• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (737) 255-4300

    Email the HIV/STD Program

    Email 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 3 - Texans with New HIV Diagnoses


Since people can live with HIV for years before being diagnosed, this section does not show the number of Texans who have new HIV infections, which is found in Section 5: Texans with Newly Acquired HIV.



Overall Trends and Profile of Texans with New HIV Diagnoses.


In 2018, 4,520 Texans were newly diagnosed with HIV, which means that every day about 12 Texans were diagnosed with HIV. The annual number of people with new HIV diagnoses has remained constant for the last 10 years (Figure 6).

Although the overall number of people with new diagnoses were flat over the past decade, new diagnoses decreased in Black women, PWID, and people who acquired HIV through heterosexual sex. The number of diagnoses in Hispanic MSM increased. These trends are shown later in this section.

Figure 6:  Number of Texans with new diagnoses, 2009-2018 
Figure 6:  Number of Texans with new diagnoses, 2009-2018
Source: Texas eHARS, 2018
Data for Figure 6


The diagnosis rate for Texas fell by 11% over the past 10 years. Since the overall annual number of Texans with new diagnosis did not change, the decline in rate is likely due to the increases in the total population of Texas.

Figure 7: Rate of Texans with new diagnoses, 2009-2018 
Figure 7: Rate of Texans with new diagnoses, 2009-2018
Source: Texas eHARS, 2018
Data for Figure 7


The profile of Texans with new diagnoses in 2018 shows a continuation of recent trends:

  • Four out of five people with new diagnoses were male; [8]
  • Three out of four were Black or Hispanic;
  • Three out of five were younger than 35;
  • At least half were Hispanic and Black MSM; and
  • Black and MSM Texans had disproportionately high diagnosis rates.

Table 9 at the end of this section shows detailed breakdowns of profile of Texans with new diagnoses over time.



Texans with New Diagnoses by Race/Ethnicity and Sex at Birth


Even though the overall number of Texans with new diagnoses was steady across the years, this masked changes. The number of Black Texans with new diagnoses fell by about 6% from 2009-2018, while the number of new diagnoses in Hispanic Texans rose by 19% (Figure 8 and Table 9). The decrease in Black Texans was driven primarily by decreases among Black women, and the increase in Hispanic Texans was driven by increases in Hispanic MSM.

Figure 8: Texans with new HIV diagnoses by race/ethnicity, 2009-2018 
Figure 8: Texans with new HIV diagnoses by race/ethnicity, 2009-2018
Data for Figure 8


The decrease in the number of Black Texans with new diagnoses led to a 22% decrease in the diagnosis rate for this group (Figure 9). Despite this decrease, the diagnosis rate for Black Texans was 2.8 times higher than the rate for Hispanic Texans, the group with the next highest rate. The diagnosis rate for Black females is five times higher than the rate for Hispanic females, the group with the next highest rate (Table 5).

Figure 9: Rates of new HIV diagnosis in Texas by selected race/ethnicity groups, 2009-2018 
Figure 9: Rates of new HIV diagnosis in Texas by selected race/ethnicity groups, 2009-2018
Source: eHARS, 2018
Data for Figure 9


Table 5: Texans with new diagnoses and diagnosis rates by sex at birth and selected race/ethnicities, 2018

Males

Females

Total

Race/Ethnicity

Number

%

Rate

Number

%

Rate

Number

%

Rate

White

790

21%

13.4

119

15%

2.0

909

20%

7.6

Black

1,169

32%

70.2

415

51%

23.4

1,584

35%

46.0

Hispanic

1,565

42%

27.3

250

31%

4.4

1,815

40%

16.0

All Others

178

5%


34

4%


212

5%


TOTAL

3,702

26.0

818

5.7

4,520

100%

15.7



Texans with New Diagnoses by Age


The age profile of Texans who were diagnosed in 2018 clearly varies by sex at birth in ways that have implications for designing testing and treatment programs. The profile of males leans towards younger ages and reflects increases in new diagnoses in young MSM of color. The age of females at diagnosis is tilted towards older women, with one in three females diagnosed in 2018 being 45 or older. During discussions in changes of the age profile of those newly diagnosed, keep in mind these differences.

Figure 10: Age profiles of Texans with new HIV diagnoses by sex at birth, 2018 
Figure 10: Age profiles of Texans with new HIV diagnoses by sex at birth, 2018
Data for Figure 10


Across the last 10 years, at least half of the newly diagnosed Texans were younger than 35 years old (Figure 11). New diagnosis in the 25-34-year-old age group increased by 25% over the past 10 years with consistent year after year increases.

Trends in youth (15-24-year-olds) are more complex. Comparing the number of new diagnoses in youth in 2009 and in 2018 makes it appear that the number of diagnoses made in this group was stable, but this is not the case. Between 2009 and 2013, the number of new diagnoses in youth increased, but between 2014 and 2018, the number of youth with new diagnoses fell by 11%. This decrease mirrors changes in the number of youth with new HIV infections, which fell significantly from 2010 to 2017 (data not shown).

While the decrease in new infections in youth is good news, the decrease in new diagnoses is a problem. Since we estimate that only about half of the youth living with HIV have been diagnosed (data not shown), the number of youth diagnosed each year needs to increase to assure full diagnosis and participation in care, and these efforts should be focused on young MSM.

Figure 11: Texans with new diagnoses by age, 2009 - 2018 
Figure 11: Texans with new diagnoses by age, 2009 - 2018
Data for Figure 11


Table 6: Texans diagnosed with HIV in 2018 by sex at birth and age

Males

Females

Total

Age group (years)

Number

%

Rate

Number

%

Rate

Number

%

Rate

0-14

5

<1%

0.2

4

<1%

0.1

9

<1%

0.2

15-24

897

24%

43.4

125

15%

6.4

1,022

23%

25.4

25-34

1,429

39%

66.2

223

27%

10.7

1,652

37%

39.0

34-44

672

18%

34.5

195

24%

10.1

867

19%

22.3

45-54 

450

12%

25.5

159

19%

8.9

609

14%

17.1

55-64

198

5%

12.6

90

11%

5.4

288

6%

8.9

65+

51

1%

3.2

22

3%

1.1

73

2%

2.0

TOTAL

3,702

26.0

818

5.7

4,520

100%

15.7



Texans with New Diagnoses by Mode of Transmission Groups


Over the past 10 years, MSM made up about 7 out of every 10 Texans with a new HIV diagnosis—an MSM was diagnosed with HIV every three hours. MSM is the only group to consistently show annual increases in new diagnoses (Figure 12). Most of these increases came from young MSM of color.

In addition to having the greatest number of people with new HIV diagnoses, MSM had much higher diagnosis rates—up to 31 times higher than the overall diagnosis rate in 2018. The highest rates are seen in MSM of color. Section 4 of this profile has more details on new diagnoses in MSM.

The number of new diagnoses in PWID and people who acquired HIV through heterosexual contact decreased across these years. These changes are also seen in Texans with new infections. The declining diagnoses in people who acquired HIV through heterosexual sex reflect the downward trends in the number of new diagnoses in Black women.

Figure 12:  Texans with new diagnoses by selected mode of transmission groups, 2009-2018 
Figure 12:  Texans with new diagnoses by selected mode of transmission groups, 2009-2018
Data for Figure 12


Mode of Transmission by Sex


As shown in Table 7, more than four out of five women diagnosed in 2018 acquired HIV though sex with a man. Most men also acquired HIV through sex with a man; a much smaller number of men acquired HIV through sex with a woman. Women have a higher biological risk of acquiring HIV from heterosexual contact than do men [9,10] which partially explains why males have a lower number of diagnoses attributable to heterosexual contact compared to females.

Table 7: Texans with new HIV diagnoses by transmission group and sex at birth, 2018

Males

Females

Total

Mode of transmission group

Number

%

Number

%

Number

%

MSM

3,177

86%



3,177

70%

PWID

126

3%

116

14%

242

5%

MSM/PWID

164

4%



164

4%

Heterosexual contact

229

6%

698

85%

927

21%

Perinatal transmission

6

<1%

4

1%

10

<1%

Total

3,702


818


4,520

100%


Mode of Transmission by Race


Mode of transmission profiles differ by race/ethnicity. MSM made up three out of four White and Hispanic Texans diagnosed in 2018. Although MSM were still the largest group of Black Texans diagnosed in 2018, people who acquired HIV through heterosexual sex made up almost one in three Black Texans with new HIV diagnosis. Since people with heterosexual transmissions are predominately Black women, any decrease in new diagnoses in Black women will also show up as a decrease in cases due to heterosexual transmission.

Figure 13: Transmission group profile of Texans with new HIV diagnosis by race/ethnicity, 2018 
Figure 13: Transmission group profile of Texans with new HIV diagnosis by race/ethnicity, 2018   
Source: Texas eHARS, 2018
Data for Figure 13


Table 8: Texans with new HIV diagnoses by race/ethnicity and mode of transmission group, 2018

White

Black

Hispanic

Mode of transmission group

Number

%

Number

%

Number

%

MSM

650

71%

987

62%

1,385

76%

PWID

69

8%

90

6%

77

4%

MSM/PWID

70

8%

23

2%

59

3%

Heterosexual contact

120

13%

479

30%

290

16%

Perinatal transmission



5

<1%

4

<1%

Total

909

20%

1,584

35%

1,815

40%

Source: Texas eHARS, 2018


Table 9: Texans diagnosed with HIV by selected characteristics, 2014-2018

2014

2015

2016

2017

2018

Number

%

Number

%

Number

%

Number

%

Number

%

TOTAL

4,460

100%

4,552

100%

4,543

100%

4,365

100%

4,520

100%

Sex at birth

Male

3,626

81%

3,714

82%

3,748

83%

3,607

83%

3,702

82%

Female

834

19%

838

18%

795

17%

758

17%

818

18%

Race/Ethnicity
White

859

19%

868

19%

877

19%

784

18%

909

20%

Black

1,608

36%

1,600

35%

1,579

35%

1,589

36%

1,584

35%

Hispanic

1,748

39%

1,831

40%

1,825

40%

1,804

41%

1,818

40%

Other

68

2%

85

2%

76

2%

62

1%

83

2%

Multiple races

177

4%

168

4%

186

4%

126

3%

129

3%

Age Group (years)
0-14

20

0%

17

0%

14

0%

10

0%

9

0%

15-24

1,151

26%

1,135

25%

1,052

23%

992

23%

1,022

23%

25-34

1,464

33%

1,558

34%

1,708

38%

1,641

38%

1,652

37%

35-44

895

20%

876

19%

808

18%

829

19%

867

19%

45-54

628

14%

633

14%

625

14%

564

13%

609

13%

55-64

235

5%

263

6%

273

6%

274

6%

288

6%

65+

67

2%

70

2%

63

1%

55

1%

73

2%

Transmission group
MSM

3,071

69%

3,146

69%

3,218

71%

3,072

70%

3,177

70%

PWID

228

5%

238

5%

252

6%

221

5%

242

5%

MSM/PWID

165

4%

183

4%

155

3%

185

4%

164

4%

Heterosexual sex

976

22%

968

21%

908

20%

877

20%

927

21%

Perinatal

20

<1%

17

<1%

10

<1%

10

<1%

10

<1%

Note: Due to rounding, numbers may not add up to 100%.
Source: Texas eHARS, 2018



Note 8. Sex at birth

Note 9. Higgins, J. A., Hoffman, S., & Dworkin, S. L. (2010). Rethinking gender, heterosexual men, and women's vulnerability to HIV/AIDS. American journal of public health, 100(3), 435-445

Note 10. Scully, E. P. (2018). Sex differences in HIV infection. Current HIV/AIDS Reports, 15(2), 136-146.


Epi Profile

Table of Contents | 1. Executive Summary | 2. Texans Living with HIV in 2018 | 3. Texans with New HIV Diagnoses | 4. New Diagnoses in MSM | 5. Texans with Newly Acquired HIV | 6. Deaths in Texans Living with HIV | 7. Comorbidities in Texans Living with HIV | 8. HIV Testing in Programs Funded by DSHS | 9. Sex and Substance Use in PLWH | 10. Sex and Substance Use in People at Increased Risk for HIV in Dallas, Texas | 11. Texas Treatment Cascade for 2018 | Data Sources and Notes


Last updated June 18, 2020