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CDC: Decline in U.S. HIV Infections but Lasting Gaps in Rates of HIV, AIDS and Death

December 18, 2014

The U.S. Centers for Disease Control and Prevention (CDC) recently released the latest version of its annual HIV Surveillance Report, "Diagnoses of HIV Infection in the United States and Dependent Areas, 2012."

So, what do the data tell us? As the CDC notes, "Overall, HIV rates continue to show encouraging declines yet disparities persist among some groups." Then comes the not-so-good news:

"However, as evidenced by this report and other previously released data, gay, bisexual, and other men who have sex with men (MSM); young adults; and racial and ethnic minorities continue to bear a disproportionate burden of HIV:

  • MSM represent approximately 2 percent of the U.S. population, but accounted for 64 percent of all new HIV diagnoses
  • Young adults aged 20-24 had the highest annual diagnosis rate (36.3 per 100,000) and accounted for the largest percentage (17 percent) of all new HIV diagnoses
  • African Americans comprise only 13 percent of the U.S. population yet accounted for 47 percent of all HIV diagnoses"

In the category of "Diagnoses of HIV Infection and Diagnoses of Infection Classified as Stage 3 (AIDS)," the highest rates were for:

  • People aged 20-24 years (36.3), followed by those aged 25-29 (35.5).
  • African Americans/blacks (58.3), followed by Latinos (18.5).
  • Men (29.9) (with women at 7.2).
  • Those attributed to male-to-male sexual contact (67%). (Heterosexual contact accounted for 26%.)
  • People in the South (20.7), followed by those in the Northeast (16.2), the West (11.5) and the Midwest (9.2).

"It's very encouraging to see that AIDS deaths are decreasing in the United States. That's really wonderful news for all of us," noted Greg Millett, vice president and director of public policy at amfAR. "The troubling parts of the report is seeing diagnoses continuing to increase in MSM while decreasing in other populations. It's also problematic to see that injection drug users (IDUs), both male and female, are the least likely to survive with HIV after a diagnosis."

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"So it's a mixture, a mixed bag like all the surveillance reports we've been getting from CDC. People living longer, but among those people diagnosed with HIV, IDUs are faring worse -- which means we have to do more in the care continuum with that population. MSM are still more likely to be diagnosed with HIV and represent most of the cases, so obviously there has to be more of an emphasis with that population as well," he concluded.

And then there's the matter of the data that aren't in the report.

There is no category for transgender people at all, though they are some of the most vulnerable to HIV. According to Cecilia Chung of the Transgender Law Project, "The CDC is interested in some different ways to collect sex and gender data -- identifying transgender men and women separately -- on their surveillance survey, but it's not included in the report." She's keeping her fingers crossed that future reports will be better.

There is also no delineation between urban and rural areas, which is especially significant in the mostly rural South. Kathie Hiers, CEO of AIDS Alabama, says of the report, "It's sliced and diced in such interesting ways. Me, I just want to know the bottom line. Where are the most people living with HIV? The South. Where are the most people dying with HIV? The South."

Carolyn McAllaster of the Southern HIV/AIDS Strategy Initiative (SASI) agrees. "The report documents once again the disproportionate impact that the HIV/AIDS epidemic is having on the Southern region of the United States," she says. "According to the report, from 2008 to 2012, the Southern region had higher rates of people dying within one, two and three years of an HIV or AIDS diagnosis than any other region in the U.S."

Sue Saltmarsh has worked in the HIV/AIDS field for over 20 years, the first 10 as an herbalist and energy therapist at Project Vida, the last six as a writer and copy editor for Positively Aware magazine. She is now a freelance writer and editor and is also able to devote more time to her passion as founder and director of the Drive for Universal Healthcare (DUH).


Copyright © 2014 Remedy Health Media, LLC. All rights reserved.


  
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