Trends in the HIV and AIDS Epidemic, 1998

African Americans and Hispanics have been disproportionately affected by the HIV epidemic. This section provides a more detailed breakdown of risk factors contributing to the spread of the epidemic in specific racial/ethnic subgroups. The data highlight that prevention challenges vary greatly depending on the populations addressed.

African-American Men * In 1996, an estimated 17,250 African-American men were diagnosed with AIDS. Of these, men who have sex with men (MSM) transmission accounted for 40% (7,070 cases), injection drug use (IDU) transmission accounted for 38% (6,610 cases), and heterosexual contact accounted for 13% (2,190). Men who reported both sex with another man and injection drug use as risk factors account for another 7% (1,150) of cases. Over the last decade, male to male sex and injection drug use have contributed relatively evenly to AIDS cases among African-American men, with heterosexual contact representing an increasing, but still relatively small proportion of cases (from 2% of cases in 1986 to 13% of cases in 1996). AIDS incidence in each risk category increased through 1995, and while both incidence among African-American MSM and African-American male IDU dropped in 1996 (-3% and -4%), heterosexual cases among African-American men continued to increase (+11%).

African-American Women * In 1996, an estimated 6,750 African-American women were diagnosed with AIDS. Of these, 53% (3,620) were among women infected heterosexually and 43% (2,910) were attributed to injection drug use (IDU). Over the last decade, AIDS incidence among African-American women increased most dramatically among women infected heterosexually. Prior to the impact of treatment, AIDS incidence in African-American women infected heterosexually was increasing at a rate of between 15%-30%. In 1996, this increase continued, but slowed slightly to an increase of 11%. AIDS incidence among African-American women infected through injection drug use also increased over the decade, but at a rate of approximately 10% to 20% each year. In addition to the direct impact of injection drug use on the spread of AIDS among African-American women, injection drug use also contributes to the heterosexual spread of the epidemic in these women. A large proportion of African-American women infected heterosexually are infected through sex with a male IDU.

Hispanic Men * In 1996, an estimated 8,680 Hispanic men were diagnosed with AIDS. Of these, 45% (3,880) were attributed to men who have sex with men (MSM), 38% (3,330) were attributed to injection drug use (IDU), and 10% (880) were infected heterosexually. About 5% (470) were among Hispanic men with both MSM and IDU as risk factors. Over the course of the decade, transmission through MSM and IDU have accounted for roughly equal proportions of cases among Hispanic men, with the proportion among heterosexuals increasing, although the number of heterosexually transmitted cases is still relatively low. AIDS incidence increased in all risk categories over the decade, although the rate of increase has been greatest for Hispanic men infected heterosexually. With the impact of treatment, only incidence among Hispanic men infected heterosexually continued to increase (+11%), with incidence declining among Hispanics infected through MSM (-8%) and among Hispanic males infected through IDU (-5%).

Hispanic Women * In 1996, an estimated 2,210 Hispanic women were diagnosed with AIDS. Of these, nearly 60% (1,320) were women infected heterosexually and 37% (830) were among women infected through injection drug use (IDU). Over the last decade, the proportion of cases among Hispanic women infected heterosexually has increased from approximately 30% to 60% of cases. AIDS incidence among Hispanic women infected heterosexually and Hispanic women infected through IDU increased through 1995, with heterosexual cases increasing most rapidly. In 1996, incidence among Hispanic women infected through IDU dropped 8%, while incidence among Hispanic women infected heterosexually continued to increase, although at a slower rate than in recent years (dropping from annual increases of about 15% to an increase of less than 4% in 1996).

White Men * In 1996, an estimated 18,790 white men were diagnosed with AIDS. Of these, three-quarters (14,020) were attributed to men who have sex with men (MSM), 12% (2,300) were attributed to injection drug use (IDU), 8% were among men who reported both sex with another man and IDU as risk factors, and 3% were among men infected heterosexually. Over the decade, cases attributed to MSM have continued to account for the largest proportion of cases among white men, but both those attributed to IDU and those attributed through heterosexual exposure have accounted for increasing proportions. AIDS incidence among white men infected through MSM began to decline in 1993, reflecting in part the influence of prevention programs in these communities in the 1980s. AIDS incidence among white men attributed to IDU and white men infected heterosexually increased throughout the decade until 1996, when incidence in both groups dropped (-8% and -6%, respectively).

White Women * In 1996, an estimated 2,390 white women were diagnosed with AIDS. Of these, 51% (1,220) were among white women infected heterosexually and 43% (1,040) were among white women infected through injection drug use (IDU). AIDS incidence in both risk categories increased through 1995. In 1996, AIDS incidence among white women infected through IDU declined 5% and AIDS incidence among white women infected heterosexually leveled (0% change).

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