Since 1981, when the U.S. Centers for Disease Control and Prevention (CDC) first began to monitor AIDS cases, more than 600,000 Americans have been diagnosed with AIDS and at least 385,000 have died. The most current statistics released by CDC in December 1997 indicate there have been 641,086 reported AIDS cases in the United States -- 633,000 among adults and adolescents and 8,086 among children under 13 years of age. The first ever declines in AIDS incidence and AIDS deaths occurred in 1996, with drops of 7% and 25%, respectively. These dramatic decreases in the numbers of AIDS cases and deaths are largely due to the successful drug treatment programs currently being implemented. These antiretroviral therapies, or "cocktail therapies," allow HIV-infected people to live longer, healthier lives by slowing the progression of the disease into AIDS.

"My view of AIDS was that I could not get it because I was a young African American teenager. I had only seen older white males or gay males with the disease... For a while, I was angry with myself for not being smart enough to see that anybody can get the disease, and those who have it are not outcasts to society."

-- A 16-year-old young woman from Atlanta, Georgia.

Despite the fact that AIDS incidence is down across the United States, the number of people living with HIV remains high and among certain population groups, HIV infections are rising steadily. Current estimates suggest that between 650,000 and 900,000 Americans are living with HIV with at least 40,000 people becoming newly infected each year. As the prevalence of HIV infection continues to expand across the nation, an increase in prevention efforts to combat this disease is necessary. Populations targeted by CDC to be in the greatest need of prevention services are African Americans, Latinos, young people ages 15 to 24, and any people who engage in high-risk sexual practices and/or drug-related behavior.

The previous statistics available on the AIDS epidemic have been a valuable resource in determining those population groups at the highest risk of contracting HIV. However, in order for reports from CDC to present a clear picture of the epidemic and its effect on the United States, more data must be compiled on both HIV infection and AIDS cases.

Reporting systems used in the past focused only on the numbers of AIDS cases, grossly underestimating the numbers of people infected with HIV whose condition had not yet progressed into AIDS. The introduction of drug treatments that can greatly slow the progression of the disease further render the tracking of AIDS incidence an inaccurate indication of HIV infection rates. Furthermore, only 30 states report the numbers of known HIV cases to CDC (27 states report adult/adolescent cases as well as pediatric HIV cases; three states report only pediatric HIV cases; 20 states do not report HIV cases). Within those states with HIV reporting, people tested at anonymous test sites and those not yet aware of their HIV status are not included among these numbers. Although CDC estimates the number of Americans living with HIV to be between 650,000 and 900,000, an accurate count is not possible without more precise methods for compiling HIV data.

Highest annual AIDS rates (number of new reported cases per 100,000 population) in 1997 in metropolitan areas of 500,000 or more Metropolitan Area Rate # New cases Total Cases New York, NY 114.9 9,897 101,670 Jersey City, NJ 92.5 510 5,822 Miami, FL 81.8 1,672 19,930 San Francisco, CA 78.0 1,297 25,432 Newark, NJ 69.8 1,356 14,553 Fort Lauderdale, FL 69.0 1,015 10,374 San Juan, PR 66.6 1,323 12,956 West Palm Beach, FL 60.9 620 6,148 Baltimore, MD 51.6 1,277 11,394 Houston, TX 46.2 1,781 16,048

Young People and HIV/AIDS

Young people under the age of 25 represent one half of all new HIV infections in the United States, and the majority of young people are infected sexually. Alarming statistics show AIDS-related illnesses are the sixth leading cause of death among 15- to 24-year-olds. Even more disturbing is that HIV/AIDS is the second leading cause of death among people between the ages of 25 and 44 and the leading cause of death among African Americans in this age group, suggesting that many of these people were infected during their teenage years.

"I feel very fortunate because my community chose to support me when I went public with my HIV status. Not all kids like me are able to speak as freely as I can, so I feel it is very important for me to speak out whenever and wherever I can."

-- A 16-year-old young man living with HIV in Duluth, Georgia

By 1997, more than 13,000 young adults in the United States were reported to be infected with HIV. Although this number grossly underestimates the total cases, the data do reveal several at-risk groups among young adults. Among the most recent reports of HIV infections, the most serious threats were among African Americans, who represented 63% of all new adolescent and young adult HIV infections from January 1994 to June 1997, and young women, who accounted for 44%. At least 26% of infections among young people were heterosexual and 31% were in men who have sex with men (MSM). The rampant spread of HIV/AIDS among young people across the country is due to a combination of unsafe sexual and drug practices, inadequate prevention and support services targeted toward this age group, and a misperception among young people that they are not at risk.

Who Is at Risk?

While any person can be at risk of becoming infected with HIV, the demographic groups most affected by the epidemic continue to be men who have sex with men (MSM), African Americans and Latinos. MSM represent 57% of all male AIDS cases and 45% of all new HIV infections among adult/adolescent males. Together, in 1997, African-American and Latino males represented 61% of all male adult/adolescent AIDS cases. More recently, however, growing numbers of women are becoming infected with HIV and developing AIDS. Women now account for 16% of all AIDS cases, a number that has been steadily rising each year. More than 23,000 of the 92,107 reported HIV infection cases are among women, with 67% of these occurring among African-American women.

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