Poster presentation at the 17th Texas HIV/STD Conference, May 24-27, 2010.

1. Epidemiology of HIV and AIDS in
Houston/Harris Co.
Jeffrey Meyer, MD, MPH; Yvonne Lu, MD, MPH; Karen
Chronister, PhD, Aaron Sayegh, PhD, MPH
Bureau of Epidemiology, HIV/STD Surveillance
Houston Dept. of Health and Human Services
Funded by CDC Cooperative Agreement 04017
Presented at 17th Texas HIV/STD Conference
May 24-27, 2010, Austin, Texas

2. • Problem Being Addressed: This poster describes the epidemiology
of HIV and AIDS in Houston/Harris County, Texas through 2008.
• Program Description: The Houston Department of Health and
Human Services has been reporting cases of AIDS since 1983 and
HIV since 1999 when it became a reportable disease in Texas.
• Analysis of new AIDS cases showed a rapid increase from 1981
through 1992. With the use of highly active antiretroviral therapy
(HAART) in 1996, the number of new AIDS cases precipitously
dropped through 1999. Deaths also dramatically decreased.
• Early in the epidemic, only 2% of the AIDS cases were in females.
By 2008, 28% of new cases were female.
• Trends in AIDS diagnosis show that from 1999 through 2008, AIDS
cases have been increasing in Hispanic males, steady in black males
and decreasing in white males.
• Over the same period there has been an increase in AIDS cases in
black females.
• The proportion of AIDS cases by race has changed from early in
the epidemic. In 2008, blacks accounted for 48% of new male
AIDS cases and 77% of new female AIDS cases.

3. AIDS Diagnoses
0
200
400
600
800
1000
1200
1400
1600
1800
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
AIDS Diagnosis Year
1997
1998
1999
2000
AIDS Diagnoses in Houston/Harris Co by Sex
2001
2002
2003
2004
2005
Male
Total
Female
2006
2007
2008

4. Deaths in AIDS Patients
0
200
400
600
800
1000
1200
1400
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
Death Year
1996
1997
1998
1999
2000
2001
2002
Deaths in AIDS Patients Diagnosed in Houston/Harris Co by Race
2003
2004
Total
White
.Black
2005
Hispanic
2006
2007

5. Male AIDS Diagnoses in Houston/Harris Co by Race
1000
900
W hite
800
Black
Hispanic
700 Multi/Unk/Other
600
AIDS Diagnoses
500
400
300
200
100
0
1982
1983
1985
1986
1987
1988
1990
1992
1993
1995
1997
1999
2000
2002
2004
2005
2006
2007
1981
1984
1989
1991
1994
1996
1998
2001
2003
2008
AIDS Diagnois Year

6. AIDS Diagnoses
0
50
100
150
200
250
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
AIDS Diagnosis Year
1997
1998
1999
2000
2001
Female AIDS Diagnoses in Houston/Harris Co by Race
2002
2003
2004
Black
White
2005
Hispanic
2006
Multi/Unk/Other
2007
2008

7. Male AIDS Diagnoses in Houston/Harris Co by Transmission Risk
1200
Male-to-Male Sex
Intravenous Drug Use
Male-to-Male/IDU
1000
Heterosexual Contact with High Risk Partner
Other
No Reported Risk
800
AIDS Diagnoses
600
400
200
0
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
AIDS Diagnosis Year

8. Female AIDS Diagnoses in Houston/Harris Co by Transmission Risk
250
Intravenous Drug Use
Heterosexual C ontact with High Risk Partner
Other
No Reported Risk
200
150
AIDS Diagnoses
100
50
0
1981
1982
1984
1985
1986
1988
1989
1992
1993
1996
1997
1999
2000
2001
2003
2004
2006
2007
2008
1983
1987
1990
1991
1994
1995
1998
2002
2005
AIDS Diagnosis Year

9. Proportion of Newly Diagnosed AIDS Cases in 2008 in
Houston/Harris Co. by Risk and Race
Male AIDS Cases (72% of Total)
Risk/Race Black Hispanic White Multi/Unk/Other T otal
Male-to-Male Sex 41% 59% 64% 62% 51%
Intravenous Drug Use 12% 3% 4% 8% 7%
Male-to-Male/IDU 7% 3% 8% 8% 6%
Heterosexual Contact with
High Risk Partner 20% 13% 5% 0% 14%
Other/No Reported Risk 20% 22% 19% 23% 21%
Total 100% 100% 100% 100% 100%
Row % 48% 29% 21% 2% 100%
Female AIDS Cases (28% of Total)
Risk/Race Black Hispanic White Multi/Unk/Other T otal
Intravenous Drug Use 14% 11% 33% 0% 15%
Heterosexual Contact with
High Risk Partner 61% 63% 39% 100% 59%
Other/No Reported Risk 25% 26% 28% 0% 25%
Total 100% 100% 100% 100% 100%
Row % 77% 15% 8% 0% 100%

10. • Analysis of new HIV cases regardless of AIDS status
showed a decrease in females from 1999 through 2008.
In males, cases decreased from 1999 through 2003 and
then increased through 2008.
• In 2008, the rate of new HIV diagnoses in males was 3.3
times the rate in females with females accounting for 23%
of new cases. Among males, blacks had 5.1 times the rate
in whites with blacks accounting for 50% of the new male
cases. In young men (13-24 yrs old) who have sex with
men, the number of new HIV cases more than doubled
from 1999 to 2008.
• Among females, blacks had 10.1 times the rate in whites
with blacks accounting for 74% of the new female cases.
• The map of new HIV cases shows that HIV cases are not
evenly distributed in Harris County but concentrated in
specific geographic areas.
• This analysis of new HIV cases in Houston/Harris Co.
suggests that groups most at risk for HIV are men who
have sex with men and black men and women in general.

11. HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co by Sex
1600
Male
Female
1400
Total
1200
1000
HIV Diagnoses
800
600
400
200
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
HIV Diagnosis Year

12. Male HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co by Race
1200
1000
800
W hite
Black
HIV Diagnoses
Hispanic
600 Multi/Unk/Other
Total
400
200
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
HIV Diagnosis Year

13. Young Men (13-24 yrs old) Who Have Sex with Men: New HIV Diagnoses, Regardless of AIDS
Status, in Houston/Harris Co by Race
180
White
160 Black
Hispanic
Total
140
120
HIV Diagnoses
100
80
60
40
20
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
HIV Diagnosis Year

14. Female HIV Diagnoses, Regardless of AIDS Status, in Houston/Harris Co. by Race
500
White
450 Black
Hispanic
400 Multi/Unk/Other
Total
350
300
HIV Diagnoses
250
200
150
100
50
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
HIV Diagnosis Year

15. Proportion and Rate of Newly Diagnosed HIV Cases, Regardless of
AIDS Status, in 2008 in Houston/Harris Co. by Race and Sex
Race Males % of Cases Population Rate Rate Females % of CasesPopulation Rate Rate
(Cases/100, Relative to (Cases/100, Relative to
000/yr) Whites 000/yr) Whites
White 179 18% 636200 28.1 1.0 36 12% 648764 5.5 1.0
Black 499 50% 345080 144.6 5.1 217 74% 385809 56.2 10.1
Hispanic 289 29% 868367 33.3 1.2 39 13% 796036 4.9 0.9
Multi/Unk/Other 26 3% 143652 18.1 0.6 3 1% 141808 2.1 0.4
Total 993 100% 1993299 49.8 295 100% 1972417 15.0
Race Total % of Cases Population Rate Rate Male Rate Relative to Female = 3.3
(Cases/100, Relative to
000/yr) Whites
White 215 17% 1284964 16.7 1.0
Black 716 56% 730889 98.0 5.9
Hispanic 328 25% 1664403 19.7 1.2
Multi/Unk/Other 29 2% 285460 10.2 0.6
Total 1288 100% 3965716 32.5

16. Proportion of Newly Diagnosed HIV Cases, Regardless of AIDS
Status, in 2008 in Houston/Harris Co. by Race, Sex, and Risk
Male HIV Cases, Regardless of AIDS Status (77% of T otal)
Risk/Race Black Hispanic White Multi/Unk/Other Total
Male-to-Male Sex 48% 60% 75% 69% 57%
Intravenous Drug Use 6% 1% 4% 0% 4%
Male-to-Male/IDU 1% 1% 2% 0% 1%
Heterosexual Contact with
High Risk Partner 13% 12% 4% 8% 11%
Other/No Reported Risk 32% 26% 14% 23% 27%
Total 100% 100% 100% 100% 100%
Row % 50% 29% 18% 3% 100%
Female HIV Cases, Regardless of AIDS Status (23% of Total)
Risk/Race Black Hispanic White Multi/Unk/Other Total
Intravenous Drug Use 3% 5% 22% 0% 6%
Heterosexual Contact with
High Risk Partner 49% 49% 33% 100% 47%
Other/No Reported Risk 48% 46% 44% 0% 47%
Total 100% 100% 100% 100% 100%
Row % 74% 13% 12% 1% 100%

17. HIV Diagnoses, Regardless of AIDS Status, in Adults/Adolescents by Age in Houston/Harris
Co. by Sex
35%
Male
30% 29% Female
29%
25%
22%
21%
% of HIV Diagnoses
20%
17%
16% 16%
15%
13%
11%
10% 9%
5% 5%
5%
3% 3%
0%
13 - 19 yrs 20 - 24 yrs 25 - 29 yrs 30 - 39 yrs 40 - 49 yrs 50 - 59 yrs 60 and over
Age Group

19. • Implications for HIV Prevention, Treatment, and Care:
Surveillance data highlights people at highest risk of
HIV/AIDS by sex, race, age, transmission risk and
geography so that prevention and treatment services can
be appropriately directed.
• Acknowledgments: We wish to thank the staff of
HIV/STD Surveillance for collecting and entering the
data in eHARS and the Bureau of Community Health
Statistics for plotting the GIS map.
• For more information contact Jeffrey Meyer at
jeffrey.meyer@cityofhouston.net or 713-832-393-4567.