African-Americans, Latinos and gay men bear the brunt of new US HIV infections

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HIV continued to spread in the US in 2002, according to figures released by the Centers for Disease Control and Prevention (CDC) in advance of World AIDS Day.

Data gathered from 29 US states with confidential name-based HIV case reporting revealed that new diagnoses rose by over 5% between 1999 and 2002, a total of 102,590 new cases, with African Americans, Latinos, and gay men being the communities most affected by increases.

It is not possible to say exactly how many people in the US are HIV-positive as not all US states collect appropriate data (unlike the United Kingdom), but it is estimated that between 950,000 and 850,00 people in the US are HIV-positive.

African Americans

In 2002 the rate of HIV cases for African Americans (58.7 per 100,000) was the times greater than that seen in whites (5.9 per 100,000), and three times greater than that seen in Latinos (19.2 per 100,000).

Glossary

AIDS defining condition

Any HIV-related illness included in the list of diagnostic criteria for AIDS, which in the presence of HIV infection result in an AIDS diagnosis. They include opportunistic infections and cancers that are life-threatening in a person with HIV.

syphilis

A sexually transmitted infection caused by the bacterium Treponema pallidum. Transmission can occur by direct contact with a syphilis sore during vaginal, anal, or oral sex. Sores may be found around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth, but syphilis is often asymptomatic. It can spread from an infected mother to her unborn baby.

efficacy

How well something works (in a research study). See also ‘effectiveness’.

risky behaviour

In HIV, refers to any behaviour or action that increases an individual’s probability of acquiring or transmitting HIV, such as having unprotected sex, having multiple partners or sharing drug injection equipment.

safer sex

Sex in which the risk of HIV and STI transmission is reduced or is minimal. Describing this as ‘safer’ rather than ‘safe’ sex reflects the fact that some safer sex practices do not completely eliminate transmission risks. In the past, ‘safer sex’ primarily referred to the use of condoms during penetrative sex, as well as being sexual in non-penetrative ways. Modern definitions should also include the use of PrEP and the HIV-positive partner having an undetectable viral load. However, some people do continue to use the term as a synonym for condom use.

Figures from the CDC also revealed that HIV was the third leading cause of death amongst African Americans aged 24 – 44, and although African Americans comprise only 12% of the total US population, they accounted for 55% of new HIV diagnoses seen in 2002.

Latinos

Latinos provided just under 12% of new HIV diagnoses between 1999 and 2002. However, the CDC believe that the extent to which Latinos are affected by HIV is underestimated as several states with large Latino populations were not included in the current analysis.

Late diagnosis of HIV was more common amongst Latinos than either African Americans or whites, with studies suggesting that Latinos are the group most likely to have an AIDS defining condition at the time of their diagnosis or to develop one within a year of their HIV infection being detected.

Gay men

Between 1999 and 2002, over 43,000 new HIV infections were diagnosed in gay men in the 29 states contributing data. These new data support findings from 25 states issued earlier this year which showed an increase in syphilis amongst gay men. The investigators believe the rise in syphilis cases signals an increase in the amount of unprotected anal sex gay men are having. “Such increases in risky behavior may be the 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 sex behaviors for a lifetime” comments the CDC.

”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” said Harold Jaffe, director of the CDC’s HIV prevention programmes. He added that greater efforts must be made to encourage people who were unaware of their HIV infection to test and receive appropriate treatment. It’s estimated that of the 850,000 – 950,000 Americans living with HIV, approximately 180,000 – 280,000 don’t know that they are infected.

References

Source. Morbidity and Mortality Weekly. Volume 52, November 28th, 2003.