Disparities in Diagnoses of HIV Infection Between Blacks/African Americans and Other Racial/Ethnic Populations -- 37 States, 2005-2008
February 4, 2011
Blacks/African Americans have been affected disproportionately by human immunodeficiency virus (HIV) infection since early in the epidemic.1 Despite representing a smaller proportion (13.6%) of the U.S. population, blacks/African Americans accounted for half of the HIV diagnoses in adolescents and adults in 37 states during 2005-2008.2 Data from the National HIV Surveillance System were used to estimate numbers, percentages, and rates of HIV diagnoses in blacks/African Americans during 2005-2008. Those data were reported to CDC through June 2009 from 37 states with mature (in operation since at least January 2005) HIV surveillance systems. This report describes the results of those analyses, which indicated that during 2005-2008, blacks/African Americans were diagnosed with HIV infection more frequently than any other racial/ethnic population. During 2008, black/African American males and females were diagnosed with HIV infection at eight and 19 times the rates for white males and females and two and four times the rates for Hispanic/Latino males and females, respectively. In addition, the number of HIV diagnoses made each year among black/African American males increased during 2005-2008. The reduction of HIV-related health disparities has been identified as one of the three goals in the National HIV/AIDS Strategy.3 Reducing HIV risk behaviors and increasing access to testing and referral to health care can help eliminate disparities between blacks/African Americans and other racial/ethnic populations in the rates at which HIV infection is diagnosed.
HIV infection is notifiable in all 50 states, the District of Columbia, and six U.S. dependent areas. However, nationwide HIV surveillance with uniform reporting was not implemented fully until 2008.* For this analysis, data representing HIV diagnoses made during 2005-2008 (the latest data available) were drawn from 37 states† that have long-term, confidential HIV infection reporting. The numbers and percentages of HIV diagnoses during 2005-2008 among adults and adolescents were calculated by year of diagnosis, race/ethnicity,§ sex, age group, transmission category, and U.S Census region of residence.¶ To calculate annual rates of HIV diagnoses per 100,000 adults and adolescents in each racial/ethnic group, yearly population estimates were obtained for the 37 states from the U.S. Census Bureau. Trends in annual rates of HIV diagnoses were assessed by race/ethnicity and sex. Surveillance data were statistically adjusted for reporting delays and missing risk-factor information, but not for incomplete reporting.2
During 2005-2008, blacks/African Americans accounted for 13.6% of the population in the 37 states and 50.3% of the 156,812 diagnoses of HIV infection during that period. Whites accounted for 67.9% of the population and 29.4% of diagnoses. Hispanics/Latinos accounted for 13.4% of the population and 17.8% of diagnoses (Table 1). Blacks/African Americans accounted for the largest percentage of HIV diagnoses in each age group. During 2005-2008, most (56.1%) HIV diagnoses were among persons aged 25-44 years; in this age group, blacks/African Americans accounted for 46.4% of HIV diagnoses. By region of residence, blacks/African Americans accounted for the majority of diagnoses in the South (55.7%).
Among adolescent and adult males, blacks/African Americans accounted for the largest percentage of diagnoses of HIV infection (44.8%) during 2005-2008 (Table 1). HIV transmissions in black/African American males were classified most frequently as male-to-male sexual contact (61.1%), followed by heterosexual contact (23.1%), injection drug use (IDU) (11.9%), and both male-to-male sexual contact and IDU (3.6%) (Table 2). Males aged 13-24 years accounted for the largest percentage (30.9%) of HIV diagnoses among black/African American males with infection attributed to male-to-male sexual contact, followed by males aged 25-34 years (28.7%) and 35-44 years (23.7%) (Table 2). Among adolescent and adult males, blacks/African Americans accounted for 50.1% of HIV diagnoses in the South and for the largest percentage (42.1%) of diagnoses in the Northeast (Table 1).
Among females, blacks/African Americans accounted for the largest percentage of diagnoses of HIV infection (65.9%) during 2005-2008 (Table 1). Most black/African American females diagnosed with HIV were exposed through heterosexual contact (85.2%), and the next greatest percentage by IDU (14.0%) (Table 2). Among black/African American females with infection attributed to heterosexual contact or to IDU, the largest percentages of diagnoses were in those aged 35-44 years (Table 2). Among females, blacks/African Americans accounted for the majority of HIV diagnoses in the South (70.9%), Midwest (60.9%), and Northeast (60.0%) (Table 1).
In 2008, among males and females of all racial/ethnic populations, black males had the highest HIV diagnosis rate (131.9 per 100,000). Trend analyses for 2005-2008 indicated that rates of HIV diagnoses increased among black/African American males (Figure). Trends in other race/ethnicity and sex groups were relatively stable (Figure).
Reported by: B. Laffoon, A. Satcher Johnson, M.P.H., S. Cohen, M.P.H., X Hu, M.S., R.L. Shouse, M.D., Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
Increase in Newly Diagnosed HIV Infections Among Young Black Men Who Have Sex With Men -- Milwaukee County, Wisconsin, 1999-2008
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication Morbidity and Mortality Weekly Report. Visit the CDC's website to find out more about their activities, publications and services.
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