Structure and Properties of Aldehydes and Ketones
Aldehydes and ketones are polar compounds with distinct structures and physical properties. The carbonyl group plays a key role in their behavior, leading to differences in boiling points and nomenclature. Understanding these aspects is essential in organic chemistry studies.
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NC Department of Health and Human Services HIV Continuum of Care in North Carolina 2022 Division of Public Health/Epidemiology Section/Communicable Disease Branch HIV/STD/Viral Hepatitis Surveillance Unit August 2023 1
HIV Continuum of Care in North Carolina, 2009-2022 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 100% Percent of People Living with HIV 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and servicesfrom CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Estimated proportion living in NC and undiagnosed is based on CDC CD4 model; 2022 uses 2021 number. **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. 2020 data should be treated with caution due to reduced availability of testing caused by the COVID-19 pandemic Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 2
North Carolina HIV Continuum of Care 2022, Diagnosis Denominator Percent of People Living with HIV in 100% 90% 78% 80% 73% 67% 70% 60% NC 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 3
North Carolina HIV Continuum of Care 2022 Percent of People Living with HIV in 100% 88% 90% 78% 80% 72% 67% 70% 60% NC 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Estimated proportion living in NC and undiagnosed is from 2020. **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 4
Upside Down HIV Continuum of Care 2022 Undiagnosed* No Care Visit ** Not Retained in Care*** Not Virally Suppressed^ 0% Percent of People Living with HIV in NC 10% 12% 20% 22% 30% 27% 33% 40% 50% 60% 70% 80% 90% 100% *People 13 years of age estimated to have HIV but not be diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Estimated proportion living in NC and undiagnosed is from 2020. **People without at least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***People neither virally suppressed within 12 months nor having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year was more than 200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 5
HIV Continuum of Care: North Carolina (2022) and the United States (2021) North Carolina United States Percent of People Living with HIV 100% 88% 87% 90% 82% 78% 80% 73% 67% 66% 70% in NC 60% 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ *NC data: People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Estimated proportion living in NC and undiagnosed is from 2021. **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year; US number is people linked to care within 1 month *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (September 2022), NC ECHO (August 2022). Most recent CDC continuum is data from 2021 https://ahead.hiv.gov/). 6
2022 North Carolina Newly Diagnosed HIV Continuum of Care 1,600 1,400 92% Number of Newly Diagnosed HIV 89% 1,200 74% 71% 1,000 800 600 400 200 0 Diagnosed & Reported* Linked to Care within 1 Month** Linked to Care within 3 Months** Linked to Care within 6 Months** Virally Suppressed^ *People 13 years of age and diagnosed in and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given period. ^Virally suppressed is defined as the last viral load during the year being <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 7
90-90-90 Status in 2022: North Carolina 100% 90% 88% 80% 78% 70% 67% 60% 50% 40% 30% 20% 10% 0% 90% of all people living with HIV will know their HIV status.* 90% of all people living with HIV will be on anti-retroviral treatment (ART)** 90% of all people with diagnosed HIV infection and on ART will have viral suppression.^ *People 13 years of age and diagnosed in and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). *received ARTs is based on the number of people with a viral load or CD4 test in a given year (assumes lab tests imply receipt of ARTs) ^Last viral load during the year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 8
North Carolina HIV Continuum of Care by Gender, 2022 Women Men Transgender Percent of People Living with HIV 100 90 83% 79% 78% 76% 80 73% 72% 68% 67% 65% 70 in NC 60 50 40 30 20 10 0 Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Transgender status is based on self-report. Due to historical and current stigma, the total number of transgender people is likely to be an underestimation. This variable was not routinely captured until 2015 in our surveillance system. *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 10
HIV Continuum by Gender and Race/Ethnicity 11
North Carolina HIV Continuum of Care among Men by Race/Ethnicity, 2022 Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Percent of Men Living with HIV in NC 100% 90% 80% 74% 71% 71% 70% 64% 63% 56% 60% 50% 40% 30% 20% 10% 0% 0% American Indian/Alaska Native Asian/Pacific Islander Black/African American Hispanic/LatinX White/Caucasian Multiple Race Unknown Race/Ethnicity *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Non-Hispanic/LatinX. Data Sources : enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 12
North Carolina Viral Suppression^ among Men by Race/Ethnicity, 2018-2022 2018 2019 2020 2021 2022 Percent of Men Living with HIV in NC 100% 90% 80% 74% 71% 71% 70% 64% 63% 56% 60% 50% 40% 30% 20% 10% 0% American Asian/Pacific Islander* Black/African American* Hispanic/LatinX White/Caucasian* Multiple Race Indian/Alaska Native* Race/Ethnicity *Non-Hispanic/LatinX. Data are preliminary (do not include vital records or national death matches). ^Last viral load during the given calendar year <200 copies/ml. Data Sources : enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 13
North Carolina HIV Continuum of Care among Women by Race/Ethnicity, 2022 Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Percent of People Living with HIV in 100% 90% 80% 70% 69% 68% 67% 70% 63% 60% 50% NC 50% 40% 30% 20% 10% 0% 0% American Indian/Alaska Native Asian/Pacific Islander Black/African American Hispanic/LatinX White/Caucasian Multiple Race Unknown Race/Ethnicity *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Non-Hispanic/LatinX. Data Sources : enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 14
North Carolina HIV Continuum of Care among Transgender by Race/Ethnicity, 2022 Please note most of these groups have small numbers Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Percent of People Living with HIV 100% 90% 83% 78% 80% 70% 64% 60% 59% 60% in NC 50% 50% 40% 30% 20% 10% 0% American Indian/Alaska Native Asian/Pacific Islander Black/African American Hispanic/LatinX White/Caucasian Multiple Race Unknown Race/Ethnicity Transgender status is based on self-report. Due to historical and current stigma, the total number of transgender people is likely to be an underestimation. This variable was not routinely captured until 2015 in our surveillance system. *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. *** Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Last viral load during the given calendar year <200 copies/ml. Non-Hispanic/LatinX. Data Sources : enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 15
North Carolina HIV Continuum of Care among Men by Current Age, 2022 Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Percent of People Living with HIV in 100% 90% 80% 71% 70% 67% 66% 66% 70% 63% 62% 60% NC 50% 40% 30% 20% 10% 0% 13-14 15-24 25-34 35-44 45-54 55-64 65 and older Current Age^^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. ^^ Age as of December 31, 2022. Data Sources : enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 17
North Carolina HIV Continuum of Care among Women by Current Age, 2022 Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Percent of People Living with HIV in 100% 90% 80% 75% 73% 72% 68% 66% 70% 60% 60% NC 60% 50% 40% 30% 20% 10% 0% 13-14 15-24 25-34 35-44 45-54 55-64 65 and older Current Age^^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. ^^ Age as of December 31, 2022 Data Sources : enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 18
North Carolina HIV Continuum of Care among Transgender^ by Current Age, 2022 Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Percent of People Living 100% 90% with HIV in NC 76% 75% 80% 70% 70% 63% 62% 62% 60% 50% 40% 30% 20% 10% 0% 13-14 15-24 25-34 35-44 45-54 55-64 65 and older Current Age^^ Transgender status is based on self-report. Due to historical and current stigma, the total number of transgender people is likely to be an underestimation. Subgroups of transgender people are small and variations between subgroups may appear large; please interpret these numbers cautiously. *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in 2022. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in 2019. ^Virally suppressed is defined as the last viral load in the calendar year with a value of <200 copies/ml. ^^ Age as of December 31, 2022 Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 19
North Carolina HIV Continuum of Care among People who Reported Heterosexual Contact by Binary Gender, 2022 100% 100% Women Men Percent of People Living with HIV in NC 100% Who Report Heterosexual Contact 90% 81% 76% 76% 80% 70% 70% 70% 63% 60% 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 21
North Carolina HIV Continuum of Care among People Who Inject Drugs by Gender, 2022 100% 100% 100% Women Men Transgender Percent of People Living with HIV in NC Who Report Injecting Drugs 100% 90% 77% 77% 76% 80% 72% 72% 70% 66% 70% 63% 60% 52% 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Transgender status is based on self-report. Due to historical and current stigma, the total number of transgender people is likely to be an underestimation. Subgroups of transgender people are small and variations between subgroups may appear large; please interpret these numbers cautiously. *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 22
North Carolina HIV Continuum of Care among Gay, Bisexual and Other Men Who Have Sex With Men, 2022 100% Percent of GBMSM Living with HIV in 100% 90% 82% 76% 80% 70% 70% 60% NC 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 23
North Carolina HIV Continuum of Care Among People With Other Risk^^ by Gender, 2022 100% 100% Female Male Transgender Percent of People Living with HIV in NC 100% 90% 76% 80% 71% 69% 65% with Other Risk 70% 62% 56% 60% 50% 40% 30% 20% 10% 0% 0% 0% 0% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Transgender status is based on self-report. Due to historical and current stigma, the total number of transgender people is likely to be an underestimation. Subgroups of transgender people are small and variations between subgroups may appear large; please interpret these numbers cautiously. ^^Includes reported exposure to HIV via blood products (adult hemophilia or transfusions), pediatric risk, needle sticks, and health care exposure. *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 24
North Carolina HIV Continuum of Care among People with Unknown Risk by Gender, 2022 100% 100% 100% Female Male Transgender Percent of People Living with HIV in 100% 84% 90% 76% 76% NC with Unknown Risk 80% 71% 69% 67% 66% 70% 63% 58% 60% 50% 40% 30% 20% 10% 0% Diagnosed & Reported* At Least 1 Care Visit ** Retained in Care*** Virally Suppressed^ Transgender status is based on self-report. Due to historical and current stigma, the total number of transgender people is likely to be an underestimation. Subgroups of transgender people are small and variations between subgroups may appear large; please interpret these numbers cautiously. *People 13 years of age and diagnosed and living through December 31 of each calendar year. Data includes labs and services from CAREWare (all Ryan White services excluding Part A), HIV Medication Assistance Program (HMAP), and Medicaid data sources. Data are preliminary (do not include vital records or national death matches). **At least 1 care marker (CD4 or VL test, HMAP dispense, or Medicaid claim) in the given calendar year. ***Retained in care is defined as being virally suppressed within 12 months or having 2 or more care markers (CD4 or VL test, HMAP dispense, or Medicaid claim) at least 90 days apart in the given calendar year. ^Virally suppressed is defined as the last viral load during the given calendar year <200 copies/ml. Data Sources: enhanced HIV/AIDS Reporting System (eHARS) (June 2023) and NC ECHO (June 2023). 25
