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New study shows overall increases in HIV diagnoses: African Americans, Latinos, Gay and Bisexual Men most affected; Impact of HIV/AIDS on Select Populations reported below
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Press Release from the CDC, National Center for HIV, STD & TB Prevention November 26, 2003 World AIDS Day 2003
The MMWR analysis of 29-state HIV surveillance data from 1999 through 2002 shows:
- HIV/AIDS diagnoses increased 5.1 percent from 1999 to 2002, an upturn from the previous downward trend seen in U.S. infections.
- 102,590 new HIV diagnoses were reported: 70.5 percent among males, 29.5 percent among females
- African Americans continue to comprise largest percentage of new HIV diagnoses (55 percent)
- Significant rises in HIV diagnoses are now being reported among Latinos (up 26 percent), gay and bisexual men (up 17 percent), men in general (up 7 percent) and whites overall (up 8 percent)
- Since data from some of the states with the largest HIV populations - New York, California, Texas - are not reflected in this analysis, the new surveillance statistics provide us with an incomplete picture of the HIV epidemic in the United States.
- Other facts to consider for World AIDS Day 2003:
- An estimated 850,000 to 950,000 Americans are HIV-positive, more than ever before
- Less than half of adults ages 18-64 have ever been tested for HIV and only 28 percent have been tested within the past 12 months.
- About one-third of people who take an HIV test never return for their result.
- Forty percent of people who test positive for HIV will be diagnosed with full-blown AIDS within one year - too late to fully benefit from available treatments
- An estimated 40,000 Americans continue to become infected with HIV each year.
A comprehensive analysis of US HIV cases reveals that new HIV diagnoses in 29 states increased in 2002, the Centers for Disease Control and Prevention announced today. Overall, new diagnoses in these states rose by 5.1 per cent over the four-year period 1999 to 2002. The increases underscore the urgent need for public awareness and action as countries around the globe observe World AIDS Day.
The new analysis of 102,590 people diagnosed with HIV in the 29 states between 1999 and 2002 shows that African-Americans continued to account for more than half (55%) the new diagnoses. Additionally, significant increases in new HIV diagnoses were observed among Latinos (26% increase) and non-Hispanic whites (8% increase). HIV diagnoses increased 17 percent among gay and bisexual men, and 7 percent among men overall. The study found no significant changes in the number of new HIV diagnoses among Asian/Pacific Islanders or Native Americans. The analysis was published in the November 28 issue of Morbidity and Mortality Weekly Report (MMWR).
“Fighting HIV in America is as urgent on World AIDS Day in 2003 as it was more than two decades ago when the epidemic began,” said Dr. Julie Gerberding, CDC director. “These new findings strongly support three key realities of today’s epidemic: the HIV epidemic in this country is not over; more often than not the face of HIV in this country is black or Latino; and gay and bisexual men in several communities are facing a possible resurgence of HIV infection.”
“Stigma and discrimination – themes for this year’s World AIDS Day – help perpetuate the HIV epidemic around the world and here in our own country,” said Dr. Harold Jaffe, director of CDC’s HIV prevention programs. “These obstacles deter people from getting tested and prevent HIV-infected people from receiving treatment. They also increase the already heavy burden of HIV in communities of color.”
The 29 states included in the analysis have conducted confidential, name-based HIV case reporting since 1999. The study is based on reported new HIV diagnoses, which is the point at which an individual learns of his/her HIV infection, not necessarily the point at which a person became infected. Increases in HIV diagnoses do not always reflect increases in new infections because numbers showing new diagnoses include individuals who were recently infected as well as those who were infected long ago but only recently tested and diagnosed.
Study authors believe, however, the data suggest that the rise in new HIV diagnoses likely represents actual new infections and not a greater amount of testing. Increases in HIV testing can lead to increased numbers of people being diagnosed with HIV. The study authors note, however, that more people who had progressed to AIDS before their HIV diagnoses might have been detected if increased testing were a major factor, and this was not the case in this study.
“Even with this still-incomplete picture of HIV infection in America, it’s clear that we still face enormous challenges in continuing to confront the AIDS epidemic,” Dr. Jaffe said. “Foremost among these challenges is working to encourage HIV-positive persons in our country, who are unaware of their infections, to seek testing, treatment and prevention counseling. CDC announced a new initiative in April of this year aimed at increasing opportunities for testing, counseling and treatment for these individuals.”
Through its new “Advancing HIV Prevention” initiative, CDC is working with communities, government groups and health care providers across the nation to help at-risk individuals learn their HIV status, better understand ways of preventing HIV infection, and, if infected, receive treatment and care. At-risk populations include people infected with HIV, those not infected, and those who are unsure of their status. A new rapid HIV test, which can provide preliminary results in as little as 20 minutes, is central to this effort.
CDC estimates that between 850,000 and 950,000 Americans are now living with HIV. This is the greatest number since the epidemic began more than two decades ago. It is estimated that one fourth of the people living with HIV, approximately 180,000 to 280,000 people, remain unaware of their infections. An estimated 40,000 new HIV infections continue to occur in the US each year.
New data indicate that African Americans continued to represent more than half of new HIV diagnoses reported to CDC, while significant increases in diagnoses were noted among Latinos and gay and bisexual men in 29 U.S. states from 1999 to 2002 (see CDC press release below). Other recent findings that highlight the impact of HIV on these populations are described below.
HIV/AIDS Still Hits African Americans Hardest
HIV disproportionately affects African Americans, who have historically had limited access to AIDS treatment and prevention services. In 2002, the rate of AIDS cases for African Americans (58.7 per 100,000 population) was 10 times greater than the rate among whites (5.9 per 100,000 population) and 3 times greater than that among Latinos (19.2 per 100,000 population). HIV/AIDS is currently the third leading cause of death among African Americans 25 to 44 years of age, while for Latinos it is number four, and for whites it is number five. African Americans comprise 12 percent of the U.S. population, but accounted for the majority (55 percent) of new HIV diagnoses reported in 2002.
These disparities are reflected geographically. For example, a study by the Kaiser Family Foundation found that African Americans comprise 19 percent of the population of the South, but represent 53 percent of people with living with AIDS in that region. African Americans not only become infected with HIV more frequently than other racial/ethnic groups, they are also more like to know someone who died from AIDS (57 percent of African Americans vs. 43 percent of whites).
HIV Diagnoses On the Rise Among Latinos
In the analysis of HIV diagnoses from 29 states, the addition of data from Florida and New Mexico – two states with sizeable Latino populations – provides a better, though still incomplete, picture of the epidemic among Latinos than previous reports. In the 29-state surveillance study, Latinos represented 11.5 percent of the new diagnoses reported from 1999 to 2002. Because many states with large Latino populations are not included in this analysis, Latinos may account for an even greater percentage of new HIV infections nationally.
According to national AIDS data, Latinos are three times more likely to be diagnosed with AIDS than non-Hispanic whites. Studies indicate that Latinos also are more likely to obtain an HIV test later in disease – to be diagnosed with AIDS at the time of their first HIV test or to develop AIDS within one year of testing positive – than blacks and whites. Such late testing results in missed opportunities for treatment that can protect the health of those with HIV and adoption or maintenance of behaviors to prevent infection of partners.
New HIV Infections Continue to Climb Among Gay and Bisexual Men
Over the four-year period 1999 to 2002, 43,144 new HIV diagnoses among gay and bisexual men were reported in 29 states, accounting for 42 percent of all new cases. These new 29-state surveillance data showing increases in HIV diagnoses among men who have sex with men support 25-state data released earlier this year at the National HIV/STD Conference and coincide with recent outbreaks of syphilis in several major metropolitan areas. These syphilis outbreaks are believed to signal increasing levels of unprotected sex among gay and bisexual men in these areas. Such increases in risky behavior may be a result of complex prevention challenges such as treatment efficacy – the belief that HIV is no longer a deadly disease because of improvements in treatment – and prevention burnout – the difficulty of maintaining safer behaviors for a lifetime.
According to CDC research presented at the XIV International AIDS Conference in 2002, many gay and bisexual men with HIV remain unaware of their HIV status. A large study of young, HIV-positive gay men in six major U.S. cities found that 77 percent did not know that they were infected. Among African-American men in that same study, 91 percent were unaware they were HIV-infected.
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