In this post, we will examine the HIV/AIDS epidemic in Michigan with particular emphasis on the Detroit Metropolitan Area. The Michigan Department of Community Health (MDCH) considers the Detroit Metropolitan Area (DMA) to include the counties of Wayne, Oakland, Macomb, St. Clair, Monroe, and Lapeer. Michigan has the 13th highest number of persons living with HIV in the United States. According to the 2012 Epidemiological Profile of HIV in Michigan, 15,753 persons were known to be infected with HIV in Michigan by the end of 2011. All told, 63% of all persons living with HIV in Michigan reside in the Detroit Metropolitan Area where 43% of the state’s population lives.
The state separately reports data for the City of Detroit and the balance of Wayne County. As can be seen in the following graph, in 2011, HIV infection was concentrated in Wayne and Oakland counties. Over half of the persons living with HIV in the DMA resided in the City of Detroit, with 16% in the balance of Wayne County and 18% in Oakland County.
HIV continues to disproportionally impact African Americans. In Michigan, the rate of infection is 10 times higher among black males than white males and 25 times higher among black females than white females. Within the DMA, the infection rate among black persons is higher than for the general population. When the information is broken down by gender and race it shows there is a higher prevalence of HIV in both black males and females. According to data on the DMA, by 2011 approximately 64% of males diagnosed with HIV and 81% of diagnosed females were black.
As shown in the graph below, almost a third of persons living with HIV were between 30 and 39 years old at the time of diagnosis. The next highest number of cases occurs with persons who were diagnosed between 20-24 years or 40-49 years old, both of which were reported at 18%. This information shows the percent of those diagnosed with HIV was highest for those in the 20-29 age group, which the MDCH epidemiologist breaks down into two groups to emphasize the differences in HIV rates, especially in trend analyses. Trend data calculated by MDCH from 2006 to 2010 indicates the rate of new HIV diagnosis increased an average of 11% per year among persons 20-24 years of age and an average of 8% per year among those persons 25-29 years of age.
HIV/AIDS is transmitted through contact with specific bodily fluids: blood, semen, vaginal secretions and breast milk (CDC, 2012). In the U.S., HIV is most commonly transmitted through specific sexual behaviors (e.g., anal or vaginal sex) or by sharing needles or injection drug equipment with an infected person. Less common transmission routes are through oral sex, transfusions, or an HIV-infected woman passing the virus to her baby.
According to the MDCH HIV/STD/VH/TB Epidemiology Section of the Bureau of Disease Control, Prevention and Epidemiology, nearly half, 49%, of people infected engaged in “man who has sex with a man” (MSM) behavior. However, keep in mind not all those in the MSM category are MSMs. MSM is a broad category that also includes transgenders and bisexuals; these groups would argue they are not MSMs.
Exposure through unprotected heterosexual sex constitutes 17% of HIV cases; 11% were exposed through injection drug use.
In terms of the 18% with no identified risk, this means it is too difficult to determine the exact route of exposure for such reasons as there can be at least three months or longer lag between exposure and a positive diagnosis. With such a time frame, many people are not sure of the exact cause, which is why it is listed as “no identified risk.” Also, some do not get diagnosed until they have symptoms, which could be 20 years post exposure. Also all exposure data is, by necessity, self-reported, and some don’t acknowledge having any risks.
More detailed information about the epidemiologic profile of HIV/AIDS in Michigan and the DMA can be found at http://www.michigan.gov/mdch/0,4612,7-132-2940_2955_2982_46000_46003-36307–,00.html
To find a free or low cost confidential HIV or STD testing location you can check the website http://hivtest.cdc.gov/Default.aspx to find free testing sites in your area. Just enter your ZIP code. Testing is confidential.