Research Paper: AIDS Rate in Florida

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AIDS Rate in Florida

Like cancer, significant progress is being made in treating acquired immune deficiency syndrome (AIDS) and there are increasing reports of outright cures and extended lifetimes for sufferers. Despite this progress, AIDS remains a significant public health threat in general and in certain states such as Florida in particular. In fact, some cities in Florida have AIDS rates that are higher than the combined total of many states and historical trends indicate that the problem continues to worsen. Although AIDS statistics were first collected in Florida in 1981, these statistics are limited in their comparability with other states due to reporting differences, but it is possible to discern some salient trends in AIDS rates over the years. To this end, this paper provides a review of the relevant peer-reviewed and scholarly literature concerning AIDS in Florida compared to national levels, followed by a description of ongoing initiatives in the state to address the problem. A summary of the research and important findings concerning AIDS rates in Florida are provided in the conclusion.

Review and Analysis

Currently, Florida residents experience comparable morbidity and mortality as the remainder of the U.S. general population, but there are some distinct differences between national rates and the state of Florida with respect to population characteristics and demographic trends, health disparities in select populations, major risk factors, and health care coverage (Dyer, 2003). According to Dyer, "As a large and diverse state (i.e., fourth largest state population), Florida is comprised of approximately 15 million residents including elderly persons, immigrants, and national and international visitors" (p. 37). In addition, the state has experienced a significant population growth during the period between 1980 and today, increasing in size by more than half (56%), with projected growth by another 29% by 2020, with two-thirds of this growth occurring among people aged 65 years and over (Dyer, 2003). This inordinately high percentage of elderly, together with large numbers of low-income residents from surrounding states and abroad, has concentrated the risk factors for several diseases and substance abuse patterns that tend to affect these populations, including acquired immune deficiency syndrome, or AIDS. In this regard, Dyer (2003) emphasizes that, "Contributing factors encompass the growing threat of infectious diseases including HIV / AIDS; the continual threat of natural disasters; a disproportionately large number of substance abusers; other lifestyle-associated health conditions and problems; and the many Floridians without access to health care services" (p. 37).

In this setting, it is not surprising that Florida has also experienced an inordinately higher AIDS rate than the country since reporting became mandatory in the early 1980s. Acquired immune deficiency syndrome cases were first made reportable in Florida in 1981 (AIDS surveillance data, 2012) and the surveillance data since that time shows a clear and steady increase of the prevalence and incidence of AIDS in Florida. In 1981, there were 152 cases of AIDS in the United States and seven cases in Florida. By 1982, though, the number of cases in Florida had increased to 65 and nationwide there were 1,300 cases (Year-by-year, 2012). By 1988, the state of Florida had 4,723 reported AIDS cases out of a population of 12,503,800, a rate of 37.8 cases per 100,000 people (Goicoechea-Balbona, 1998). By 1989, there were 115,786 AIDS cases in the U.S. And 9,802 cases in Florida. By the turn of the century, there were 774,467 AIDS cases in the U.S. And 76,543 cases in Florida. In 2004, there were 916,997 AIDS cases in the U.S. And 95,566 cases in Florida (Year-by-year, 2012).

The most recent data reported by the Florida State Department of Heath (based on 2009 estimates) indicates there were 1,108,611 AIDS cases in the U.S. And 121,161 cases in Florida (Year-by-year, 2012). Minorities, especially younger, lower-income Latinos, are at higher risk for acquiring AIDS. Currently, 70% of all Latinos in the United States live in just five states: California, Texas, New York, Florida, and Illinois, and young Latinos experience disproportionately high rates of AIDS (Perez, 2004).

At the national level, 25% of people living with AIDS or HIV in 2006 were aged 50 years and older, an increase from approximately 65,000 in 2001 to approximately 116,000 in 2005 (Jacobson, 2011). Although there may be other factors involved in these rising trends (such as improved reporting mechanisms and more effective treatments that extend lifespans of AIDS infected patients), there does appear to be a general increase in the AIDS rates for adults over the age of 50 years, including in the state of Florida (Jacobon, 2011). According to Jacobson, "In Florida, the number of older women newly diagnosed with AIDS rose 40% between 2000 and 2005. In 2005, adults age 50 and older accounted for 15% of new HIV and AIDS diagnoses and 35% of all AIDS-related deaths" (2011, p. 11).

In sum, Florida's population of 18.8 million ranks it fourth in the country, but it has a cumulative AIDS case rate of 124,069 which ranks it third in the nation. Moreover, the state's cumulative pediatric AIDS case rate of 1,543 ranks it second in the U.S. (AIDS surveillance data, 2012). At present, there are about 95,000 Floridians living with either HIV or AIDS (AIDS surveillance data, 2012). According to Nichols, Speer, Watson, Vergon, Vallee and Meah (2002), these AIDS sufferers are "relatively healthy, have unimpaired activities of daily living and cognitive functioning, and are slightly better educated than others their age in the general population" (pp. 28-29).

Finally, the five Florida counties with the highest AIDS rates are set forth in Table 1 and depicted graphically in Figure 2 below.

Table 1

Five Florida Counties with Highest AIDS Rates: 2010

County

Number of Cases

Miami-Dade

1,242

Broward

Orange

Duval

Hillsborough

Figure 1. Five Florida Counties with Highest AIDS Rates: 2010

Source: Based on tabular data from AIDS surveillance data (2012)

It is important to note that increased AIDS cases in 2004 were attributable to increased statewide CD4 testing that year. Likewise, delays in electronic laboratory reporting in late 2007 resulted in a decreased number of AIDS cases that year, and contributed to a spike the following year. In addition, the expansion of electronic lab reporting also facilitated the timeliness of reporting efforts in ways that further contributed to the spike experienced in 2008 as well as the dip that occurred in 2009 and 2010 (AIDS surveillance data, 2012). These reporting waves are leveling out as of 2011 as shown in Table 2 and depicted graphically in Figure 2 below.

Table 2

AIDS cases and rates, by year of report, 2002-2011: State of Florida

Year

No. Of AIDS Cases

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

Source: AIDS surveillance data, 2012

Figure 2. AIDS cases and rates, by year of report, 2002-2011: State of Florida

Source: AIDS surveillance data, 2012

Although innovations in pharmacological treatments for AIDS continue to increase the lifespan of AIDS sufferers, HIV / AIDS remains the leading cause of death both for black males and females aged 25 to 44 years in Florida (Dyer, 2003). Moreover, AIDS is second only to unintentional injuries with respect to the causes of premature death and Florida has rates of death from unintentional injuries that are higher than the national norm (37.3 vs. 35.9/100,00) (Dyer, 2003). Taken together, these trends place Florida in the leading ranks of cumulative AIDS cases across the country. According to Dyer, "Florida has the third highest number of cumulative AIDS cases in the nation, and state rates currently account for 11% of all persons living with HIV / AIDS in the U.S." (p. 37).

These statistics paint the state with a very broad brush, though, and the reality is that the vast majority of these AIDS cases are concentrated in several metropolitan areas, some of which have AIDS rates higher than many other states combined. In this regard, Dyer reports that, "Of the six HIV / AIDS epicenters in the state, Miami currently reports 25,357 cases, a number that surpasses the combined cases of Georgia, Maryland, Massachusetts, and Virginia. Fort Lauderdale's rate of 13,594 cases is greater than the combined cases of Louisiana, Connecticut, Ohio, Michigan, North Carolina, South Carolina, Missouri, and Tennessee" (2003, p. 38). Besides the inordinately high rates of AIDS among ethnic groups in Florida, there are also significantly higher rates being experienced among other population groups, including the elderly, aged 65 years and older (Dyer, 2003).

There are also some differences in Florida's rates for the mode of disease exposure, with the state reporting higher rates for heterosexuals and injection drug users but lower rates for men who have sex with other men (Dyer, 2003). These trends have made accurately categorizing many AIDS cases difficult or even impossible, and the "no identified risk" category has experienced the largest growth as a result, making it difficult to formulate effective interventions for these Florida residents (Dyer, 2003).

The state of Florida provides a wide range of social and medical services for AIDS patients, including an AIDS Drug Assistance Program (ADAP), Housing Opportunity for… [END OF PREVIEW]

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