Mass.Gov · Web view2019/02/20 · Massachusetts Department of Public Health. Bureau of Infectious...

Massachusetts Department of Public HealthBureau of Infectious Disease and Laboratory Sciences

2018 Massachusetts HIV/AIDS Epidemiologic ProfileRegional HIV/AIDS Epidemiologic Profile of

Plymouth County, Massachusetts

Suggested citation:

Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory Sciences. 2018 Massachusetts HIV/AIDS Epidemiologic Profile: Regional HIV/AIDS Epidemiologic Profile of Plymouth County, Massachusetts. https://www.mass.gov/lists/hivaids-epidemiologic-profiles Published September 2018. Accessed [date].

Massachusetts Department of Public Health Bureau of Infectious Disease and Laboratory Sciences305 South StreetJamaica Plain, MA 02130

To speak to the on-call epidemiologist

Tel: (617) 983-6800

Questions about infectious disease reporting

Tel: (617) 983-6801

Questions about this report

Tel: (617) 983-6560

Requests for additional data

https://www.mass.gov/lists/infectious-disease-data-reports-and-requests

Slide sets for 2018 Epidemiologic Profile Reports

https://www.mass.gov/lists/hivaids-epidemiologic-profiles


https://www.mass.gov/lists/infectious-disease-data-reports-and-requests


2018 Regional HIV/AIDS Epidemiologic Profile of Plymouth County

Table 1. Total number of people reported with HIV infection or AIDS1

by mortality status on January 1, 2018: Plymouth County, Massachusetts

N %

People Living with HIV infection2 999 64%People Reported with HIV or AIDS Who Are Deceased3 573 36%Total Number of People Reported with HIV Infection or AIDS 1,572 100%

1 Does not include individuals diagnosed with HIV infection (non-AIDS) who died prior to January 1, 1999 or who were not in care on January 1, 1999.2 HIV prevalence data include all individuals who were residing in Massachusetts as of 1/1/18, regardless of where they were first diagnosed.3 All-cause HIV/AIDS death data include only individuals who were first diagnosed in Massachusetts.Data Source: MDPH Bureau of Infectious Disease and Laboratory Sciences, data are current as of 1/1/18 and may be subject to change

Table 2. Average annual rate of HIV infection diagnosis1 from 2014 to 2016 and HIV prevalence2 rate on 1/1/18: Plymouth County, Massachusetts

Average annual HIV diagnosis rate from 2014–2016 Average rate per 100,000

Average annual number of HIV

diagnosesPlymouth County, MA 7.1 35Massachusetts Total 9.7 633

HIV prevalence rate on 1/1/18 Rate per 100,000

Number of people living with HIV infection

Plymouth County, MA 201.9 999Massachusetts Total 337.7 22,112

1 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.2 HIV prevalence data include all individuals who were residing in Massachusetts as of 1/1/18, regardless of where they were first diagnosed.Data Source: MDPH Bureau of Infectious Disease and Laboratory Sciences, data are current as of 1/1/18 and may be subject to change; The denominators for rate calculations are from the MDPH Massachusetts Race Allocated Census 2010 Estimates (MRACE 2010), Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation

2


Table 3. People living with HIV infection,1 deaths among people reported with HIV/AIDS,2 and newly diagnosed HIV infections3 by year: 2007–2016, Plymouth County, Massachusetts

Year HIV Prevalence1 Deaths among those with HIV/AIDS

Diagnosis of HIV Infection

2007 590 12 372008 615 14 352009 635 11 352010 657 9 322011 680 12 452012 711 8 442013 746 17 482014 775 9 292015 794 9 312016 816 10 45

1 Number of individuals living with HIV infection on 12/31 of each year. Residence calculated based on vital status. For those alive as of 1/1/18, residence based on most recent record available. For those deceased with known residence at death, residence at death. For those deceased with unknown residence at death, residence at diagnosis.2 All-cause HIV/AIDS death data include only individuals who were first diagnosed in Massachusetts.3 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.Data source: MDPH Bureau of Infectious Disease and Laboratory Sciences, data are current as of 1/1/18 and may be subject to change

3


Table 4b. Number and percentage of people diagnosed with HIV infection from 2014–20161 and people living with HIV infection (ILWH) on 1/1/182 by sex at birth, place of birth, race/ethnicity, exposure mode, and age: Plymouth County, Massachusetts

HIV Infection Diagnoses ILWHSex at Birth: N % N %Male 69 66% 626 63%Female 36 34% 373 37%Place of Birth: N % N %US ≥57 N/A 620 62%Puerto Rico/US Dependency3 <5 N/A 38 4%Non-US 44 42% 341 34%Race/Ethnicity: N % N %White (non-Hispanic) 32 30% 429 43%Black (non-Hispanic) 55 52% 430 43%Hispanic/Latino 15 14% 117 12%Asian/Pacific Islander <5 N/A 11 1%Other/Undetermined <5 N/A 12 1%Exposure Mode: N % N %Male-to-male sex (MSM) 28 27% 288 29%Injection Drug Use (IDU) 10 10% 113 11%MSM/IDU <5 N/A 32 3%Heterosexual Sex 11 10% 192 19%Other4 <5 N/A 28 3%Total No Identified Risk (NIR) 52 50% 346 35% Presumed Heterosexual Sex5 20 19% 138 14% NIR6 32 30% 208 21%Age: N % N %

At Diagnosis On January 1, 2018Under 13 0 0% 0 0%13 to 19 <5 N/A 5 1%20 to 24 12 11% 15 2%25 to 29 11 10% 36 4%30 to 34 16 15% 54 5%35 to 39 14 13% 56 6%40 to 44 12 11% 74 7%45 to 49 9 9% 111 11%50 to 54 10 10% 180 18%55 to 59 <5 N/A 200 20%60 to 64 8 8% 137 14%65 to 69 <5 N/A 77 8%70+ <5 N/A 54 5%Total8 105 100% 999 100%1 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.2 HIV prevalence data include all individuals who were residing in Massachusetts as of 1/1/18, regardless of where they were first diagnosed.3 All individuals diagnosed with HIV infection from 2014–2016 who were born in a US dependency were born in Puerto Rico; 99% of individuals living with HIV infection in MA who were born in a US dependency were born in Puerto Rico,1% were born in US minor outlying areas, <1% were born in the US Virgin Islands, and <1% were born in Guam.4 Includes pediatric and blood/blood products exposure modes5 Includes a woman having sex with a man of unknown HIV status or risk. This category is limited to women only.6 Includes a man having sex with a woman of unknown HIV status or risk, those still being followed up for risk information, those who have died with no determined risk, and those lost to follow-up.7 Value >5 suppressed to protect privacy, N/A=Not Applicable8 Total includes numbers suppressed to protect privacyData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

4


Table 5. Number and percentage of people living with HIV infection on January 1, 2018 by sex at birth1 and race/ethnicity: Plymouth County, Massachusetts2

Men WomenRace/Ethnicity: N % N %

White (non-Hispanic) 342 55% 87 23%Black (non-Hispanic) 191 31% 239 64%Hispanic/Latino 78 12% 39 10%Total3 626 100% 373 100%

1 Data reflect sex at birth not gender identity or gender expression of transgender individuals (N=107 transgender individuals living with HIV infection in MA). Please note “women” and “men” are used for stylistic reasons to describe female and male populations diagnosed with HIV infection that include a small number of girls and boys (N=24 children living with HIV infection under age 13 as of 1/1/18). 2 HIV prevalence data include all individuals who were residing in Massachusetts as of 1/1/18, regardless of where they were first diagnosed.3 Total includes Asian/Pacific Islander, American Indian/Alaska Native, other and unspecified race/ethnicityData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

Table 6. Number and percentage of people living with HIV infection on January 1, 2018 by sex at birth1 and exposure mode: Plymouth County, Massachusetts2

Men WomenExposure Mode: N % N %

Male-to-male sex (MSM) 288 46% N/A N/AInjection drug use (IDU) 76 12% 37 10%MSM/IDU 32 5% N/A N/AHeterosexual sex 49 8% 143 38%Other3 15 2% 13 3%Total No Identified Risk (NIR) 166 27% 180 48%

Presumed heterosexual sex4 N/A N/A 138 37% NIR5 166 27% 42 11%

Total 626 100% 373 100%

1 Data reflect sex at birth not gender identity or gender expression of transgender individuals (N=107 transgender individuals living with HIV infection in MA). Please note “women” and “men” are used for stylistic reasons to describe female and male populations diagnosed with HIV infection that include a small number of girls and boys (N=24 children living with HIV infection under age 13 as of 1/1/18).2 HIV prevalence data include all individuals who were residing in Massachusetts as of 1/1/18, regardless of where they were first diagnosed.3 Includes pediatric and blood/blood products exposure modes4 Includes a woman having sex with a man of unknown HIV status or risk. This category is limited to women only.5 Includes a man having sex with a woman of unknown HIV status or risk, those still being followed up for risk information, those who have died with no determined risk, and those lost to follow-up.Data Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

5


Table 7. Number and percentage of people diagnosed with HIV infection from 2014–20161 by sex at birth2 and race/ethnicity: Plymouth County, Massachusetts3

Men WomenRace/Ethnicity: N % N %

White (non-Hispanic) 27 39% 5 14%Black (non-Hispanic) 29 42% 26 72%Hispanic/Latino 11 16% <5 N/AAsian/Pacific Islander <5 N/A <5 N/AOther/Unspecified <5 N/A <5 N/ATotal4 69 100% 36 100%

1 Reflects year of HIV infection diagnosis among all individuals reported with HIV infection, with or without an AIDS diagnosis for the most recently available three-year period after the implementation of HIV infection reporting in 1999.2 Data reflect sex at birth not gender identity or gender expression of transgender individuals (N=107 transgender individuals living with HIV infection in MA). Please note “women” and “men” are used for stylistic reasons to describe female and male populations diagnosed with HIV infection that include a small number of girls and boys (N=24 children living with HIV infection under age 13 as of 1/1/18).3 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.4 Total includes numbers suppressed to protect privacy, N/A=Not ApplicableData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

6


Table 8. Number and percentage of people diagnosed with HIV infection from 2014–20161 by sex at birth2 and exposure mode: Plymouth County, Massachusetts3

Men WomenExposure Mode: N % N %

Male-to-male sex (MSM) 28 41% N/A N/AInjection drug use (IDU) 6 9% <5 N/AMSM/IDU <5 N/A N/A N/AHeterosexual sex 5 7% 6 17%Other3 <5 N/A <5 N/ATotal No Identified Risk (NIR) 26 38% 26 72%

Presumed heterosexual sex4 N/A N/A 20 56% NIR5 26 38% 6 17%

Total6 69 100% 36 100%

1 Data reflect sex at birth not gender identity or gender expression of transgender individuals (N=107 transgender individuals living with HIV infection in MA). Please note “women” and “men” are used for stylistic reasons to describe female and male populations diagnosed with HIV infection that include a small number of girls and boys (N=24 children living with HIV infection under age 13 as of 1/1/18).2 HIV prevalence data include all individuals who were residing in Massachusetts as of 1/1/18, regardless of where they were first diagnosed.3 Includes pediatric and blood/blood products exposure modes4 Includes a woman having sex with a man of unknown HIV status or risk. This category is limited to women only.5 Includes a man having sex with a woman of unknown HIV status or risk, those still being followed up for risk information, those who have died with no determined risk, and those lost to follow-up.6 Total includes numbers suppressed to protect privacy.Data Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

7


Table 9. Number and percentage of people diagnosed with HIV infection by sex at birth1 and year of diagnosis: Plymouth County, Massachusetts,2 2007–20163

Men Women TotalN % N % N

2007 25 68% 12 32% 372008 22 63% 13 37% 352009 22 63% 13 37% 352010 20 63% 12 38% 322011 24 53% 21 47% 452012 28 64% 16 36% 442013 36 75% 12 25% 482014 21 72% 8 28% 292015 16 52% 15 48% 312016 32 71% 13 29% 45

1 Data reflect sex at birth not gender identity or gender expression of transgender individuals (N=107 transgender individuals living with HIV infection in MA). Please note “women” and “men” are used for stylistic reasons to describe female and male populations diagnosed with HIV infection that include a small number of girls and boys (N=24 children living with HIV infection under age 13 as of 1/1/18).2 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.3 Reflects year of HIV infection diagnosis among all individuals reported with HIV infection, with or without an AIDS diagnosis for the most recently available ten-year period after the implementation of HIV infection reporting in 1999.Data Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

8


Table 10. Number and percentage of people diagnosed with HIV infection by race/ethnicity and year of diagnosis: Plymouth County, Massachusetts1, 2007–20162

White Non-Hispanic Black Non-Hispanic Hispanic/Latino Total3

N % N % N % N

2007 14 38% 16 43% 6 16% 372008 ≥54 N/A 20 57% <5 N/A 352009 11 31% 17 49% 6 17% 352010 12 38% 14 44% 6 19% 322011 15 33% 23 51% 5 11% 452012 ≥54 N/A 29 66% <5 N/A 442013 19 40% 22 46% 6 13% 482014 7 24% 15 52% 5 17% 292015 ≥54 N/A 20 65% <5 N/A 312016 15 33% 20 44% 9 20% 45

1 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.2 Reflects year of HIV infection diagnosis among all individuals reported with HIV infection, with or without an AIDS diagnosis for the most recently available ten-year period after the implementation of HIV infection reporting in 1999.3 Totals include Asian/Pacific Islander, American Indian/Alaskan Native individuals, those of other or undetermined race/ethnicity, and suppressed numbers.4 Value >5 suppressed to protect privacy, N/A=Not ApplicableData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

9


Table 11. Number and percentage of people diagnosed with HIV infection by place of birth and year of diagnosis: Plymouth County, Massachusetts1, 2007–20162

USPuerto Rico/

US Dependency3 Non-US Total4

N % N % N % N

2007 ≥55 N/A <5 N/A 20 54% 372008 ≥55 N/A <5 N/A 17 49% 352009 17 49% 0 0% 18 51% 352010 ≥55 N/A <5 N/A 12 38% 322011 25 56% 0 0% 20 44% 452012 ≥55 N/A <5 N/A 27 61% 442013 ≥55 N/A <5 N/A 19 40% 482014 15 52% 0 0% 14 48% 292015 ≥55 N/A <5 N/A 10 32% 312016 ≥55 N/A <5 N/A 20 44% 451 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.2 Reflects year of HIV infection diagnosis among all individuals reported with HIV infection, with or without an AIDS diagnosis for the most recently available ten-year period after the implementation of HIV infection reporting in 1999.3 Ninety-nine percent of people diagnosed with HIV infection from 2007–2016 who were born in a US dependency were born in Puerto Rico, 1% were born in US minor outlying areas, <1% were born in the US Virgin Islands, and <1% were born in Guam.4 Total includes numbers suppressed to protect privacy.5 Value >5 suppressed to protect privacy, N/A=Not ApplicableData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

10


Table 12. Number and percentage of people diagnosed with HIV infection by exposure mode and year of diagnosis: Plymouth County, Massachusetts1, 2007–20162

MSM IDUMSM/IDU HTSX Other3

Pres.HTSX4 NIR5 Total6

N % N % N % N % N % N % N % N

2007 12 32% <5 N/A <5 N/A 6 16% 0 0% <5 N/A 12 32% 372008 12 34% <5 N/A <5 N/A 8 23% 0 0% <5 N/A 8 23% 352009 9 26% <5 N/A <5 N/A 9 26% 0 0% 7 20% 8 23% 352010 11 34% <5 N/A 0 0% 5 16% <5 N/A 7 22% 8 25% 322011 15 33% <5 N/A 0 0% 7 16% <5 N/A 10 22% 12 27% 452012 11 25% <5 N/A 0 0% <5 N/A <5 N/A 14 32% 14 32% 442013 16 33% <5 N/A 0 0% <5 N/A <5 N/A 8 17% 20 42% 482014 8 28% <5 N/A 0 0% <5 N/A <5 N/A 7 24% 10 34% 292015 <5 N/A <5 N/A <5 N/A 5 16% 0 0% 9 29% 9 29% 312016 17 38% 5 11% <5 N/A 5 11% 0 0% <5 N/A 13 29% 451 New HIV diagnoses include only individuals who were first diagnosed in Massachusetts.2 Reflects year of HIV infection diagnosis among all individuals reported with HIV infection, with or without an AIDS diagnosis for the most recently available ten-year period after the implementation of HIV infection reporting in 1999.3 Includes pediatric and blood/blood products exposure modes4 Includes a woman having sex with a man of unknown HIV status or risk. This category is limited to women only.5 Includes a man having sex with a woman of unknown HIV status or risk, those still being followed up for risk information, those who have died with no determined risk, and those lost to follow-up.6 Total includes numbers suppressed to protect privacy.HTSX = Heterosexual Sex; IDU = Injection Drug Use; MSM = Male-to-Male Sex; MSM/IDU = Male-to-Male Sex and Injection Drug Use; N/A=Not Applicable; NIR = No Identified Risk Pres. HTSX = Presumed Heterosexual SexData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

11


Table 13. Number and percentage of people diagnosed with AIDS by sex at birth1 and year of diagnosis: Plymouth County, Massachusetts,2 2007–2016

Men Women Total4

N % N % N

2007 11 46% 13 54% 242008 11 65% 6 35% 172009 16 70% 7 30% 232010 17 63% 10 37% 272011 17 59% 12 41% 292012 18 64% 10 36% 282013 ≥53 N/A <5 N/A 242014 ≥53 N/A <5 N/A 182015 ≥53 N/A <5 N/A 152016 12 71% 5 29% 17

1 Data reflect sex at birth and therefore not gender identity or gender expression of transgender individuals (N=107 transgender individuals living with HIV infection). Please note “women” and “men” are used for stylistic reasons to describe female and male populations diagnosed with HIV infection that include a small number of girls and boys (N=24 children living with HIV infection under age 13 as of 1/1/18). 2 AIDS diagnoses include only individuals who were first diagnosed in Massachusetts.3 Value >5 suppressed to protect privacy, N/A=Not Applicable4 Total includes numbers suppressed to protect privacy.Data Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

12


Table 14. Number and percentage of people diagnosed with AIDS by race/ethnicity and year of diagnosis: Plymouth County, Massachusetts,1 2007–2016

White Non-Hispanic Black Non-Hispanic Hispanic/Latino Total2

N % N % N % N

2007 ≥53 N/A 12 50% <5 N/A 242008 ≥53 N/A 10 59% <5 N/A 172009 10 43% 7 30% 5 22% 232010 7 26% 12 44% 7 26% 272011 11 38% 12 41% 5 17% 292012 ≥53 N/A 15 54% <5 N/A 282013 ≥53 N/A 12 50% <5 N/A 242014 ≥53 N/A 11 61% <5 N/A 182015 10 67% <5 N/A <5 N/A 152016 ≥53 N/A 6 35% <5 N/A 17

1 AIDS diagnoses include only individuals who were first diagnosed in Massachusetts.2 Totals include Asian/Pacific Islander, American Indian/Alaskan Native individuals, those of other or undetermined race/ethnicity and suppressed numbers.3 Value >5 suppressed to protect privacy, N/A=Not ApplicableData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

13


Table 15. Number and percentage of people diagnosed with AIDS by exposure mode and year of diagnosis: Plymouth County, Massachusetts,1 2007–2016

MSM IDUMSM/IDU HTSX Other2

Pres.HTSX3 NIR4 Total5

N % N % N % N % N % N % N % N

2007 <5 N/A 6 25% <5 N/A <5 N/A <5 N/A <5 N/A 6 25% 242008 5 29% 0 0% 0 0% <5 N/A <5 N/A <5 N/A 6 35% 172009 9 39% <5 N/A <5 N/A <5 N/A 0 0% <5 N/A 5 22% 232010 8 30% <5 N/A 0 0% 6 22% <5 N/A 7 26% 5 19% 272011 9 31% 0 0% 0 0% 5 17% 0 0% 5 17% 10 34% 292012 9 32% <5 N/A <5 N/A <5 N/A <5 N/A 7 25% 5 18% 282013 5 21% <5 N/A 0 0% <5 N/A <5 N/A <5 N/A 14 58% 242014 <5 N/A 0 0% <5 N/A <5 N/A <5 N/A <5 N/A 9 50% 182015 5 33% <5 N/A 0 0% <5 N/A 0 0% <5 N/A 5 33% 152016 7 41% <5 N/A <5 N/A <5 N/A <5 N/A <5 N/A <5 N/A 171 AIDS diagnoses include only individuals who were first diagnosed in Massachusetts.2 Includes pediatric and blood/blood products exposure modes3 Includes a woman having sex with a man of unknown HIV status or risk. This category is limited to women only.4 Includes a man having sex with a woman of unknown HIV status or risk, those still being followed up for risk information, those who have died with no determined risk, and those lost to follow-up.5 Total includes numbers suppressed to protect privacy.HTSX = Heterosexual Sex; IDU = Injection Drug Use; MSM = Male-to-Male Sex; MSM/IDU = Male-to-Male Sex and Injection Drug Use; N/A=Not Applicable; NIR = No Identified Risk Pres. HTSX = Presumed Heterosexual SexData Source: MDPH Bureau of Infectious Disease and Laboratory Sciences (percentages may not add up to 100% due to rounding), data are current as of 1/1/18 and may be subject to change

14


Technical Notes:

Configuration of Massachusetts Cities/Towns and Counties

Individuals living with HIV infection by current residence:

As of January 1, 2018, the Massachusetts Department of Public Health (MDPH), Bureau of Infectious Disease and Laboratory Sciences (BIDLS), HIV/AIDS fact sheets, epidemiologic reports, and other HIV data presentations include all individuals living with HIV infection who are currently residing in Massachusetts. These prevalent cases include those who may have been first diagnosed in another state. Reports of incidence or new diagnoses will continue to include only individuals who are first diagnosed in Massachusetts. Please note that HIV/AIDS fact sheets, data reports, and presentations published from 2011 to 2017 include only cases that were first diagnosed in Massachusetts.

Presumed heterosexual:

The presumed heterosexual risk category is used exclusively for women to identify HIV exposure mode when sex with men was the only reported risk factor, there was no evidence of current or past injection drug use (IDU), and behavioral risk and HIV status information about male sexual partners were unknown. The rationale for the application of the presumed heterosexual risk category to women only has been addressed in the MDPH Office of HIV/AIDS report “Intersecting Risks: HIV Infection among Heterosexual Women and Men in Massachusetts.” (2010) http://www.mass.gov/Eeohhs2/docs/dph/aids/intersecting_risks.pdf.

15

http://www.mass.gov/Eeohhs2/docs/dph/aids/intersecting_risks.pdf

Mass.Gov · Web view2019/02/20 · Massachusetts Department of Public Health. Bureau of Infectious...

Documents

Transcript of Mass.Gov · Web view2019/02/20 · Massachusetts Department of Public Health. Bureau of Infectious...