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One in 64 in US--Including 1 in 2 Black MSM--Will Get HIV in Their Lifetime
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Conference on Retroviruses and Opportunistic Infections (CROI), February 22-25, 2016, Boston
Mark Mascolini
WEBCAST link: http://www.croiwebcasts.org/console/player/29467?mediaType=audio&
One of every 64 people alive in the United States today will get diagnosed with HIV infection in their lifetime, according to calculations by the Centers for Disease Control and Prevention (CDC) [1]. The overall US rate has dropped substantially since the CDC's last estimate in 2004-2005, but some subgroups have dauntingly high rates, including women who inject drugs (1 in 23) and men who have sex with men (MSM) (1 in 6). Half of all black MSM and one quarter of all Hispanic MSM will get diagnosed with HIV in their lifetime.
CDC researchers who conducted this study noted that the lifetime risk methods is often used to describe cancer risk but rarely used to estimate HIV risk. The CDC last ran such an exercise using 2004-2005 data. The investigators based the new analysis on (1) HIV diagnosis data from the National HIV Surveillance System, (2) mortality data from the National Center for Health Statistics, and (3) population data from the US Census for the years 2009-2013. Lifetime risk is the cumulative probability of being diagnosed with HIV from birth. The researchers also figured 10-year age-conditional risk, which is the probability that a person of a specific age will get diagnosed with HIV in the next 10 years.
Overall the CDC calculated that 1 in 64 people in the United States will get diagnosed with HIV in their life. Lifetime risk is highest in blacks (1 in 20) and successively lower in Hispanics (1 in 48), Hawaiian and Pacific Islanders (1 in 82), American Indians and Alaskan Natives (1 in 129), whites (1 in 132), and Asians (1 in 174). Estimated lifetime risk among black women stood at 1 in 48, compared with 1 in 227 in Hispanic women and 1 in 880 in white women.
One in every 6 MSM in the United States stands to get diagnosed with HIV infection in their lifetime, according to the CDC calculations, including 1 in 2 black MSM, 1 in 4 Hispanic MSM, and 1 in 11 white MSM. One in 23 women who inject drugs will get diagnosed with HIV, as will 1 in 36 men who inject drugs. Among blacks who inject drugs, lifetime HIV risk is 1 in 6 among women and 1 in 9 among men. Among Hispanics who inject, HIV risk is 1 in 21 among both women and men. Among heterosexuals, 1 in 49 black women and 1 in 86 black men will get diagnosed with HIV infection in their lifetime.
By state, people living in Maryland have the highest lifetime HIV risk (1 in 49), followed by Georgians (1 in 51) and Floridians (1 in 54). One in every 13 residents of Washington, DC, stands to get diagnosed with HIV infection.
Overall, 1 in 15 people 20 years old will get diagnosed with HIV in the next 10 years, the CDC estimated. That 10-year risk rises to 1 in 21 for 30-year-olds, 1 in 26 for 40-year-olds, and 1 in 55 for 50-year-olds. But in some groups the 10-year risk gets higher with age, such as men who inject drugs (1 in 196 for 20-year-olds, 1 in 173 for 30-year-olds, 1 in 141 for 40-year-olds, and 1 in 138 for 50-year-olds.
For all heterosexual men, the 10-year risk is highest among 40-year-olds (1 in 1673), but for all heterosexual women, the youngest groups run the greatest risk: 1 in 931 for 20-year-olds and 1 in 933 for 30-year-olds versus 1 in 1076 for 40-year-olds and 1 in 1669 for 50-year-olds. The CDC researchers suggested that having the highest 10-year risk at age 40 or 50 "may suggest late diagnosis and a need for more testing."
"Without improvements in prevention," the CDC team concluded, "millions of Americans are expected to acquire HIV infection during their lifetime, and large disparities persist by sex and race/ethnicity."
Reference
1. Hess K, Hu X, Lansky A, Mermin J, Hall HI. Estimating the lifetime risk of a diagnosis of HIV infection in the United States. Conference on Retroviruses and Opportunistic Infections (CROI), February 22-25, 2016, Boston. Abstract 52.
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