CDC estimate over 1 million HIV-positive people in US

Data presented at the 2005 National HIV Prevention Conference in Atlanta, Georgia, indicate that roughly one million Americans were living with HIV at the end of 2003 and that HIV prevalence remains extremely high among African-American men who have sex with men (MSM) in several U.S. cities. Other data show that while HIV diagnoses reported among adolescent and young adult females have declined steadily, diagnoses in males have increased in recent years. Data presented also show that some prevention programs are substantially reducing sexual risk behavior among people with HIV and those at risk for infection, and that voluntary rapid testing efforts are increasing the number of people who find out their HIV status.

African Americans and MSM Most Affected

New Centers for Disease Control and Prevention (CDC) estimates of HIV prevalence in the United States indicate that between 1,039,000 and 1,185,000 people were living with HIV in December 2003. The estimates provide the clearest picture to date of the scope of the U.S. epidemic overall and among specific racial and ethnic and risk groups.

The new estimates indicate that HIV continues to have the greatest impact among African Americans and MSM. At the end of 2003, blacks accounted for 47 percent of people estimated to be living with HIV in the US; whites accounted for 34 percent and Hispanics for 17 percent. Asian/Pacific Islanders and American Indians/Alaska Natives each represented roughly 1 percent of the HIV-positive population. By transmission category, MSM remained the most heavily affected group, accounting for 45 percent of people living with HIV. Individuals infected through high-risk heterosexual contact comprised 27 percent, and those infected through injection drug use accounted for 22 percent of the HIV-positive population. Roughly three-quarters (74%) of Americans estimated to be living with HIV are male.

A separate CDC analysis suggests that undiagnosed HIV infection continues to play a significant role in the extremely high rates of infection among African-American MSM. Consistent with earlier research, black MSM in a new five-city study were more than twice as likely to be infected with HIV as other MSM, and were less likely to be aware of their infection. Forty-six percent of black MSM in the study were HIV-positive, compared to 21 percent of white MSM and 17 percent of Hispanic MSM. Among HIV-infected MSM, 67 percent of black men, 48 percent of Hispanic men, and 18 percent of white men were unaware of their infection before study participation, underscoring the need to reach MSM with testing and prevention services. The study surveyed 1,767 MSM over age 18 at public venues in Baltimore, Los Angeles, Miami, New York City, and San Francisco between June 2004 and April 2005 (Plenary session, New Approaches to Tracking the HIV Epidemic in the U.S.).

Other CDC data point to the continuing impact of HIV on young African-American MSM across the nation. Researchers examined trends in new HIV diagnoses (with or without AIDS) among persons 13 to 24 years of age between 1994 and 2003 in 25 U.S. states with longstanding, name-based HIV reporting . Results indicate that new diagnoses declined significantly among young women, but rose among young men. Among 13- to 24-year-old females, new HIV diagnoses fell 20 percent over the 10-year period. HIV diagnoses also declined among young men for the first few years of the period (by 30% from 1994 to 1998); but the decline was offset by a 41 percent increase from 1999 to 2003. The increase among young men was driven by a 47 percent rise in diagnoses among MSM ages 20-24, 60 percent of whom were black. While researchers were unable to determine if the increases in HIV diagnoses among young men were the result of increased testing or an actual increase in new infections, the findings are consistent with other recent data suggesting a possible resurgence of HIV among young MSM.