Epi Profile Section 2 – Texans Living with HIV in 2018

Texans Living with Diagnosed HIV Infections

This section describes Texans living with diagnosed HIV infections, which is also called prevalence.

As of the end of 2018, over 94,000 Texans were living with a diagnosed HIV infection. The number of people living with HIV (PLWH) increased by 16% over the past 5 years, but this is not due to increases in the annual number of Texans getting diagnosed. The number of Texans diagnosed each year has been flat over the last decade at about 4,500 (Figure 1).

The number of PLWH increased because effective treatment extends the lifespan of PLWH. In fact, PLWH who are diagnosed early and begin treatment right away have lifespans almost as long as people who are not living with HIV. [5] Longer lives means that deaths in PLWH are low (about 1,400 a year). Since the annual number of deaths is lower than the number of people diagnosed each year, the number of people living with HIV rises.

Please note that the number of people living with HIV does not include an estimated 16,000 Texans who are living with undiagnosed HIV infections.
 

Figure 1: Texas PLWH, Texans with new HIV diagnoses, and deaths among Texas PLWH, 2009-2018

Source: Texas eHARS, 2018
Data for Figure 1
 

The profile of Texans living with HIV in 2018 shows:

• Almost four out of five PLWH were male; [6]
• About 1% identified as transgender women;
• About 7 out of 10 of the PLWH were Black or Hispanic;
• About half of the PLWH were 45 or older;
• About three out of five were gay and bisexual men or other men who have sex with men (MSM);
• About half of all Texas PLWH lived in the Dallas and Houston areas; and that
• Black Texans and MSM were disproportionately affected by HIV.

Table 4 at the end of this section gives a detailed look at the profile of PLWH.
 

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Texas PLWH by Sex at Birth and Race/Ethnicity

About 70% of the PLWH in 2018 were Black or Hispanic, but the profile differed by sex. Almost three out of five female PLWH were Black, but males showed a more even distribution across groups (Figure 2 and Table 1).
 

Figure 2: Texans living with HIV by race/ethnicity and sex at birth, 2018


Data for Figure 2
 

Table 1: Numbers and rates per 100,000 of Texans living with HIV in 2018 by sex at birth and selected race/ethnicities

Demographics	Number of Males	% of Males	Rate for Males	Number of Females	% of Females	Rate for Females
Race/Ethnicity
White	20,208	27%	342.2	2,687	14%	45.6
Black	23,447	32%	1,408.8	11,201	56%	630.6
Hispanic	26,826	36%	468.7	4,817	24%	80.8

Source: Texas eHARS, 2018
 

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Texas PLWH by Mode of Transmission Groups

Mode of transmission means the most likely way someone acquired HIV. We group people with the same mode of transmission together to follow trends and gauge the impact of HIV. The most common mode of transmission groups in Texas are MSM, people who inject drugs (PWID), MSM who inject drugs (MSM/PWID), and men and women who acquired HIV through heterosexual sex.

In Texas, over 6 out of 10 PLWH were MSM, but men and women had different profiles. Close to four out of five men and four out of five women acquired HIV through sex with a man (Figure 3 and Table 4).
 

Figure 3: Transmission group profiles of Texas PLWH by sex at birth, 2018

PLWH with other mode of transmission categories made up 1% of male PLWH and 3% of female PLWH.
Source: Texas eHARS, 2018
Data for figure 3
 

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Texans Living with HIV by Geography

More than half of PLWH lived in the Dallas and Houston areas in 2018. An additional 21% live in the Austin, Fort Worth, and San Antonio areas.
 

Table 2: Texas PLWH by current residence, 2018

Area	Number	%
Austin Transitional Grant Area (TGA) [7]	6,445	7%
Dallas Eligible Metropolitan Area (EMA)	23,036	25%
Fort Worth TGA	6,290	7%
Houston EMA	29,078	31%
San Antonio TGA	6,893	7%
All other areas	18,241	19%
Texas Department of Criminal Justice facilities/ Immigration and Customs Enforcement facilities/ Federal Prisons	4,123	4%
Total	94,106	100%

Source: Texas eHARS, 2018
 

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Prevalence Rates

Rates allow direct comparison of the impact of HIV on groups of different size and are used to show health disparities. The HIV prevalence rate is the number of people with HIV in a group for every 100,000 members of that group.

Figure 4 shows that Black Texans had rates that were 3 to 13 times higher than those for White and Hispanic Texans.
 

Figure 4: Prevalence rates by sex at birth and selected race/ethnicities, Texas 2018

Data for Figure 4
 

MSM were also disproportionately affected; White, Black, and Hispanic MSM had rates that were 15 to 35 times higher than the overall rates for these race/ethnicity groups (Figure 5).
 

Figure 5: Prevalence rates per 100,000 in MSM, Texas 2018

Data for Figure 5

The other way of looking at burden of disease is ‘1 in’ statements. For Texas overall in 2018, 1 in 305 Texans was living with a diagnosed HIV infection. DSHS estimates that about 1 in 6 Black MSM were living with diagnosed HIV in 2018, as were 1 in 10 Hispanic MSM, and 1 in 15 White MSM.
 

Table 3: 'One in' statements for groups of Texans living with HIV in 2018

Demographics	1 in	Demographics	1 in
All Texans	305	White Texans	359
Men	192	White men	292
Women	728	White women	2,193
MSM	11	Black Texans	99
White MSM	15	Black men	71
Black MSM	6	Black women	159
Hispanic MSM	10	Hispanic Texans	359
		Hispanic men	213
		Hispanic women	1,238

Source: Texas eHARS, 2018
 

Table 4: Texans living with HIV by select characteristics, 2018

Demographics	Number	%	Rate per 100,000
Sex at birth
Male	74,263	79%	520.7
Female	19,843	21%	137.4
Current Gender Identity
Transgender Women	683	1%
Transgender Men	17	<1%
Race/Ethnicity
White	22,895	24%	192.2
Black	34,648	37%	1,006.7
Hispanic	31,643	34%	278.3
Age group (years)
0-14	206	<1%	3.3
15-24	3,747	4%	93.0
25-34	19,039	20%	449.4
35-44	21,321	23%	549.3
45-54	25,109	27%	706.7
55-64	18,650	20%	576.6
65+	6,034	6%	167.5
Mode of transmission group
MSM	57,602	61%	8,818.8
PWID	8,390	9%
MSM/PWID	5,263	6%
People with heterosexual contact	21,853	23%
All other modes	998	1%
Total	94,106		327.9

Source: Texas eHARS, 2018 rates cannot be calculated for most transmission groups due to a lack of established methods of estimating the denominator.
 

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Note 5. cdc.gov/vitalsigns/hiv-aids-medical-care/infographic.html

Note 6. Based on sex at birth

Note 7. The EMA and TGA designations come from the Ryan White HIV/AIDS Program. It is a common geographic unit used in HIV analysis.
 

Texas HIV Epidemiologic Profile

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