2017 Profile of HIV in Dallas County
Dallas County Health and Human Services
New HIV Cases and Cumulative Numbers of
HIV Diagnoses and Persons Living with HIV, 2017 Synopsis HIV in Dallas County by Age Group
New Persons Living with HIV in Dallas County, 2008-2017
HIV Cases Reported
Persons Living with HIV
Sums of subgroups HIV Incidence Rates by Race/Ethnicity, 2008-2017
18,000
16,000
14,000
12,000
10,000
8,000
Black White Hispanic Other Total
2008 Prevalence April 2019 Dallas Medical Journal 3
Dr. Huang has led Travis County
and Austin, Texas in 35-fighting 44
the AIDS
epidemic and, on June 19%
18, 2018,
Austin’s mayor and county judge
signed the Paris Declaration on Fast-
Track Cities Ending AIDS.3 This is
a global initiative in which over 250
cities around the world and 20 cities
in the US have adopted specific
goals for 2020:
140
120
HIV Incidence Rates by Age Groups, 2008-2017
<2 2-12 13-24 25-34
35-44 45-54 55+ Total
GOALS FOR 2020
100
80
60
40
20
With the support of DCMS and Dr.
Huang, we should get Dallas to join
in this worthwhile effort.
I remember vividly when the AIDS
epidemic began in 1981 while I was
an intern at Parkland Hospital. At
first the disease did not even have a
name. Patients came in with bizarre
skin cancers (Kaposi’s sarcoma)
and even stranger infections
(pneumocystis pneumonia and
cryptococcal meningitis). Everyone
with HIV died rather quickly. Acquired
Immunodeficiency Syndrome was
a death sentence. There was great
fear and uncertainty at the time about
1,800
1,600
1,400
1,200
1,000
800
how the disease was transmitted. I
lost friends, classmates, coworkers,
and even a family member. Doctors
and nurses were afraid to enter the
room, much less touch a patient.
The stigma of HIV and its association
with homosexual men and IV drug
users was profound. For a reflection
on the history of AIDS in Dallas see
Dr. Green’s excellent article in The
Pharos, Spring 2018.4
We have come a long way in
understanding HIV and its treatment
and diagnosis over the past 40 years
but there is still much progress to be
made. Recent large clinical studies
have demonstrated that undetectable
equals untransmittable HIV (U=U).5
This means that patients with HIV on
antiretroviral therapy who maintain
an undetectable viral load will not
transmit HIV to others. Also, persons
living with HIV and properly treated
can expect to live a near normal
lifespan. Both will go a long way to
reduce the stigma of HIV infection.
Additionally, pre- and post-exposure
prophylaxis appear to be effective.
Theoretically, these advances
indicate that the HIV epidemic
could be ended quickly in the US.
Realistically, eliminating HIV will take
a concerted and coordinated effort
by federal, state, and local health
departments as well as a grassroots
effort by primary care physicians
especially those who care for our
indigent and underserved populace.
On February 19, the DCMS
hosted a reception for Dr. Huang to
reintroduce him to the physicians
of Dallas County. He was able to
meet past directors of HHS, primary
care physicians, infectious disease
specialists, epidemiologists, UT
Southwestern research physicians,
and the DCMS Board of Directors.
I am hopeful about our chances to
make a significant impact on the HIV
epidemic in our community. After all,
we eliminated polio from the US. But,
as I was reminded by my mentor,
Professor Jim Luby, we have yet to
eradicate syphilis and tend to be
overly optimistic about eliminating
disease. DMJ
1,600
1,400
1,200
1,000
References
1. Fauci AS, Redfield RR, Sigounas
G, et al. Ending the HIV epidemic:
a plan for the United States. JAMA.
2019;321(9):844-845.
2. New HIV Cases and Cumulative
Numbers of Persons Living with HIV in
Dallas County, 2008-2017, https://www.
dallascounty.org/Assets/uploads/docs/
hhs/stdstats/HIV2017DiseaseProfile_
Dallas.pdf
3. Huang P, Seidel S. Fast-track cities
initiative to end the AIDS epidemic.
TCMS J. 2018;64:26-28.
4. Green G. Back in the day: a roman á
clef. The Pharos. Spring 2018:25-28.
5. Eisinger RW, Dieffenbach CW, Fauci
AS. HIV viral load and transmissibility
of HIV infection: undetectable
equals untransmittable. JAMA.
2019;321(5):451–452.
DCMS President Kevin Klein, MD with Dallas County Health
and Human Services Director Philip Huang, MD
■ 90% of all people living with HIV
will know their HIV status
■ 90% of all people diagnosed with
HIV will receive antiretroviral
therapy (ART)
■ 90% of all people receiving ART
will have viral suppression
■ 50% reduction in new HIV
infections
■ End stigma related to HIV
Black
48%
31%
Other
3%
White
18%
Hispanic
140
120
100
80
60
40
20
0
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Incidence Rates per 100,000
Year
HIV in Dallas County by Age Groups
• In 2017, an Dallas County,• From 2013 in Dallas within 12 • Case rates Americans,the US.
• In 2017, 63%35 years of Data Sources: Dallas Services, 2018
• Data for new available diagnosis initial diagnosis,adjustments • Numbers of Persons as of 2017, which Texas, and exclude adjusted for deaths • HIV in Dallas County by Race/Ethnicity New HIV Diagnoses New Diagnoses Persons Living with HIV/AIDS
DCHHS Epidemiology New Diagnoses Persons Living with HIV/AIDS
N/A = Not applicable
New HIV Diagnoses Persons Living with HIV
n Incidence per
100,000 n Prevalence per
100,000
Total 814 31.6 18,073 701.9
Sex
Male 679 53.6 14,656 1,156.4
Female 135 10.3 3,417 261.3
Race/Ethnicity
Black 391 66.2 7,772 1,316.5
White 142 18.1 5,020 639.3
Hispanic 255 24.8 4,363 425.1
Other 26 15.0 918 530.3
Age Group (years)
0-1 2 2.5 3 3.7
2-12 0 N/A 12 2.8
13-24 195 45.2 748 173.3
25-34 318 76.4 3,656 878.8
35-44 153 43.0 4,220 1,185.1
45-54 94 28.6 5,095 1,549.8
≥55 52 9.7 4,339 807.0
Mode of Transmission n % n %
Men Who Have Sex with
Men (MSM) 603 74.1% 12,514 69.3%
Heterosexual 148 18.2% 3,522 19.5%
Injection Drug Use (IDU) 40 4.9% 1,188 6.6%
MSM/IDU 21 2.6% 737 4.1%
Pediatric 2 0.2% 101 0.6%
<12
<1%
13-24
24%
25-34
39%
45-54
12%
≥55
6%
<12
<1%
13-24
4%
25-34
20%
35-44
24%
45-54
28%
≥55
24%
Black
24% 43%
Other
5%
White
28%
Hispanic
Male
83%
6,000
600
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number of Persons Living with HIV
Annual Number of Cases Reported
Year
800
600
400
200
0
Rates per 100,000
Persons 0
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Incidence Rates per 100,000
Year
2