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HIV in the United States: An Overview

June 2010

Creating an overview of the HIV epidemic in the United States requires combining different indicators of the epidemic, such as prevalence, incidence, transmission rates, and deaths. Therefore, this document uses multiple sources to provide a comprehensive picture of HIV in this country.

Estimated Number of New HIV Infections and Persons Living With HIV, 1977-2006

Despite continued increases in the number of people living with HIV infection over time, HIV prevention efforts have helped to keep the number of new infections stable.

Despite continued increases in the number of people living with HIV infection over time, HIV prevention efforts have helped to keep the number of new infections stable.


Currently, only 37 states have collected HIV diagnosis data from name-based HIV reporting systems for a sufficient length of time (defined as being submitted to CDC since at least January 2005) to be included in CDC's HIV surveillance estimates. However, CDC's AIDS data are representative of all 50 states and the District of Columbia. The 2008 HIV Surveillance report contains HIV and AIDS tables that include 50 states, Washington DC, and 5 US territories (American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the US Virgin Islands). National prevalence estimates (number of persons living with HIV infection) are also for the 50 states and DC, as are estimates for incidence (the number of new HIV infections) and transmission rate (the number of HIV transmissions per 100 people).


Key References That Explain the HIV Epidemic in the United States

Following are some of the key indicators of HIV disease in the United States and the references that best explain them.

The following indicators can be found in the CDC's HIV Surveillance Report (CDC. HIV Surveillance Report, 2008; vol 20.)


References

  1. CDC. HIV prevalence estimates -- United States, 2006. MMWR. 2008;57(39):1073-1076.
  2. Hall HI, Song R, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA 2008;300(5):520-529.
  3. Holtgrave DR, Hall HI, Rhodes PH, et al. Updated annual HIV transmission rates in the United States, 1977-2006. J Acquir Immune Defic Syndr 2009;50(2):236-238.
  4. Campsmith, ML, Rhodes PH, Hall HI et al. Undiagnosed HIV prevalence among adults and adolescents in the United States at the end of 2006. J Acquir Immune Defic Syndr. 2010 Apr;53(5):619-24.
  5. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005;39:446-453.

  1. New diagnoses are not the same as new infections (incidence). A person can be infected with HIV for years before being diagnosed.

  1. CDC. HIV Surveillance Report, 2008; vol 20.
  2. CDC. National Health Interview Survey, 2008: Early Release of Selected Estimates. Tables 10.1, 10.2, 10.3. Accessed 19 May 2010.
  3. Purcell DW, Johnson C, Lansky A, et al. Presented at 2010 National STD Prevention Conference; Atlanta, GA. abstract #22896. Accessed May 4, 2010.

  1. The MSM rates were calculated using the methodology described in reference #9, which is different than the methodology used to calculate the other rates in this fact sheet, which are based on population estimates from the US Census Bureau.

  1. CDC. Late HIV testing -- 34 states, 1996-2005. MMWR 2009;58:661-665.

  1. MSM accounts for a higher proportion of testing for acute (newly acquired) infection relative to other risk groups.

  1. Hall, I, An Q, Hutchinson A, et al. Estimating the Lifetime Risk of a Diagnosis of the HIV Infection in 33 States, 2004-2005. J Acquir Immune Defic Syndr. 2008;49(3):294-297.
  2. CDC. Subpopulation Estimates from the HIV Incidence Surveillance System -- United States, 2006. MMWR 2008. 57(36);985-989.
  3. CDC. WISQARS Leading Causes of Death Reports, 1999-2006. Accessed May 4, 2010.

  1. Deaths of persons with a diagnosis of HIV or AIDS may be due to any cause, not necessarily HIV disease.




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