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U.S. Centers for Disease Control and Prevention
HIV/AIDS Surveillance in Urban and Nonurban Areas (Through 2006)

June 5, 2008


Slide 1: HIV/AIDS in Urban and Nonurban Areas There are many classifications areas and populations (urban and non-urban). Although each classification system differs slightly, most places designated urban by one system are also designated urban by the others. Some systems distinguish larger and smaller metropolitan areas, some consider proximity to metropolitan areas, and others consider the economic and social integration in a core area of high population. The Centers for Disease Control and Prevention uses the Office of Management and Budget's system, which designates metropolitan statistical areas (MSAs). Areas are divided into MSAs of populations of more than 500,000; 50,000 to 500,000; and nonmetropolitan. This slide set excludes cases reported from U.S. dependent areas for they are not included in the regional classification system used for these slides.
Slide 1
HIV/AIDS in Urban and Nonurban Areas
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Slide 2: Reported AIDS Cases and Rates among Adults and Adolescents, by Population of Area of Residence, 2006 and Cumulative 50 States and DC In 2006, the majority of the adults and adolescents reported with AIDS resided in metropolitan areas with populations of more than 500,000. The rate of AIDS diagnosis was highest (19.3 per 100,000) for adults and adolescents residing in metropolitan areas with populations of more than 500,000 compared with adults and adolescents residing in areas with smaller populations at the time of diagnosis.
Slide 2
Reported AIDS Cases and Rates among Adults and Adolescents by Population of Area of Residence, 2006 and Cumulative 50 States and DC
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Slide 3: Proportion of AIDS Cases among Adults and Adolescents by Population of Area of Residence 1994-2006 -- 50 States and DC In 1994, 87% of reported AIDS cases were diagnosed among adults and adolescents from metropolitan areas with populations of more than 500,000 and 5% were among adults and adolescents from nonmetropolitan areas. Despite steady decreases in the number of adults and adolescents reported with AIDS since 1994, the percentages reported in 2006 (82% from metropolitan areas with populations of more than 500,000 and 7% from nonmetropolitan areas) were similar to those in 1994.
Slide 3
Proportion of AIDS Cases among Adults and Adolescents by Population of Area of Residence 1994-2006 -- 50 States and DC
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Slide 4: Regions of the United States This map shows the 50 states (and the District of Columbia) that are included in each of four regions of the United States. American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands are not included in this regional classification system, although they report AIDS cases to CDC. Regions of residence are defined as follows: Northeast -- Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont Midwest -- Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin South -- Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia West -- Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming
Slide 4
Regions of the United States
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Slide 5: Reported AIDS Cases and Rates for Adults and Adolescents by Region and Population of Area of Residence 2006 -- 50 States and DC In each region of the United States, the majority of adults and adolescents reported with AIDS are from metropolitan areas with populations of more than 500,000 and the fewest are from nonmetropolitan areas. The South has the largest number and proportion of cases reported from nonmetropolitan areas. Although metropolitan areas with populations of more than 500,000 have the largest number of AIDS cases, smaller metropolitan and nonmetropolitan areas, especially in the South, share a substantial burden of the AIDS epidemic. The Northeast and South have the highest AIDS case rates regardless of the size of the population of residence. Regions of residence are defined as follows: Northeast -- Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont Midwest -- Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin South -- Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia West -- Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming
Slide 5
Reported AIDS Cases and Rates for Adults and Adolescents by Region and Population of Area of Residence 2006 -- 50 States and DC
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Slide 6: Proportion of AIDS Cases among Adults and Adolescents by Region and Population of Area of Residence 2006 -- 50 States and DC In 2006, the majority of AIDS cases among adults and adolescents were reported from metropolitan areas with a population of more than 500,000; the South had the greatest proportion of cases reported from smaller metropolitan (50,000-500,000) and nonmetropolitan areas. Regions of residence are defined as follows: Northeast -- Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont Midwest -- Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin South -- Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia West -- Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming
Slide 6
Proportion of AIDS Cases among Adults and Adolescents by Region and Population of Area of Residence 2006 -- 50 States and DC
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Slide 7: Reported AIDS Cases among Adults and Adolescents by Race/Ethnicity and Population of Area of Residence 2006 -- 50 States and DC In 2006, most AIDS cases among adults and adolescents in each racial/ethnic group were reported from metropolitan areas with populations of more than 500,000. Blacks (not Hispanic) accounted for the greatest number of cases regardless of the population of the area of residence at diagnosis.
Slide 7
Reported AIDS Cases among Adults and Adolescents by Race/Ethnicity and Population of Area of Residence 2006 -- 50 States and DC
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Slide 8: Proportion of AIDS Cases among Male Adults and Adolescents by Transmission Category and Population of Area of Residence 2002-2006 -- 50 States and DC In each of the population categories, more than half of cumulative AIDS cases from 2002 through 2006 have been in males who have had male-to-male sexual contact. Approximately 20% of males reported from each population category were injection drug users. On the national level, the overall pattern of the distribution of risk factors does not differ by the population of the area of residence at the time of diagnosis.
Slide 8
Proportion of AIDS Cases among Male Adults and Adolescents by Transmission Category and Population of Area of Residence 2002-2006 -- 50 States and DC
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Slide 9: Proportion of AIDS Cases among Female Adults and Adolescents by Transmission Category and Population of Area of Residence 2002-2006 -- 50 States and DC The distribution of risk factors by population of area of residence for females reported with AIDS shows that injection drug use is less frequently reported as the source of infection when comparing areas of decreasing population and urbanization. In all areas, the proportion of cases attributed to high-risk heterosexual contact with a male at risk for HIV (other than an injection drug user) is higher than the proportion attributed to other risk factors. Most of the females who attributed their infection to high-risk heterosexual contact reported that their male partners were HIV-infected but the partner's risk factor was not reported.
Slide 9
Proportion of AIDS Cases among Female Adults and Adolescents by Transmission Category and Population of Area of Residence 2002-2006 -- 50 States and DC
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Slide 10: Reported AIDS Cases among Adults and Adolescents by Age at Diagnosis and Population of Area of Residence 2006 -- 50 States and DC The distribution of reported AIDS cases among adults and adolescents by age at diagnosis does not differ by population of area of residence. In each category, approximately 40% of the AIDS cases reported in 2006 were among adults age 35 to 44 years at diagnosis, 21% to 23% were among adults age 25 to 34 years, and an additional 24% to 25% were among adults age 45 to 54 years. Approximately 10% of cases in each category were among adults age 55 years and older at diagnosis, and 6% in persons 13-24 years.
Slide 10
Reported AIDS Cases among Adults and Adolescents by Age at Diagnosis and Population of Area of Residence 2006 -- 50 States and DC
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Slide 11: Reported AIDS Cases among Adults and Adolescents in Nonmetropolitan Areas, 2006 -- 50 States and DC The number shown in each state is the number of AIDS cases reported in 2006 for adults and adolescents who resided in nonmetropolitan areas. The color of the state reflects the percentage of the total cases reported that were from nonmetropolitan areas. For states shown in orange, more than 25% of the cases were in adults and adolescents who resided in nonmetropolitan areas of the state. For states shown in yellow, 10% to 25% of the reported cases were in adults and adolescents from nonmetropolitan areas. Some states shown in light blue may have a large number of cases in persons reported from nonmetropolitan areas; however, they represent a small proportion of the total number of adults and adolescents reported from that state in 2006.
Slide 11
Reported AIDS Cases among Adults and Adolescents in Nonmetropolitan Areas, 2006 -- 50 States and DC
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Slide 12: Reported Cases of HIV Infection (not AIDS) among Adults and Adolescents in Nonmetropolitan Areas 2006 -- 38 States This map shows the number of cases of HIV infection (not AIDS) reported in 2006 among adults and adolescents who resided in nonmetropolitan areas. Data are shown for the 45 states with confidential name-based HIV infection reporting as of December 2006. These numbers are underestimates of the number of adults and adolescents with HIV infection, because only persons who have been tested confidentially are reported. Georgia, North Carolina, and Illinois reported the largest number of HIV cases in adults and adolescents residing in nonmetropolitan areas in 2006. In 2006, the following 45 states conducted confidential name-based HIV case surveillance and reported cases of HIV infection in adults, adolescents, and children to CDC: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Slide 12
Reported Cases of HIV Infection (not AIDS) among Adults and Adolescents in Nonmetropolitan Areas 2006 -- 38 States
PDF File or PPT File

Slide 13: AIDS Rates for Adults and Adolescents by Population of Area of Residence and Region Reported in 2006 -- 50 States and DC The distribution of AIDS diagnosis rates per 100,000 for adults and adolescents is shown for each region and population category for area of residence. The highest rate for each region is found in metropolitan areas with a population of more than 500,000. Regions of residence are defined as follows: Northeast -- Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont Midwest -- Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin South -- Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia West -- Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming
Slide 13
AIDS Rates for Adults and Adolescents, by Population of Area of Residence and Region, Reported in 2006 50 States and DC
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Slide 14: Reported AIDS Cases and Rates for Adults and Adolescents by Population of Area of Residence and Sex 2006 -- 50 States and DC The majority of AIDS cases reported in 2006 were among males, regardless of the population of the area of residence at diagnosis. The AIDS diagnosis rate per 100,000 for males was nearly 3 times higher than the rate for females in each of the population categories for area of residence.
Slide 14
Reported AIDS Cases and Rates for Adults and Adolescents, by Population of Area of Residence and Sex, 2006 -- 50 States and DC
PDF File or PPT File

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