About AIDSVu
AIDSVu is a leading free resource for visualizing the HIV epidemic in the United States and seeks to engage and provide users with a highly interactive and easy way to access HIV surveillance data at enhanced geographic levels. AIDSVu currently maps HIV prevalence and new diagnoses data for all US states, all counties in 48 states, ZIP Codes in 41 cities, community/ward in 2 cities, and census tracts in 3 cities. The maps are also available to be viewed by demographic breakdowns and can be overlaid with HIV testing and treatment service locations to enable examination of these resources relative to HIV prevalence and diagnosis data at fine geographic levels. HIV Awareness Day infographics, as well as city and state profile pages provide supplementary visualizations and information and compliment the data presented in the maps and existing surveillance reports. Other public data, such as Census data on poverty, education, and health insurance, can be used to generate tandem-tethered interactive maps and provide context considering social determinants of health. Consumer-oriented features include locator functions for HIV testing, HIV care facilities, and HOPWA grantee sites. Downloadable resources include data sets, map images, and PowerPoint slide decks of HIV prevalence maps. Below you can learn more about the data methods and sources for the state and county data on AIDSVu. Click here to learn more about data methods and sources for ZIP Code, census tract, or neighborhood/community area/ward data.
Definitions
Prevalence Data: The data reflect persons living with diagnosed HIV infection or persons living with diagnosed HIV infection ever classified as stage 3 (AIDS) at the end of 2014. The map title “Persons Living with Diagnosed HIV” has been used to encompass persons living with diagnosed HIV and persons living with diagnosed HIV infection ever classified as AIDS. Cases are based on most recent known address.
New HIV Diagnoses Data: The data reflect persons newly diagnosed with HIV infection, defined as a diagnosis of HIV infection regardless of the stage of disease (stage 0, 1, 2, 3 [AIDS], or unknown) and refers to all persons with a diagnosis of HIV infection during a given 1-year time period (i.e. 2015). Multiple single-year data are available from 2008-2015. The map title “Persons Newly Diagnosed with HIV” has been used to encompass persons newly diagnosed with HIV and/or AIDS.
Mortality Data: The data reflect deaths of persons diagnosed with HIV infection or with diagnosed HIV infection classified as stage 3 (AIDS) regardless of the cause of death. The map title “Deaths of persons diagnosed with HIV” has been used to encompass deaths of persons diagnosed with HIV and/or AIDS.
HIV Surveillance Data
The HIV prevalence and new HIV diagnoses data presented on AIDSVu are collected by state and local health departments, and de-duplicated and processed by the U.S. Centers for Disease Control and Prevention (CDC) to meet data quality standards for comparability and reliability. All 50 states, the District of Columbia (DC), and U.S. territories collect comparable confidential, name-based case reports of persons living with diagnosed HIV infection. All diagnoses are based on an established case definition. Medical providers, laboratories, and other organizations providing HIV testing services are required, by law, to report persons diagnosed with HIV to the state or local health department. Health departments report case data without names to CDC for monitoring of the national HIV epidemic.
Data Source
All state- and county-level HIV surveillance data for AIDSVu were obtained from CDC’s national HIV surveillance database housed in the Division of HIV/AIDS Prevention’s HIV Incidence and Case Surveillance Branch in Atlanta, GA. Data were released to AIDSVu by CDC in accordance with HIV-surveillance-specific data re-release agreements between CDC and each state/U.S. territory health department, and in accordance with other CDC data release guidelines. Data reflected on AIDSVu may slightly differ from data obtained directly from state HIV surveillance programs (e.g., on a state health department website or through a data request to a state surveillance program) because states may use analysis criteria that are different from the criteria used by AIDSVu. Further, data on AIDSVu may differ from data obtained directly from the states because AIDSVu’s data source was the CDC’s National HIV Surveillance System, from which duplicate records are removed. In addition to state- and county-level data, AIDSVu also displays ZIP Code data for 41 jurisdictions (i.e., cities or Metropolitan Statistical Areas or select counties or ZIP Codes), and a few cities have census tract- and/or neighborhood-level data as well. More information about where these data come from and their presentation on AIDSVu can be found here.
All state- and county-level HIV surveillance data displayed on AIDSVu maps and state profile pages are estimated data for persons aged 13 and older living with diagnosed HIV infection as of December 31, 2014. New HIV diagnoses data include persons aged 13 and older diagnosed with HIV infection between January 1, 2008 and December 31, 2015, displayed year-by-year. Estimated numbers resulted from statistical adjustment that accounted for reporting delays and missing risk-factor information, but not for incomplete reporting. Estimates are based upon actual data reported to CDC through June 2016 (See CDC methodology for estimating HIV prevalence). Most recent known address was used in all analyses. Denominators used to calculate rates for all state and county populations were obtained by the CDC from the U.S. Census Bureau’s census for each respective year. Population denominators are restricted to persons aged 13 and older. There are no county-level maps for Alaska, District of Columbia, and Puerto Rico, because there are no counties in these states.
Estimated rates of persons living with diagnosed HIV infection were calculated per 100,000 population to permit data standardization and comparison. For estimated rate ratios by race/ethnicity displayed on state profile pages, White race is the referent group.
Data Suppression and Rate Stability
To protect the privacy of persons living with diagnosed HIV infection, AIDSVu does not display rates and case counts for states and counties when one or more of the following suppression criteria are met:
- Numerator (number of persons living with diagnosed HIV infection) is less than 5 at the county-level and/or the denominator (number of people in the county in that population group) is less than 100. If the overall county case count is less than 5 and/or the overall county population is less than 100, all data for the county are suppressed.
- For breakdowns by sex at the county-level, if either the male or female rate and/or case count is suppressed because of the numerator/denominator thresholds mentioned in #1, both sex groups are suppressed to prevent indirect identification.
- For breakdowns by age at the county-level, if the rate and/or case count for only one age group is suppressed in a county because of the numerator/denominator thresholds mentioned in #1, then the 13-24 age group is also suppressed to prevent indirect identification. If the 13-24 age group is the only age group suppressed for a county, then the 55+ age group is also suppressed.
- If data for only one county in a state is suppressed, then one additional county is also suppressed, with the additional county selected based on having the smallest total population of the remaining counties. In the event there are multiple counties in a state with the exact same total population, the county with the lowest number of HIV cases is also suppressed. In the event there are multiple counties in a state with the same total population and the same total number of HIV cases, then both or all of these counties are suppressed.
States and counties are noted by the color white when one or more of these conditions are met. As is standard in the display of health statistics, rates generated from a numerator less than 12 are considered unstable and should be interpreted with caution. Because rates at the county-level are not displayed when the numerator is less than 5, the “unreliable rate” indicator will only display when the numerator is 5 or greater and less than 12.
For year-by-year new HIV diagnoses data, if the overall county case count breakdown is less than 5, all data for the county are suppressed.
Data Stratification
AIDSVu allows viewers to look at state- and county-level HIV surveillance data at the overall geographic level, and by race/ethnicity, sex, and age groups. Additionally, AIDSVu displays transmission categories with two-way stratification possibilities at the state level for both prevalence and new HIV diagnoses. The county-level HIV prevalence data includes one-way transmission categories in addition to the other demographic data. All race groups are non-Hispanic, and the Hispanic/Latino ethnicity is inclusive of all races. Sex is defined as “sex at birth.” Cases were assigned to age groups based on “age at the end of 2014.” Caution should be exercised when viewing and interpreting these different maps because the scales change across the different demographic breakdowns and geographic levels.
Data Caveats
Data are displayed only for black, white, and Hispanic/Latino persons at the county level because data for Asian, Native Hawaiian/Other Pacific Islander, Multiple Race, and American Indian/Alaska Native persons do not meet CDC’s criteria for statistical reliability, data quality, or confidentiality due to small population denominators or small HIV case counts.
- Race/ethnicity data for Puerto Rico is displayed only by case counts and not by rate.
- New HIV diagnoses data are displayed only for overall rates and cases and not for any race/ethnicity, sex, or age groups at the county level.
- Due to the data re-release agreement between the state and CDC, South Dakota does not display county-level data.
Ranges/Legend Values
Range intervals were initially developed using deciles in SAS analytic software (SAS Institute, Cary, NC). Set cut points were derived using rounded deciles from the previous year, when previous year data were available. When previous year deciles were not available, rounded current year deciles were used for data new to this release. In order to illustrate the variation in the data, ranges were developed specific to each geographic level (i.e., states or counties), for each one-way grouping (i.e., overall, separately by race, by sex, by age group and by transmission category), and for each two-way group combination (i.e., by sex and age group, by sex and race, by sex and transmission category, etc.), when data were available.
Thus, for state prevalence and new HIV diagnoses maps, a total of 19 sets of map scales exist for each (rate/count by overall/race/sex/age/two-way, proportion/case by transmission category and age/transmission category and sex/transmission category and race, and transmission category total case counts for heterosexual, IDU, and other). For state mortality, there are 15 sets of scales (rate/count by overall/race/sex/age and proportion/case by male/female transmission category, and transmission category total case counts for heterosexual, IDU, and other). A total of eight sets of map scales exist for county-level prevalence data (rate/count by overall/race/sex/age and proportion/case by male/female transmission category). For county-level new HIV diagnoses maps, a total of two map scales exist (rate/count by overall).
For each scale calculation, the original deciles used to create the rounded set cut points were determined by combining the individual rates or counts for all areas with data included on the maps for that geographic level and demographic grouping.
Social Determinants of Health
Social determinants of health are displayed on a secondary map and their associated scales were developed using the same method as above. Therefore, there are 5 additional ranges for both state- and county-level data. The five social determinants displayed are: poverty (percent of population living in poverty), high school education (percent of population with a high school degree or equivalent), median household income, income inequality (measured by the Gini Coefficient, a measure of income inequality where 0 reflects complete equality and 1 reflects complete inequality), and people without health insurance (percent of population lacking health insurance).
Corrections Warning
The data displayed on AIDSVu include state and federal correctional populations. Their inclusion may artificially inflate the HIV prevalence rate and case count of counties that house institutions. A correctional warning is displayed in the map hover-over balloon of certain counties when artificial inflation may be present based on predefined criteria.
To determine in which counties the correctional warning should appear, the following process and predefined thresholds were used to categorize counties.
- All U.S. counties were categorized by level of urbanization using the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme.
- Federal and state correction populations were obtained for each county from the 2010 U.S. Census.
- Within these strata of urbanization, counties are assigned the corrections warning if they had:
- Above average HIV prevalence rate (as compared to counties with no correctional population)
AND
-
- Above average correctional population or above average percent of the population housed in state/federal correctional institutions
Static Maps
HIV Ever Tested data from the BRFSS were obtained from the CDC’s State HIV Prevention Progress Report, 2010-2013, which was released in December 2015. People aged 18-64 years were asked the question, “Have you ever been tested for HIV? Do not count tests you may have had as part of a blood donation. Include testing fluid from your mouth.”
Medicaid Expansion data were obtained from the Kaiser Family Foundation’s “Status of State Action on the Medicaid Expansion Decision,” KFF State Health Facts, updated January 12, 2016.
Data Sources
Surveillance Data
| Data Element | Location on AIDSVu | Data Source | Anticipated Update Frequency on AIDSVu Website |
| Estimated Rates and Case Counts of Persons Living with Diagnosed HIV, State & County Data | Maps | Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch; Data Request, January 2017. | Annually |
| Estimated year-by-year Rates and Case Counts of Persons Newly Diagnosed with HIV, 2008-2014, State & County Data | Maps | Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch; Data Request, January 2017. | Annually |
| Estimated % Late HIV Infection Diagnoses | State Profile Pages | Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch; Data Request, January 2017. | Annually |
| Estimated HIV Prevalence Rate Ratios by Race/Ethnicity | State Profile Pages | Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch; Data Request, January 2017. | Annually |
| Estimated HIV Prevalence Case Counts and Percentages by Transmission Category, State & County Level | Maps; State Profile Pages | Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch; Data Request, January 2017. | Annually |
| STD Case Counts and Rates | State Profile Pages | Centers for Disease Control and Prevention. Sexually Transmitted Disease ATLAS website. | Annually |
| Age-Adjusted HIV Mortality Rates, 2011-2013 | State Profile Pages | Centers for Disease Control and Prevention; National Center for Health Statistics. Compressed Mortality File (CMF) on CDC WONDER Online Database, 1999-2015. | Annually |
| State Progress Toward CDC’s Division of HIV/AIDS Prevention Goals for 2015 | State Profile Pages | Centers for Disease Control and Prevention; HIV Surveillance Supplemental Report, 2014. | Annually |
Service Locators and Federal Funding for HIV/AIDS
| Data Element | Location on AIDSVu | Data Source | Anticipated Update Frequency on AIDSVu Website |
| HIV Testing Sites | Maps; HIV Testing Site Locator | Centers for Disease Control and Prevention, National Prevention Information Network; Ongoing Data Access Request. | Annually |
| Ryan White HIV/AIDS Medical Care Providers | Maps; HIV Treatment Site Locator | Health Resources and Services Administration, HIV/AIDS Bureau; Ongoing Data Access Request. | Annually |
| PrEP Locator | Maps; PrEP Locator | Emory University, Rollins School of Public Health; preplocator.org. | Annually |
| NIH-Funded HIV Prevention, Vaccine and Treatment Trials Sites | Maps | National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS; Ongoing Data Access Request. | Annually |
| Federal Grant Funding for HIV/AIDS, FY 2015 | State Profile Pages | Kaiser Family Foundation. State Health Facts. | Annually |
| Housing Opportunities for People with AIDS | Maps | US Department of Housing & Urban Development, Office of Community Planning and Development; Ongoing Data Access Request. | Annually |
Social Determinants of Health
State Health Department Websites
| Data Element | Location on AIDSVu | Data Source | Anticipated Update Frequency on AIDSVu Website |
| State Health Department Websites | State Profile Pages | State health departments and internet. | Annually |
Policy Maps
| Data Element | Location on AIDSVu | Data Source | Anticipated Update Frequency on AIDSVu Website |
| HIV Ever Tested, 2013 | AIDSVu in Use | BRFSS Data from the Centers for Disease Control and Prevention; HIV Prevention State Progress Reports, 2015. | Annually |
| Medicaid Expansion | AIDSVu in Use | “Status of State Action on the Medicaid Expansion Decision,” KFF State Health Facts, updated January 12, 2016 | Annually |
