Indicators of HIV Risk in HIV-negative Persons at High Risk for HIV - Epi Profile Section 8
Epi Profile Section 8 - Indicators of HIV Risk in HIV-negative Persons at High Risk for HIV
This section describes public health testing programs funded by the Texas Department of State Health Services (DSHS). DSHS funds two types of HIV testing programs: focused testing programs and routine testing programs in medical care settings. Funded providers either work with populations who carry a high burden of HIV or offer testing through their broader health services in areas and settings likely to serve low income and uninsured people.
The program profiles and outcomes are shown in Table 22. The first set of columns for each program show the number and proportion of tests for various groups of clients. The second set of columns show the number of positive test results within groups of clients and the positivity rate, which is the number of clients with positive test results for every hundred clients tested. The final set of columns shows the number of diagnoses and diagnosis rate. Some of the clients with positive test results had been previously diagnosed. The diagnosis columns show only those clients who were newly diagnosed by the testing program.
Focused Testing Programs
Focused testing sites offer HIV testing to persons at highest risk for HIV, such as MSM. These programs are carried out by community-based organizations and some local health departments. To be effective, these programs should have client profiles like the profile of Texans with new diagnoses. We also expect a diagnosis rate that is higher than the diagnosis rate for Texans overall (0.016%). [16]
The focused testing client profile shows the following:
-
Two-thirds of the tests were for men;
-
70% of the tests were for Black or Hispanic clients;
-
3 out of 5 tests were for clients younger than 35 years old;
-
72% of the tests were for clients in the areas with the greatest number of PLWH—Austin, Dallas, Fort Worth, Houston, and San Antonio; and
-
1 in 3 of the tests were for MSM.
391 clients were diagnosed through the focused program in 2018. The diagnosis rate was 0.8%, which was 47 times higher than the overall diagnosis rate.
Routine HIV Testing in Health Care Settings
Routine testing programs test all clients in a medical care setting unless they decline. The testing is not based on individual patient risk. These programs are carried out in hospital emergency departments in areas with higher numbers of people living with HIV. A small number of tests in this program are conducted in primary care settings. Since all clients in a setting are tested, risk information is usually not collected by routine testing programs and is not shown in the tables below.
The routine testing client profile shows the following:
-
More than half of the tests were for women;
-
Almost 70% of the tests were for Black or Hispanic clients;
-
36% of the tests were for clients younger than 35 years old; and
-
Almost 90% of the tests were for clients in the areas with the greatest number of PLWH and new diagnoses—Austin, Dallas, Fort Worth, and Houston.
293 clients were diagnosed through the focused program in 2018. The diagnosis rate was 0.1%, which was 8 times higher than the overall diagnosis rate in the general population.
Table 22a: Profiles of HIV testing programs funded by DSHS in 2018
|
|
Focused Testing Programs |
|||||
|
|
Tests |
All positive |
Only new |
|||
|
|
Number |
% of |
Number |
Positive |
Number |
Diagnosis |
|
Total |
51,952 |
|
637 |
1.2% |
391 |
0.8% |
|
Sex |
|
|
|
|
|
|
|
Men |
34,211 |
66% |
555 |
1.6% |
352 |
1.0% |
|
Women |
17,307 |
33% |
68 |
0.4% |
34 |
0.2% |
|
Transgender women |
362 |
1% |
14 |
3.9% |
5 |
1.4% |
|
Transgender men |
11 |
0% |
0 |
0.0% |
0 |
0.0% |
|
Unknown |
61 |
0% |
0 |
0% |
0 |
0% |
|
Race/Ethnicity |
|
|
|
|
|
|
|
White |
13,062 |
25% |
118 |
0.9% |
76 |
0.6% |
|
Black |
15,290 |
29% |
219 |
1.4% |
122 |
0.8% |
|
Hispanic |
21,081 |
41% |
271 |
1.3% |
178 |
0.8% |
|
Other |
2,071 |
4% |
23 |
1.1% |
12 |
0.6% |
|
Multi-race |
448 |
1% |
6 |
1.3% |
3 |
0.7% |
|
Age group (years) |
|
|
|
|
|
|
|
0-14 |
62 |
0% |
1 |
1.6% |
0 |
0% |
|
15-24 |
14,109 |
27% |
148 |
1.0% |
107 |
0.8% |
|
25-34 |
18,853 |
36% |
269 |
1.4% |
170 |
0.9% |
|
35-44 |
9,468 |
18% |
123 |
1.3% |
73 |
0.8% |
|
45-54 |
5,501 |
11% |
67 |
1.2% |
31 |
0.6% |
|
55-64 |
3,077 |
6% |
22 |
0.7% |
8 |
0.3% |
|
65+ |
851 |
2% |
7 |
0.8% |
2 |
0.2% |
|
Unknown |
51 |
0% |
0 |
0% |
0 |
0% |
|
Geography |
|
|
|
|
|
|
|
Austin TGA |
4,776 |
9% |
28 |
0.6% |
21 |
0.4% |
|
Dallas EMA |
9,991 |
19% |
192 |
1.9% |
99 |
1.0% |
|
Fort Worth TGA |
5,596 |
11% |
67 |
1.2% |
50 |
0.9% |
|
Houston EMA |
5,158 |
10% |
55 |
1.1% |
37 |
0.7% |
|
San Antonio TGA |
11,728 |
23% |
126 |
1.1% |
68 |
0.6% |
|
Rest of Texas |
14,703 |
28% |
169 |
1.1% |
116 |
0.8% |
|
Reported Risk |
|
|
|
|
|
|
|
MSM |
17,706 |
34% |
469 |
2.6% |
308 |
1.7% |
|
PWID |
3,164 |
6% |
19 |
0.6% |
8 |
0.3% |
|
MSM/PWID |
655 |
1% |
27 |
4.1% |
14 |
2.1% |
|
Adult Other |
29,277 |
56% |
115 |
0.4% |
58 |
0.2% |
|
Unknown |
1,089 |
2% |
7 |
0.6% |
3 |
0.3% |
Table 22a: Profiles of HIV testing programs funded by DSHS in 2018
|
|
Routine Testing Programs |
|||||
|
|
Tests |
All positive |
Only new |
|||
|
|
Number |
% of |
Number |
Positive |
Number |
Diagnosis |
|
Total |
227,860 |
|
1,496 |
0.7% |
293 |
0.1% |
|
Sex |
|
|
|
|
|
|
|
Men |
99,825 |
44% |
1,087 |
1.1% |
217 |
0.2% |
|
Women |
128,000 |
56% |
407 |
0.3% |
75 |
0.1% |
|
Transgender women |
10 |
0% |
2 |
20.0% |
1 |
10.0% |
|
Transgender men |
|
|
|
|
|
|
|
Unknown |
25 |
0% |
0 |
0% |
0 |
0% |
|
Race/Ethnicity |
|
|
|
|
|
|
|
White |
55,205 |
24% |
288 |
0.5% |
65 |
0.1% |
|
Black |
63,594 |
28% |
837 |
1.3% |
132 |
0.2% |
|
Hispanic |
91,173 |
40% |
268 |
0.3% |
83 |
0.1% |
|
Other |
17,994 |
8% |
90 |
0.5% |
12 |
0.1% |
|
Multi-race |
17 |
0% |
13 |
76.5% |
1 |
5.9% |
|
Age group (years) |
|
|
|
|
|
|
|
0-14 |
697 |
0% |
1 |
0.1% |
0 |
0% |
|
15-24 |
37,475 |
16% |
132 |
0.4% |
47 |
0.1% |
|
25-34 |
46,242 |
20% |
430 |
0.9% |
88 |
0.2% |
|
35-44 |
44,045 |
19% |
353 |
0.8% |
63 |
0.1% |
|
45-54 |
40,838 |
18% |
306 |
0.7% |
51 |
0.1% |
|
55-64 |
36,739 |
16% |
228 |
0.6% |
41 |
0.1% |
|
65+ |
21,820 |
10% |
43 |
0.2% |
3 |
0.0% |
|
Unknown |
127 |
0% |
3 |
2.4% |
0 |
0% |
|
Geography |
|
|
|
|
|
|
|
Austin TGA |
40,961 |
18% |
126 |
0.3% |
24 |
0.1% |
|
Dallas EMA |
60,133 |
26% |
431 |
0.7% |
156 |
0.3% |
|
Fort Worth TGA |
66,884 |
29% |
492 |
0.7% |
43 |
0.1% |
|
Houston EMA |
31,117 |
14% |
315 |
1.0% |
41 |
0.1% |
|
San Antonio TGA |
|
|
|
|
|
|
|
Rest of Texas |
28,888 |
13% |
132 |
0.5% |
29 |
0.1% |
|
Reported Risk |
|
|
|
|
|
|
|
MSM |
|
|
46 |
|
17 |
|
|
PWID |
|
|
6 |
|
1 |
|
|
MSM/PWID |
|
|
1 |
|
0 |
|
|
Adult Other |
|
|
196 |
|
30 |
|
|
Unknown |
|
|
1,247 |
|
245 |
|