More Than 1M HIV-Positive People Living in United States; Nearly Half of Cases Among African Americans, CDC Says
About 1.1 million people living in the United States are HIV-positive -- the highest number ever recorded in the country -- and nearly half of those cases are among African Americans, CDC officials said on Monday at the 2005 National HIV Prevention Conference in Atlanta, the Atlanta Journal-Constitution reports (Wahlberg, Atlanta Journal-Constitution, 6/14). An estimated 1.039 million to 1.185 million people nationwide were HIV-positive as of December 2003, an increase over the estimated 850,000 to 950,000 cases at the end of 2002, officials said at the conference -- which began on Sunday and runs through Wednesday. In addition, an estimated 25% of HIV-positive individuals are unaware of their status, according to CDC (Sternberg, USA Today, 6/14). The increase reflects the growing number of HIV/AIDS patients who are living longer because of antiretroviral treatment, but it also shows the failure in preventing the spread of the virus, CDC said. With more HIV-positive people living longer and nearly one-quarter unaware of their status, experts estimate that a majority of new cases are caused by people who do not know they are HIV-positive (Maugh, Los Angeles Times, 6/14). The number of HIV/AIDS cases has increased among men in recent years, and the virus is mostly affecting African Americans and men who have sex with men, agency officials said, the New York Times reports. Of the approximately 1.1 million HIV-positive people in the United States, 47% are black, 34% are white, 17% are Hispanic and 2% are Asian, Pacific Islander, American Indian or Alaskan Native (Altman, New York Times, 6/14). In addition, data show that MSM accounted for about 45% of all cases at the end of 2003 (Simao, Reuters, 6/13).
The estimates are based on back calculations and give a picture of HIV prevalence, according to CDC epidemiologist Kate Glynn. The statistical method does not directly measure the number of new infections or the incidence, but there was no evidence of increased diagnoses among women, injection drug users or heterosexuals, Ronald Valdiserri, deputy director of CDC's National Center for HIV, STD and TB Prevention, said. In addition, the findings are consistent with other data that suggest an increase in the number of HIV cases among young MSM (New York Times, 6/14).
Comments, Next Steps
"We are encouraged by our collective successes and challenged by the continuing severity of this epidemic," Valdiserri said (Spice, Pittsburgh Post-Gazette, 6/14). He added, "While treatment advances have been an obvious godsend to those living with the disease, it presents new challenges for prevention." Those challenges include reaching the approximately 25% of people who do not know they are HIV-positive and educating those who have been tested about HIV prevention strategies (Yee, AP/Chicago Tribune, 6/14). These challenges in part are why CDC has not yet reached its goal of halving the number of new HIV cases by this year. The number of new cases has held stable at about 40,000 annually since the 1990s (LaMendola/McVicar, South Florida Sun-Sentinel, 6/14). Valdiserri said providing testing and prevention services to high-risk populations, including black MSM, is an important step in slowing the spread of HIV (Washington Times, 6/14). "Knowing your HIV status is key to protecting your health and that of your sexual partners. Ensuring that people have access to testing and receive their HIV test results -- along with post-test prevention counseling -- is essential to reducing the number of new HIV infections in the U.S.," Valdiserri said, adding, "Voluntary testing links people at risk for HIV to counseling to help them stay uninfected and helps ensure that HIV-positive individuals are linked with medical care and prevention services to help them protect others from infection" (CDC release, 6/13).
Several studies presented at the conference on Monday show that the number of HIV cases is increasing among African Americans, particularly men. A study of MSM conducted over the past year in Baltimore, Los Angeles, Miami, New York City and San Francisco showed that of the 46% of black men who tested HIV-positive, about two-thirds were unaware of their status (Atlanta Journal-Constitution, 6/14). A 25-state study conducted between 1994 and 2003 among people ages 13 to 24 who were newly diagnosed with HIV showed that the number of diagnoses fell by about 20% among young women during that period. Although the number of diagnoses declined by nearly one-third among men between 1994 and 1998, there was a 41% increase in the number of HIV cases among men between 1999 and 2003. The increase in diagnoses among young men was driven by a 47% increase in cases among 20- to 24-year-old MSM, about 60% of whom were black (USA Today, 6/14).
The CDC conference this week will focus on preventing the spread of the disease among blacks, the Atlanta Journal-Constitution reports. The HIV/AIDS epidemic in the United States recently has taken on more of a "black identity," with blacks representing more than 50% of new HIV cases despite making up only 12% of the U.S. population, according to the Journal-Constitution. Black women are 19 times as likely to be infected with HIV as white women, and 32% of black men ages 23 to 29 who have sex with men are HIV-positive, compared with 14% of Latino MSM and 7% of white MSM of the same age, according to a CDC study conducted four years ago. "In the past five years, the evidence has accumulated to emphasize the importance of this population," Richard Wolitski, acting chief of prevention research at CDC's HIV center, said, adding, "We need to do as much as we can to reduce their HIV risk." Researchers also are beginning to study condom use among black MSM who do not self-identify as gay and often also have sexual relationships with women, according to the Journal-Constitution (Wahlberg, Atlanta Journal-Constitution, 6/13).
NPR's "Morning Edition" on Tuesday reported on the updated HIV/AIDS data. The segment includes comments from Valdiserri and Gary English, executive director of People of Color in Crisis (Wilson, "Morning Edition," NPR, 6/14). The complete segment is available online in RealPlayer. Webcasts of select sessions of the National HIV Prevention Conference are available online from kaisernetwork.org.