California - 2015 State Health Profile HIV/AIDS Epidemic In 2015, an estimated 39,393 people in the United States were diagnosed with HIV, the virus that causes AIDS. About 1 in 7 people with HIV in the United States do not know that they are infected. In 2015, an estimated 4,720 adults and adolescents were diagnosed with HIV in California. California ranked 2nd among the 50 states in the number of HIV diagnoses in 2015. Figure 1: Estimated adults and adolescents diagnosed with HIV, by transmission category, California, 2015 Chart Data Points: (MSM/IDU) 3.9% (IDU) 5% (HET) 11.9% (MSM) 79.2% *MSM, men who have sex with men; IDU, injection drug users; MSM/IDU, men who have sex with men who also inject drugs; HET, Heterosexuals **Other: <0.064% Figure 2: Estimated adults and adolescents diagnosed with HIV, by race/ethnicity, California, 2015 Chart Data Points: (MultRace) 1.7% (Asian) 6.3% (Black) 18.8% (White) 28.7% (Hisp/Lat) 43.9% *AI/AN, American Indian/Alaska Native; Black, Black/African American; Hisp/Lat, Hispanic/Latino; MultRace, Multiple races; NHOPI, Native Hawaiian/Other Pacific Islander; Unk, Unknown **NHOPI, AI/AN: <0.61% Adolescent and School Health Many young people engage in sexual risk behaviors that can result in unintended health outcomes. Sexual risk behaviors place adolescents at risk for HIV infection, other sexually transmitted diseases, and unintended pregnancy. However, there has been a nationwide decrease in the percentage of adolescents who have ever had sex; in 2015 among high school students in California: * 14.9% of 9th graders had ever had sexual intercourse. * 26% of 10th graders had ever had sexual intercourse. Sexually Transmitted Diseases (STDs) Syphilis – Primary and secondary (P&S) syphilis (the stages in which syphilis is most infectious) remains a health problem, primarily among men who have sex with men, but congenital transmission of syphilis from infected mothers to their unborn children persists in many areas of the country. Figure 3: Chlamydia and Gonorrhea among Women by Age Group, California, 2015 Chart Data Points: Age 0-14, Chlamydia 663 Cases Gonorrhea 146 Cases Age 15-19, Chlamydia 28,047 Cases Gonorrhea 3,601 Cases Age 20-24, Chlamydia 48,822 Cases Gonorrhea 5,802 Cases Age 25-29, Chlamydia 23,087 Cases Gonorrhea 3,759 Cases Age 30-34, Chlamydia 10,103 Cases Gonorrhea 2,196 Cases Age 35-39, Chlamydia 4,965 Cases Gonorrhea 1,261 Cases Age 40+, Chlamydia 5,368 Cases Gonorrhea 1,573 Cases * In California, the rate of primary and secondary syphilis was 6.5 per 100,000 in 2011 and 12.6 per 100,000 in 2015. California now ranks 3rd in rates of P&S syphilis among 50 states. * There were 376 cases of congenital syphilis from 2011 through 2015. Chlamydia and Gonorrhea – Untreated STDs are a common cause of pelvic inflammatory disease, infertility and chronic pelvic pain. In addition, they can increase the spread of HIV, and cause cancer. Pregnant women and newborns are particularly vulnerable. In 2015, California: * Ranked 17th among 50 states in chlamydial infections (487.5 per 100,000 persons) and ranked 14th among 50 states in gonorrheal infections (139.5 per 100,000 persons). * Reported rates of chlamydia among women (621.4 cases per 100,000) that were 1.8 times greater than those among men (350.2 cases per 100,000). Figure 4: TB Cases by Race/Ethnicity, California, 2015 Chart Data Points: (Black) 4.6% (White) 6.2% (Hisp/Lat) 35.8% (Asian) 52.9% *AI/AN, American Indian/Alaska Native; Black, Black/African American; Hisp/Lat, Hispanic/Latino; MultRace, Multiple races; NHOPI, Native Hawaiian/Other Pacific Islander; Unk, Unknown **AI/AN (0.05%), MultRace (0.05%), NHOPI (0.47%): <0.56% Tuberculosis (TB) Although the overall rate of TB in the United States has declined substantially since 1992, the rate of decrease among non-U.S. born has been much smaller than that for U.S.-born persons. In 2015, California: * Ranked 3rd among the 50 states in TB rates (5.5 per 100,000 persons). * 80.81% of TB cases occurred in non-U.S. born. Hepatitis A, B, and C Virus (HAV, HBV, HCV) While acute hepatitis A virus and acute hepatitis B virus (HBV) infections have generally been declining in incidence since 1990 mainly due to effective vaccination strategies, the number of cases in the United States increased in 2015 compared to 2014. Nationwide, reported cases of acute hepatitis C virus (HCV) infection also continued to increase in 2015, more than 2.9-fold from 2011– 2015. Approximately 4.4 million people in the U.S. are living with HBV and HCV infection; most do not know they are infected. Lifelong infections with HBV and HCV are shown to be major risk factors for liver cancer. In California, between 2011 and 2015: * Reported rates of acute hepatitis A did not increase. * Reported rates of acute hepatitis B did not increase. * Reported rates of acute hepatitis C increased by 100%. Program Initiatives Supported by CDC CDC Funding to California, 2016 HIV/AIDS $72,029,365 STDs $12,861,715 TB $19,982,743 Viral Hepatitis $1,070,389 Includes direct assistance. HIV/AIDS – CDC funds the California State health department, as well as two local health departments, to implement cost-effective and scalable programs and policies that will have the greatest impact on HIV prevention in the state’s most affected communities and regions. Funding supports science-based disease monitoring, service delivery, staff development, routine program evaluation, and research on preventing HIV. CDC also supports 24 community-based organizations, 8 capacity building assistance providers. CDC funds the California State education department and four local education agencies for HIV prevention activities, to assess adolescent health-risk behaviors, and to increase access to youth-friendly health services and effective education programs to delay sexual initiation and prevent HIV infection and other STDs. STD – In California, CDC funds the state and two local health departments to reduce STDs through science-based prevention and control services that are high impact, scalable, cost effective, and sustainable. California is home to a participant in the National Network of STD/HIV Prevention Training Centers, which trains clinicians to effectively serve at-risk patients, and a network of STD programs that collect additional information to better and more quickly shed light on STD trends TB – In California, CDC funds the State and three city health departments for TB prevention and control activities. These funds also support the identification and evaluation of persons exposed to TB, as well as laboratory services. CDC also supports a regional medical consultation and training center for complex TB cases, and funds the State and a university for TB research. Viral Hepatitis – In California, CDC supports projects to improve the delivery of primary and secondary viral hepatitis prevention services in health-care settings and public health programs that serve at-risk adults and adolescents. CDC supports community-based projects to improve the identification and care for chronic hepatitis B infection among people in the U.S. who were born in countries with intermediate to high prevalence. Additionally, CDC supports enhanced, active surveillance projects to monitor the burden of acute and chronic viral hepatitis. For More Information California: http://www.cdph.ca.gov/ CDC: https://www.cdc.gov/nchhstp/