At the 13th International AIDS Conference in Durban, South Africa, the U.S. Centers for Disease Control and Prevention (CDC) presented a review of research on HIV/AIDS in the United States which underscored the need for expanded HIV-prevention services.
The following are some of the key findings presented:
- Among African-Americans and Latinos, reported HIV/AIDS prevalence rates vary widely by city. A CDC study examined the number of people diagnosed with HIV and AIDS in metropolitan areas with populations of more than 50,000 African-Americans or Latinos. Results revealed that the rate of African-Americans living with HIV and AIDS in Jersey City, NJ, the highest in the study, was 13 times higher than the rate in Flint, MI, the lowest.
Among Latinos, the rate for those living in Newark, NJ, was more than five times higher than for those in Albuquerque, NM.
- Overall HIV diagnoses fell among women, but rose among young women. In a study of 25 states in which HIV trends can be examined, the number of women diagnosed with HIV decreased by 9% from 1994 to 1998.
AdvertisementHowever, the number of young women (those born between 1975 and 1979) diagnosed with HIV more than doubled during that period. Among this group, HIV cases attributed to both injection drug use and heterosexual sexual contact increased.
- HIV infection from injection drug use remains high in New York and New Jersey. A CDC study examined trends in new infections among 18,837 people admitted to 12 drug treatment centers in four cities. Findings suggest that the annual rate of HIV infection among injection drug users in Newark, NJ, and New York City remained relatively stable from 1994 to 1997.
The study also found high incidence of HIV infection among non-injection drug users in New York City, suggesting that sexual risk may also be contributing to the spread of infection.
The authors conclude that a reduction in infection will require increased access to drug treatment, coupled with increased HIV testing, prevention, and treatment services.
- Unsafe sexual activity is increasing among HIV-infected gay men. A study of 1,942 HIV-infected gay and bisexual men in 12 cities and states found that the proportion of HIV-infected gay and bisexual men who had unprotected anal intercourse during the previous 12 months rose from 13% in 1995-96 to 19% in 1997-98 -an increase of nearly 50%.
- Bisexual behavior is increasing the spread of HIV infection. A CDC study of 3,492 gay and bisexual men, ages 15 to 22, in seven U.S. cities found that one in six young men who had sexual intercourse with men had recently had sexual intercourse with women. In addition, nearly one-fourth of those men reported recently having had unprotected sexual intercourse with both men and women.
The study confirms that young bisexual men are a "bridge" for HIV transmission to women, particularly given that 6.6% of bisexual men in the study were HIV positive.
- Attitudes about HIV may be associated with HIV sexual risk behavior among young gay men. A CDC study of 1,887 gay men, ages 23 to 29, in six U.S. cities found that men whose concerns about HIV infection were reduced by the availability of highly active antiretroviral therapy and who perceived sexual partners with low viral loads as less risky, had more sexual partners than men who did not report such perceptions.
- Young gay men are not getting tested for HIV. A study of 2,621 gay and bisexual men, ages 15 to 25, in 10 U.S. cities found that more than one-fifth (22%) of young gay or bisexual men had never been tested for HIV and over half had not been tested in the past six months.
The study also found that these men were more likely to get tested if they knew of a place where they felt "comfortable" and if they have had exposure to information from a variety of prevention sources such as flyers or workshops.
- Perinatally infected children are reaching adolescence. According to a CDC study, approximately 2,100 children born with HIV are now teenagers and an estimated 10,000 perinatally infected children will enter adolescence during the next five years.
Overall, the data demonstrates that HIV and AIDS are dramatically affecting many African-American and Latino communities as well as young gay men. Data further suggests a resurgence of risk behaviors among gay men. According to the CDC, in order to meet the unique needs of each of the affected groups, prevention approaches will have to become increasingly sophisticated.
The CDC stressed the need for expanded HIV surveillance in light of treatment success. One official explained that: "In the United States, HIV is the epidemic, not AIDS. Knowing the number of AIDS cases in the United States reveals very little about the leading edge of the epidemic, while details on HIV infections give public health officials information they need to respond to the epidemic most effectively within their communities."
The CDC concluded that evidence shows prevention can and does work and that, the current challenge is to maintain successful prevention efforts and expand programs to reach all of the groups now at risk.
For more information:
"HIV Trends in U.S. Highlight Need For Expanded Prevention," U.S. Centers for Disease Control and Prevention Press Briefing: Monday, July 10, 2000. 13th International AIDS Conference, Durban, South Africa.