2003 countywide risk assessment survey findings from a large-scale multi-site survey in los angeles...

2003 Countywide Risk Assessment Survey

Findings From a Large-scale Multi-site Survey in Los Angeles County

Pamela Ogata, Research & EvaluationMike Janson, Research & EvaluationOffice of AIDS Programs and Policy

Presented at the Los Angeles HIV Prevention Planning Committee Meeting, January 6, 2004

Los Angeles County

4,061 Square Miles

9.9 Million Residents (Estimated)

Proportion of State Population: 27%(Estimated)

Proportion of State AIDS Cases: 35%

Living with HIV/AIDS: 52,000 (Estimated)

2

South

South Bay

West

San Fernando

Metro

San Gabriel

Antelope Valley

East

2003 Estimated Population Statistics, U.S. Census Bureau

HIV/AIDS Semi-Annual Surveillance Summary, Los Angeles County HIV Epidemiology Program

Source: 2003 CRAS Data (weighted) 3

Background

One Important Data Source for

Priority Setting Evaluation of the Linkages Among

HIV Prevention PlanResource AllocationCDC Application

Local Needs Assessment


Provider Trainings

22 Trainings (May 2003) 238 Staff from 50 Agencies

Attended Training covered

Sampling MethodologySurvey Instruments and ProceduresIRB and HIPAA protocolsCalifornia Mandated Child and Elder

Abuse Reporting On-Site Technical Assistance


CRAS 2003 Participation

Surveys Total Expected: 2,520 Total Received: 2,107

Survey Return Rate: 83.6% Total Completed: 1,847

Proportion of Surveys Complete: 87.7%

Agencies 47 out of 50 Participated

Programs 164 out of 175 Participated


Instrument and Eligibility

Four Sections Examine Behavior and Perceptions

EligibilityReceiving HIV Prevention Services from

OAPP-funded Contractor(s) in Los Angeles County

12 Years of Age or OlderNot Previously Surveyed in 2003

7

Data Collection and Analysis Surveys Administered May 5 -July 30,

2003Agency StaffOne-on-one Interviews

RespondentsRandomly Selected Using Systematic

SamplingReceived Compensation (Value $10)

Data EntryOAPP StaffPassword-protected DatabaseData Entry Error Rate was <2%No Critical Variables Involved

8

Weighting

Surveys Weighted to Represent Average Number of Prevention Service Clients by Agency

Analyses Conducted on Weighted Sample Equivalent to 5,147


Clients by Service Planning Area

05

101520253035404550

1 2 3 4 5 6 7 8

CRAS HCT data PPC Priorities

SPAs

N=5147

Pe

rce

nt


Numbers may not equal 100% due to rounding

CRAS Respondents by Gender

Female25%

Male71%

TG F-M0.1%

TS M-F0.3%

TG M-F3%

N=5147


Clients by Age

05

1015202530354045

12-14 15-19 20-24 25-29 30-34 35+

CRAS N=5,147 HCT data N=23,875

Pe

rce

nt


CRAS Respondents by Race Ethnicity and Service Planning Area

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6 7 8

Afr-Am N. Am A/NH/OPI White Latino

N=5147

Pe

rce

nt


Selected CRAS Respondents by Education

N=3,696

Completed HS or received a GED 76.7%

1-2 years of college includes technical/ vocational school

40.8%

3 or more years of college 21.6%

Four-year college degree 15.6%

Graduate or professional school 5.7%

Of participants 25 years of age or older…


CRAS Respondents by Living Situation

House or Apartment 70.2%

Transitional Living (Halfway House, Treatment Center, Board and Care Facility, Hotel, Motel or Rooming House)

20.0%

Homeless (Shelter, Mission, Vacant Building, Car or Other Vehicle, Outside, Street, Park, Bench, Under an Overpass)

8.6%

With Friends or Relatives 0.6%

Numbers may not equal 100% due to rounding and missing data


Proportion of CRAS Respondents Who Are Homeless by PPC Priority

Pe

rce

nt

0

10

20

30

40

50

60

MSM MSM/W MSMIDU HM/IDU F/IDU WSR TG N. Am HIV+

Source: 2001-03 CRAS Data (weighted) 16

Homeless CRAS Respondents

26.7% 31.9% 28.6%

0

10

20

30

40

50

60

70

80

90

100

2001 2002 2003

Pe

rce

nt


Of CRAS Respondents

22% Born Outside of the United States

Mexico57%

Philippines6%

Other17%

El Salvador9%

Columbia3%

Guatemala8%


CRAS Respondents and Substance Use

Any Substance

86.9% Alcohol

71.8% Tobacco

56.3% Marijuana

37.3% Any Drug

56.8%(Excluding Marijuana, Alcohol,

Tobacco) Crack Cocaine

19.1% Crystal Methamphetamine

15.6%


CRAS Respondents and Substance Use (Cont’d)

Heroin

14.3% Cocaine (not crack)

11.4% Other Opiate

10.9% Speedball

7.2% Inhalant

6.8% Other Amphetamine

6.5% Club Drugs

6.9% Other Drugs

6.8%


CRAS Respondent Drug Use by BRG

0102030405060708090

MSM MSM/W MSM/IDU HM/IDU F/IDU WSR

Crystal Crack Cocaine Heroin Club Drugs

Pe

rce

nt

N=3,684


CRAS Respondent Injection Drug Use

N=5,147

Injected Drugs (last 6 mos.) 19.1%

N=990

Shared Needle(s) 56.2%

Cleaned Needle(s) with Bleach 37.8%

Of those who injected drugs…


Sexual Risk BehaviorsHIV-Negative CRAS Respondents

Main CasualPartner

PartnerN=1,825

N=1,716Had a Main Partner 65.3%Had a Casual Partner(s)

61.4%Median Number Casual Partners 5Partner(s) HIV-Positive 4.2%

6.0%Did Not Know Partner(s) Serostatus 9.5%

39.3%Partner(s) Injects Drugs 16.1%

17.1%Sex While High 58.1%

65.4%Inconsistent Condom Use 74.1%

59.2%


Sexual Risk BehaviorsHIV-Positive CRAS Respondents

Main CasualPartner

PartnerN=1,825

N=1,716Had a Main Partner 61.5%Had a Casual Partner(s)

64.6%Median Number Casual Partners 6Partner(s) HIV-Positive 53.8%

35.3%Did Not Know Partner(s) Serostatus 8.0%

51.1%Partner(s) Injects Drugs 22.0%

26.2%Sex While High 44.2%

59.8%Inconsistent Condom Use 48.1%

57.2%


Male CRAS Respondents, Sexual Orientation and Sexual Behavior

Self-Reported Sexual Orientation31.7% Heterosexual52.6% Gay15.7% Bisexual

Sexual BehaviorProportion of Heterosexual Men who

Reported Sex with a Man

13.4%Proportion of Gay Men Reporting Sex

With a Woman <1%


CRAS Respondents by Behavioral Risk Group (BRG) N=5,147

MSM35%

WSR15%

Unknown29%

MSM/IDU4%

MSM/W6%

Hetero Male IDU4%

Female IDU7%


Clients by Behavioral Risk Group (BRG)

0

10

20

30

40

50

60

70

MSM MSM/W MSM/IDU HeteroMale IDU

FemaleIDU

WSR Unknown

CRAS HCT

Pe

rce

nt


CRAS Respondents by Behavioral Risk Group (BRG) and SPA

0

10

20

30

40

50

1 2 3 4 5 6 7 8

MSM MSM/W MSM/IDU HM/IDU F/IDU WSR

Pe

rce

nt


Reported Inconsistent Condom, Barrier Use by PPC Priorities

Pe

rce

nt

0

10

20

30

40

50

60

70

80

90

100

MSM MSM/W MSMIDU HM/IDU F/IDU WSR TG NA HIV+

Main Partner Casual Partner


CRAS Respondents and HIV Counseling & Testing

HE/RR, HCT Clients

N=4,903Ever Received HCT

87.2%Received HCT Results

82.1%HCT Last Six Months

51.2%


CRAS Respondents and HIV Counseling & Testing (Cont’d)

Received HCT Results

N=4,021HIV-Positive

10.1%Positive Result, Last Six Months

4.5%HIV-Negative

82.6%Unknown

5.8%

Source: 2001-03 CRAS Data (weighted) 31

CRAS Respondents by HIV Counseling & Testing 2001-2003 (HE/RR, HCT clients)

0

10

20

30

40

50

60

70

80

90

100

2001 2002 2003

ReceivedCouselingandTesting

ReceivedResults

Receiveda Test inthe Last 6Months

Pe

rce

nt


Limitations

Limited Time PeriodMay Not Capture All Drug UsersMay Contribute to the Unknown BRG

Category

33

Conclusions

CRASProvides timely and geographically

relevant data.Shows a need for more focused

outreach in communities of colorSuggests a need to refine the targeting

of prevention services


Data Requests

Please send an e-mail or FAX data request to:

Pamela [email protected]

or

Mike [email protected]

Fax: 213/381-8023

This presentation is available at

www.LAPublicHealth.org/AIDS

2003 countywide risk assessment survey findings from a large-scale multi-site survey in los angeles...

Documents

participated slide

cras data

data collection

important data source

technical assistance

hiv prevention services

survey return rate

proportion of state