which prevention and care services are needed.The profile presents data for the state as a whole, the 7-county metropolitan
Prevention funds are prioritized and distributed based on the epidemiology in the State, whereas funds for services are prioritized and distributed based both on the epidemiology in the TGA (Part A) and in the State (Part B).
MDH has collected AIDS data since 1982 and HIV data since 1985. Data for the epi profile are mainly obtained through the HIV/AIDS surveillance system (eHARS) at MDH. These data are mostly obtained through passive surveillance from providers and consist of reports of confirmed Western-blot tests, viral loads and CD4 counts, in addition to case reports and interview data that include information on risk factors and behavior. Data on risk factors and demographics rely heavily on patient and provider reporting. The data in this report are from both interviewed and non-interviewed cases (cases are interviewed by DIS when possible). Cases living with HIV/AIDS include persons currently living in Minnesota but were diagnosed outside of the state. However, these analyses do not include persons diagnosed in Minnesota but are known to no longer reside in the state. The analyses also do not include persons incarcerated at federal correctional facilities in Minnesota.
Additional data on reportable bacterial STDs, viral hepatitis and TB were obtained from the MDH STD Surveillance System, MDH Viral Hepatitis Surveillance System, and MDH TB Surveillance System, respectively.
More people than ever are living with HIV/AIDS in Minnesota due to both the introduction of new therapies that have slowed the progression of disease for many and, unfortunately, a sustained number of new infections diagnosed each year.
The HIV epidemic in Minnesota is driven by sexual exposure. Among men, MSM represent the primary mode of exposure. Among females, heterosexual contact accounts for the vast majority of living and new cases.
The HIV epidemic in Minnesota affects racial and ethnic minorities disproportionately, especially African Americans, who are over represented in every risk group. While the emerging epidemic among African-born persons seems to be leveling off, Minnesota continues to see an increasing number of living cases among foreign-born persons. These disparities have significant implications for both prevention and care activities.
One of the success stories in HIV prevention is the reduction of perinatal transmission of HIV. While the number of births to HIV-positive women continues to increase, the rate of perinatal transmission has remained quite low (1.7 percent in 2010-2012).
Adolescents and young adults (ages 13-24) represent a small percentage of living cases however they have represented an increasing proportion of new cases in the past decade.
While HIV/AIDS continues to be geographically centered in the Twin Cities metropolitan area, injection drug users and heterosexual people living with HIV/AIDS appear to be more likely than other groups to live in Greater Minnesota than within the TGA.
Over the past decade the HIV epidemic in Minnesota has changed in several ways, both when looking at new infections and persons living with HIV/AIDS. The population living with HIV has become more racially, ethnically, culturally and linguistically diverse, which will pose additional challenges to both prevention and service providers. The success of antiretroviral medications has not only extended the life of those recently diagnosed, but also of those diagnosed long ago, which is reflected in the “aging” of those living with HIV/AIDS.