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Minnesota HIV/AIDS Prevalence & Mortality Report, 2002
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Introduction
Data Source
Data Limitations
Persons Living With HIV/AIDS in the United States
Persons Living With HIV/AIDS in Minnesota
Overview of HIV/AIDS in Minnesota, 1990-2002
Living HIV/AIDS Cases, 2002
Gender & Race/Ethnicity
Age
Mode of Exposure
Emerging Trend
HIV/AIDS Mortality in Minnesota
The Minnesota HIV/AIDS Prevalence & Mortality Report, 2002 contains estimates of HIV/AIDS prevalence (the number of persons living with HIV or AIDS) and mortality in Minnesota. These estimates can be used to help educate, plan for HIV/AIDS services and develop policy.
Data Source
The data in this report are based on confidential case reports collected
through the Minnesota Department of Health (MDH) HIV/AIDS Surveillance
System. In Minnesota, laboratory-confirmed infections of human immunodeficiency
virus (HIV) are monitored by the MDH through this active and passive surveillance
system. State law (Minnesota Rule 4605.7040) requires both physicians
and laboratories to report all cases of HIV infection (HIV or AIDS) directly
to the MDH (passive surveillance). Additionally, regular contact is maintained
with several clinical sites to ensure completeness of reporting (active
surveillance).
Data Limitations
The prevalence estimate is calculated by totaling the number of HIV and
AIDS cases diagnosed through December 31, 2002 who are not known to be
deceased and whose most recently reported state of residence was Minnesota.
It bears noting that persons who are HIV-infected but not yet tested are
not included in this prevalence estimate. Migration (known HIV-infected
persons moving in or out of the state) also affects the estimate. Refer
to the HIV/AIDS Prevalence & Mortality Technical Notes for a more
detailed description of data inclusions and exclusions.
Factors that impact the completeness and accuracy of the available surveillance data on HIV/AIDS include the level of screening and compliance with case reporting. Thus, any changes in numbers of infections may be due to one of these factors, or due to actual changes in HIV/AIDS occurrence.
PERSONS LIVING WITH HIV/AIDS IN THE UNITED
STATES
The Centers for Disease Control & Prevention (CDC) estimates that there are 800,000 to 900,000 people currently living with HIV/AIDS in the United States. The number of people specifically living with AIDS in the United States has been increasing in recent years: from approximately 290,400 in 1998 to approximately 344,000 in 2001. (1)
PERSONS LIVING WITH HIV/AIDS IN MINNESOTA
Overview of HIV/AIDS in Minnesota, 1990-2002
The number of persons assumed to be living with HIV/AIDS in Minnesota
has been steadily increasing over time. As of December 31, 2002, an estimated
4,598 persons with HIV/AIDS were residing in Minnesota, a 6% increase
from 2001. While the number of new HIV (non-AIDS) cases has remained steady
since the mid-1990s at just under 200 cases per year, both the number
of newly diagnosed AIDS cases and the number of deaths among AIDS cases
have been declining since 1996. The decreases are primarily due to the
success of new treatments introduced in 1995 (protease inhibitors) and
1996 (highly active antiretroviral therapy, HAART). These treatments do
not cure, but can delay progression to AIDS among persons with HIV (non-AIDS)
infection and improve survival among those with AIDS. Thus, the declines
slowed during the late 1990s and the numbers have become relatively stable
the past few years.
Living HIV/AIDS Cases, 2002
Among the estimated 4,598 prevalent cases in Minnesota, 2,736 are diagnosed
with HIV (non-AIDS) and 1,862 are diagnosed with AIDS. The majority (88%)
of prevalent cases reside in the seven-county metropolitan area surrounding
the Twin Cities of Minneapolis and St. Paul (Hennepin, Ramsey, Anoka,
Carver, Dakota, Scott, and Washington counties). Although HIV infection
is more common in communities with higher population densities and greater
poverty, HIV or AIDS has been diagnosed in over 80% of counties in Minnesota.
Gender & Race/Ethnicity
Approximately 80% of prevalent HIV/AIDS cases are males. Broken down by
race/ethnicity, 65% of male cases are White, 20% African American, 7%
Hispanic, 4% African-born, 1% American Indian, and 1% Asian/Pacific Islander.
In total, 35% of males living with HIV/AIDS are non-White whereas only
12% of the general male population is Non-White. Among female cases, the
distribution is even more skewed toward women of color: 33% White, 36%
African American, 18% African-born, 6% Hispanic, 4% American Indian, and
2% Asian/Pacific Islander. Thus, 67% of prevalent female HIV/AIDS cases
are non-White whereas only 11% of the general female population in Minnesota
is non-White.
Please note that race is not considered a biological reason for disparities related to HIV/AIDS experienced by persons of color. Race, however, can be considered a marker for other personal and social characteristics that put a person at greater risk for HIV exposure. These characteristics may include, but are not limited to, lower socioeconomic status, less education, and less access to health care.
Age
Seventy-eight percent (78%) of persons living with HIV/AIDS in 2002 are
currently 35 years of age or older. Broken down into five-year age groups,
40-44 year olds make up the largest group (24% of cases), followed by
35-39 year olds (22%) and 45-49 year olds (15%).
Mode of Exposure
The proportions of living cases attributable to particular modes of exposure
differ among gender and race groups. While 88% of White males reported
male-to-male sex (MSM or MSM/IDU) as a risk factor, only 52% of non-White
males reported this mode of exposure. The difference in proportions is
partly explained by the relatively large number of non-White males with
unspecified risk, particularly among African American, African-born and
Asian men. It is hypothesized that due, in part, to social stigma many
of the cases with unspecified risk were unclassified MSM cases. This may
not hold as true for African-born cases given that heterosexual contact
and contaminated medical equipment have been established modes of HIV
exposure in their countries of origin. The percent of male cases who identified
IDU or MSM/IDU as a risk factor was particularly high for American Indians
(28%) and African Americans (26%) and Hispanics (24%). The percentages
among White, Asian, and African-born males were 11%, 5%, and 3%, respectively.
Similar to the MSM category, IDU may be underreported due to social stigma.
Across all race/ethnicity groups, females most frequently report heterosexual contact as their mode of HIV exposure. However, IDU was reported as directly or indirectly (via heterosexual contact with a person who injected drugs) involved in a large percentage of female cases among most race/ethnicity groups. The largest percentage of IDU-related cases occurred among American Indians (63%) followed by Whites, African Americans, and Hispanics with 39%, 38%, and 34%, respectively. One case among African-born females was related to IDU and no cases among Asian females. African-born females living with HIV/AIDS had the largest percentage of cases with unspecified risk: 75% compared to approximately 22% among the other female race/ethnicity groups. The number of prevalent HIV/AIDS cases among Asian females was too small (n = 20) to make generalizations about risk. See the HIV/AIDS Prevalence & Mortality Technical Notes for a detailed discussion of mode of exposure categories.
Emerging Trend
Between 1990 and 2002, the number of foreign-born persons living with
HIV/AIDS in Minnesota increased substantially, especially among the African-born
population. In 1990, 50 foreign-born persons were reported to be living
with HIV/AIDS in Minnesota. By 2002, this number increased ten-fold to
550 persons. This trend illustrates the growing diversity of the infected
population in Minnesota and the need for culturally appropriate HIV care
services and prevention efforts.
HIV/AIDS MORTALITY IN MINNESOTA
The number of deaths (2) among Minnesota AIDS cases decreased between 1995 and 1997 and remained relatively constant between 1997 and 2002. The largest declines in mortality were observed among White males in the mid 1990s. In recent years, the number of deaths among AIDS cases has been comparable between White and non-White males and between White and non-White females. Only 7 deaths among AIDS cases were reported in 2002 among women and 39 among men.
(Last Revised: 4/8/2003)
(1) HIV/AIDS Surveillance Report Vol. 13, No. 2: December 2001. Centers for Disease Control & Prevention. (return to text)
(2) Includes all deaths, regardless of cause. (return to text)
