August 14, 2006
Looking at how the HIV epidemic is affecting people in the United States is important to understanding both HIV prevention and treatment needs. The objective of this study1 was to describe the recent epidemiology of HIV infection in the 33 states of the United States that have been reporting HIV infections to the U.S. Centers for Disease Control and Prevention (CDC). This was an analysis conducted by Michael Campsmith of the CDC on HIV surveillance data from 33 states reporting confidential name-based HIV infections since 2000. Data was adjusted for reporting delays and redistribution of unknown transmission categories. Reporting included both HIV infection, AIDS, and prevalence rates per 100,000 population.
Results of the study demonstrated that the estimated number of people living with HIV/AIDS in the United States as of 2004 was 462,164 in the 33 states, of which 28% were female and 72% were male. There was an overall estimated increase in the HIV-infected population of 6.3% per year from 2000-2004. Of those infected, 34% were white, 48% black, 17% Hispanic, and less than 1% each Asian/Pacific Islander and American Indian/Alaska Indian. This is in contrast to the general population in the 33 states, which is 70% white, 13% black, 13% Hispanic, 3% Asian/Pacific Islander, and 1% American Indian/Alaska Indian.
Infection prevalence expressed as a function of age revealed that 1% of those infected were less than 13 years of age, 10% were 13 to 29 years old, 49% were 30 to 44 years old, 35% were 45 to 59 years old, and 5% were 60 years or older.
HIV risk factors for males (more than 13 years, n = 332,190) were 60% men who have sex with men (MSM), 19% injection drug use (IDU), 13% heterosexual transmission, and 7% MSM and IDU. HIV risk factors for females (n = 123,178) were 71% heterosexual transmission and 27% IDU.
Prevalence and rates by race were as follows:
|Living With HIV||Prevalence Rate (Per 100,000)|
|American Indian/Alaskan Native||1,995||11|
The conclusions from this analysis indicate that the number of people living with HIV infection continues to increase. Blacks make up 48% of the cases of HIV infection, but only 13% of the population in the 33 states. Sexual contact is the main risk factor for transmission for both men and women.
The limitations of this study are that the data is limited to 33 states and reporting trends are limited to five years starting from 2000. The analysis is also missing some states with known high HIV infection prevalence, such as California, Illinois and Maryland. Finally, not all patients with HIV infection have been tested, diagnosed and reported to the CDC in the 33 reporting states, which further underestimates the prevalence.