THURSDAY, Nov. 17, 2005 (HealthDay News) -- The rate of HIV diagnoses has been dropping among blacks over the past four years but remains alarmingly high, at more than eight times the rate among whites, a new U.S. government report finds.
Fewer diagnoses among injection drug users and among heterosexuals, mostly in New York state, seems to be driving the trend, according to officials.
Among blacks, the rate of new HIV diagnoses (with or without a concurrent AIDS diagnosis) dropped about 5 percent each year between 2001 and 2004.
Yet in 2004, the rate of diagnosis among blacks was 76 per 100,000 people vs. only nine per 100,000 people in whites and 29.5 per 100,000 people in Hispanics.
"We found that new HIV diagnoses continue to be disproportionately high and severely impact African-Americans, both men and women," said Dr. Ronald O. Valdiserri, acting director of U.S. Centers for Disease Control and Prevention's National Center for HIV, STD and TB Prevention. "Because this finding is not new, it may be tempting to minimize its importance but it is critical that we not become complacent with this data, that we not accept the status quo."
Valdiserri spoke Thursday at a news conference timed to coincide with the publication of new HIV data in this week's issue of Morbidity and Mortality Weekly Report, a CDC publication. The report includes data from 33 state and local health departments, with name-based HIV reporting between 2001 and 2004. This year marks the first time that data from New York state, which has 20 percent of the nation's new diagnoses, has been included.
"Although it's not a complete picture, it is the most complete picture to date of what is happening in the United States," Valdiserri said.
California, Illinois and other areas with high rates of infection are still not included in the analysis.
As of 2003, more than 1 million people in the United States were estimated to be living with HIV, the virus that causes AIDS. More people with HIV are living longer, thanks to new treatments, but it means that AIDS is no longer a reliable way to estimate the epidemic.
For this reason, the CDC is recommending that all states and territories adopt confidential name-based systems to report HIV infection. To date, 38 states adhere to the practice.
According to the new data, the impact of HIV continues to be greatest among men who have sex with men (MSM), regardless of race. This group represented 44 percent of diagnoses during the four-year period.
High-risk heterosexual contact accounted for 34 percent of new cases, followed by injection drug users at 17 percent.
There was a 9 percent annual decline in diagnoses among injection drug users and a 4 percent decline among heterosexuals, much of which occurred in New York state, which has a more "mature" epidemic.
By race and ethnicity, 51 percent of diagnoses during the four-year period were among blacks, 29 percent among whites and 18 percent among Hispanics, said Lisa M. Lee, a co-author of the report and senior epidemiologist with the CDC's Division of HIV/AIDS Prevention. Asian/Pacific Islanders and American Indian/Alaska Natives each accounted for 1 percent or less of new diagnoses, and those groups continue to have the lowest HIV/AIDS rates of any racial/ethnic population in the United States.
The majority of diagnoses among males occurred among MSM (61 percent). The proportion of male diagnoses attributed to heterosexual exposure varied from 6 percent among whites to a high of 25 percent among blacks.
"Among men who have sex with men, diagnoses remained roughly stable in the first three years of the period, but increased 8 percent between 2003 and 2004," Lee said.
More than three-quarters (76 percent) of diagnoses among females occurred through heterosexual contact. "Black women continue to be severely and disproportionately impacted," Valdiserri said.
Overall, the number of diagnoses in the 33 states decreased slightly, from 41,207 in 2001 to 28,685 in 2004.
It's not entirely clear what factors are driving these trends, Valdiserri said.
What is clear is the need for continued prevention and treatment programs.
"There's no simple or single solution to address the complex factors now driving the HIV epidemic in the U.S.," Valdiserri said.
Despite accelerated programs in many areas, he added, "clearly, more must be done."
More information
The U.S. Centers for Disease Control and Prevention has more on HIV prevention and treatment.
