• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (512) 533-3000

    E-mail the HIV/STD Program

    E-mail data requests to HIV/STD Program - This email can be used to request data and statistics on HIV, TB, and STDs in Texas. It cannot be used to get treatment or infection history for individuals, or to request information on programs and services. Please do not include any personal, identifying health information in your email such as HIV status, Date of Birth, Social Security Number, etc.

    For treatment/testing history, please contact your local Health Department.

    For information on HIV testing and services available to Persons Living with HIV and AIDS, please contact your local HIV services organization.

Epi Profile Section 4 - Co-Morbidities


Figure 4-1. Chlamydia, Gonorrhea, and Primary & Secondary Syphilis Cases and
Incidence Rates among PLWH in Texas, 2009-2016

Figure 4-1. Chlamydia, Gonorrhea, and Primary & Secondary Syphilis Cases and Incidence Rates among PLWH, 2009-2016. Data in link following.

Data for Figure 4-1

  • DSHS performs a cross-registry match between Texas' STD Surveillance data and Texas' enhanced HIV/AIDS Reporting System (eHARS) to determine how many STDs were diagnosed in Persons Living with HIV (PLWH).

  • Persons living with HIV were considered to have an STD coinfection if their STD diagnosis occurred ≤ 30 days of their HIV diagnosis. Persons living with HIV may have >1 diagnosis of any STD. To calculate the rate of diagnoses among PLWH, we used the total number of STD diagnoses in HIV positive persons as the numerator and the total number of PLWH as the denominator.

  • Because chlamydia and gonorrhea infections are often asymptomatic, increases in the annual number and rate of chlamydia and gonorrhea diagnoses may reflect increases in STD screening among PLWH.

  • The number and rate of P&S Syphilis cases in PLWH are lower compared to chlamydia and gonorrohea; however, syphilis infections are much more prevalent in PLWH compared to the general population . In Texas, the rate of P&S syphilis is 100 times than the rate in the general population.

  • The disparity in chlamydia and gonorrhea case rates between PLWH and HIV-negative persons is not as large. PLWH are 4 times more likely to be diagnosed with chlamydia and 18 times more likely to be diagnosed with gonorrhea compared to HIV-negative persons.



Table 4-1. STD Cases and Incidence Rates among PLWH in Texas, 2016

Chlamydia

Gonorrhea

P&S Syphilis

EL Syphilis

Total
Cases

Cases in
PLWH

Rate

Cases in
PLWH

Rate

Cases in
PLWH

Rate

Cases in
PLWH

Rate

Total PLWH

86,669

1,799

2,075.7

2,329

2,687.2

590

680.8

1,122

1,294.6

Age Group
0-14

252

0

0.0

0

0.0

0

0.0

0

0.0

15-24

3,980

309

7,763.8

436

10,954.8

91

2,286.4

147

3,693.5

25-34

16,898

815

4,823.1

1,111

6,574.7

243

1,438.0

450

2,663.0

35-44

20,133

359

1,783.1

432

2,145.7

132

655.6

251

1,246.7

45+

45,406

316

695.9

350

770.8

124

273.1

274

603.4

Race/Ethnicity
White

22,697

333

1,467.2

473

2,084.0

145

368.9

290

1,277.7

Black

32,371

710

2,193.3

1,023

3,160.2

193

596.2

337

1,041.1

Hispanic

27,739

674

2,429.8

720

2,595.6

212

764.3

454

1,636.7

Other

987

12

1,215.8

24

2,431.6

8

810.5

15

1,519.8

Unknown

2,875

70

-

89

-

32

-

26

-

Sex
Female

18,487

227

1,227.9

127

687.0

0

0.0

11

59.5

Male

68,182

1,572

2,305.6

2,202

3,229.6

590

865.3

1,111

1,629.5

Current Residence
Austin

5,916

232

3,921.6

306

5,172.4

103

1,741.0

115

1,943.9

Dallas

21,062

491

2,331.2

704

3,342.5

131

622.0

311

1,476.6

Houston

27,023

598

2,212.9

734

2,716.2

153

566.2

277

1,025.1

Fort Worth

5,745

90

1,566.6

132

2,297.7

35

609.2

101

1,758.1

San Antonio

6,343

160

2,522.5

203

3,200.4

64

1,009.0

152

2,396.3

Risk Group*

MSM

44,594

1,314

2,946.6

1,871

4,195.6

512

1,148.1

970

2,175.2

Black MSM

11,966

448

3,743.9

787

6,577.0

169

1,412.3

289

2,415.2

Hispanic MSM

15,805

528

3,340.7

602

3,808.9

186

1,176.8

406

2,568.8

White MSM

14,955

279

1,865.6

390

2,607.8

123

822.5

239

1,598.1

* The number of MSM LWH in this table differs from other DSHS reports because we did not use multiple imputation to assign mode of exposure to persons with no reported risk.

  • The demographic profile of PLWH diagnosed with STDs is similar to that of persons diagnosed with STDs in the general population.

  • Young PLWH age 15-34, Black and Hispanic PLWH, and MSM are more likely be diagnosed with an STD.

  • STD diagnoses in PLWH may be indicators of condomless sex. PLWH who have achieved viral suppression but continue to practice condomless sex are still vulnerable to bacterial STIs.


Table 4-2. HIV+ Persons among Diagnosed STD Cases, Texas, 2016

Chlamydia

Gonorrhea

P&S Syphilis

EL Syphilis

Cases

Cases in
PLWH

%

Cases

Cases in
PLWH

%

Cases

Cases in
PLWH

%

Cases

Cases in
PLWH

%

128,036

1,799

1.4%

40,971

2,329

5.7%

1,874

590

31.5%

1,860

1,122

60.3%

Age Group
0-14

998

0

0.0%

262

1

0.4%

1

0

0.0%

3

0

0.0%

15-24

89,050

355

0.4%

21,643

508

2.3%

569

107

18.8%

739

174

23.5%

25-34

36,145

789

2.2%

12,941

1,074

8.3%

721

238

33.0%

1,046

441

42.2%

35-44

8,220

356

4.3%

3,902

417

10.7%

304

132

43.4%

441

245

55.6%

45+

3,214

299

9.3%

2,168

329

15.2%

279

1113

40.5%

463

262

56.6%

Race/Ethnicity
White

28,306

378

1.3%

9,003

536

6.0%

514

166

32.3%

707

331

46.8%

Black

30,827

748

2.4%

14,320

1,042

7.3%

564

210

37.2%

863

316

41.8%

Hispanic

45,097

573

1.3%

9,857

617

6.3%

735

198

26.9%

1,049

408

38.9%

Other

3,027

32

1.1%

884

51

5.8%

52

15

28.8%

63

20

31.7%

Unknown

30,500

68

-

6,907

83

-

9

1

-

10

2

-

Sex

Female

97,695

227

0.2%

17,962

127

0.7%

221

0

0.0%

468

11

2.4%

Male

39,715

1,572

4.0%

22,940

2,202

9.6%

1.653

590

35.7%

2,224

1,111

50.0%

Current Residence
Austin

12,002

232

1.9%

3,574

306

8.6%

305

103

33.8%

275

115

41.8%

Dallas

21,877

491

2.2%

7,532

704

9.3%

391

31

33.5%

648

311

48.0%

Houston

31,620

598

1.9%

9,369

734

7.8%

379

153

40.4%

517

277

53.6%

Fort Worth

9,764

90

0.9%

3,215

132

4.1%

127

35

27.6%

317

101

31.9%

San Antonio

14,236

160

1.1%

4,565

209

4.6%

232

64

27.6%

300

152

50.7%

Risk Group*

MSM

*

1,314

N/A

*

1,871

N/A

972

512

52.7%

1,800

970

53.9%

Black MSM

*

482

N/A

*

798

N/A

329

182

55.3%

415

310

74.7%

Hispanic MSM

*

453

N/A

*

524

N/A

508

175

34.4%

604

273

45.2%

White MSM

*

308

N/A

*

440

N/A

366

142

38.8%

440

273

62.0%

* Sexual risk information is not routinely collected for chlamydia and gonorrhea cases

  • Ongoing syphilis transmission is increasingly limited to MSM in Texas. MSM living with HIV comprise nearly 1/3 of Texas' Primary & Secondary (P&S) and over half of Texas' Early Latent (EL) syphilis diagnoses.

  • This disparity may be due to higher biological risk of syphilis infection in PLWH or serosorting among MSM.


Table 4-3. Number and % of PLWH in 2016 with Tuberculosis Co-morbidity, by Sex

TB Diagnoses
Ever (1993-2016)

In 2016

PLWH

Number of
PLWH with
TB Diagnosis
after
HIV Diagnosis

%

Number of
PLWH with
TB Diagnosis
in 2016

%

Rate per
100,000
population

Total PLWH

86,669

482

0.6%

35

100.0%

40.4

Age Group
0-14

252

0

0.0%

0

0.0%

0.0

15-24

3,980

5

0.1%

2

5.7%

50.3

25-34

16,898

73

0.4%

9

25.7%

53.3

35-44

20,133

154

0.8%

10

28.6%

49.7

45+

45,406

250

0.6%

14

40.0%

30.8

Race/Ethnicity
White

22,697

31

0.1%

2

5.7%

8.8

Black

32,371

188

0.6%

16

45.7%

49.4

Hispanic

27,739

217

0.8%

15

42.9%

54.1

Other

987

22

2.2%

0

0.0%

0.0

Unknown

2,875

24

0.8%

2

5.7%

69.6

Sex
Female

18,487

100

0.5%

8

22.9%

43.3

Male

68,182

382

0.6%

27

77.1%

39.6

Current Residence
Austin

5,916

25

0.4%

2

5.7%

33.8

Dallas

21,062

121

0.6%

12

34.4%

57.0

Houston

27,023

161

0.6%

9

25.7%

33.3

Fort Worth

5,745

37

0.6%

3

8.6%

52.2

San Antonio

6,343

38

0.6%

3

8.6%

47.3

  • Persons living with HIV who also have latent tuberculosis (TB) infection are more likely to develop TB disease because the immune system is weakened.

  • The rate of TB in PLWH is 9 times the rate of TB in the general population (4.5/100,000).

  • Hispanics and persons of Asian descent living with HIV are more likely to develop TB disease, mainly due to a higher prevalence of latent TB infection in these populations.


Epi Profile

Table of Contents | 1. Executive Summary | 2. New HIV Diagnoses | 3. Persons Living with HIV | 4. Co-Morbidities | 5. HIV/AIDS Deaths | 6. HIV Incidence | 7. Focused and Routine HIV Testing | 8. Indicators of HIV Risk in HIV-negative Persons at High Risk for HIV | 9. Indicators of HIV Risk in PLWH Currently in Care | 10. Men Who Have Sex With Men (MSM) | 11. HIV Treatment Cascade | Data Sources and Notes


Last updated December 21, 2017