Hawaii - 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 115 adults and adolescents were diagnosed with HIV in Hawaii. Hawaii ranked 37th among the 50 states in the number of HIV diagnoses in 2015. Figure 1: Estimated adults and adolescents diagnosed with HIV, by transmission category, Hawaii, 2015 Chart Data Points: (MSM/IDU) 1.7% (IDU) 9.6% (HET) 14.8% (MSM) 73.9% *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 Figure 2: Estimated adults and adolescents diagnosed with HIV, by race/ethnicity, Hawaii, 2015 Chart Data Points: (Hisp/Lat) 8.7% (Black) 9.6% (NHOPI) 12.2% (MultRace) 15.7% (Asian) 17.4% (White) 35.7% *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: <0.87% 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: * 24% of 9th graders have reported ever having sex in 2015 compared to 34% in 2005. * 35.7% of 10th graders have reported ever having sex in 2015 compared to 42.8% in 2005. 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, Hawaii, 2015 Chart Data Points: Age 0-14, Chlamydia 47 Cases Gonorrhea 7 Cases Age 15-19, Chlamydia 1,136 Cases Gonorrhea 98 Cases Age 20-24, Chlamydia 1,858 Cases Gonorrhea 133 Cases Age 25-29, Chlamydia 847 Cases Gonorrhea 71 Cases Age 30-34, Chlamydia 425 Cases Gonorrhea 67 Cases Age 35-39, Chlamydia 180 Cases Gonorrhea 23 Cases Age 40+, Chlamydia 225 Cases Gonorrhea 44 Cases * In Hawaii, the rate of primary and secondary syphilis was 1 per 100,000 in 2011 and 6.4 per 100,000 in 2015. Hawaii now ranks 14th in rates of P&S syphilis among 50 states. * There were 2 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, Hawaii: * Ranked 14th among 50 states in chlamydial infections (498.3 per 100,000 persons) and ranked 34th among 50 states in gonorrheal infections (87.3 per 100,000 persons). * Reported rates of chlamydia among women (672.9 cases per 100,000) that were 2.1 times greater than those among men (327.5 cases per 100,000). Figure 4: TB Cases by Race/Ethnicity, Hawaii, 2015 Chart Data Points: (MultRace) 1.6% (White) 2.4% (NHOPI) 26% (Asian) 68.5% *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 **Black (0.79%), Unk (0.79%): <1.57% 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, Hawaii: * Ranked 2nd among the 50 states in TB rates (8.9 per 100,000 persons). * 84.25% 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 Hawaii, between 2011 and 2015: * Reported rates of acute hepatitis A decreased by 33%. * Reported rates of acute hepatitis B increased by 150%. Program Initiatives Supported by CDC CDC Funding to Hawaii, 2016 HIV/AIDS $1,032,599 STDs $385,305 TB $1,748,499 Viral Hepatitis $82,904 HIV/AIDS – CDC funds the Hawaii State health department 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 evidence-based disease monitoring, service delivery, staff development, and routine program evaluation. CDC also supports one community-based organization. CDC funds the Hawaii State education department to assess health-risk behaviors that contribute to the leading causes of death and disability among youth and adults. STD – In Hawaii, CDC funds the state health department to reduce STDs through science-based prevention and control services that are high impact, scalable, cost effective, and sustainable. TB – In Hawaii, CDC funds the State health department 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 funds the health department for TB research. Viral Hepatitis – In Hawaii, 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. For More Information Hawaii: http://health.hawaii.gov/ CDC: https://www.cdc.gov/nchhstp/