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One Third of New HIV Cases Are Heterosexual, Feds Report

New data from 29 states show young black women at highest risk

THURSDAY, Feb. 19, 2004 (HealthDayNews) -- More than a third of Americans recently infected with the AIDS virus acquired it through heterosexual sex, claims a new federal study of data from 29 states.

Young black women appear to be at the highest risk, along with people who are in their 30s, the report issued Thursday by the U.S. Centers for Disease Control and Prevention finds.

"Worldwide, this is still a disease of heterosexuality, probably close to 90 percent of cases, if not more," says Dr. Michael Horberg, director of HIV/AIDS for the Kaiser Permanente Health Plan. "In our country, it has not been. But this is a very fast-growing group."

In fact, other statistics suggest that a bit less than half of all newly diagnosed HIV cases in the United States are not among gay or bisexual men, but instead among heterosexuals who had sex with each other or engaged in the risky habit of injecting drugs.

Federal researchers examined 1999-2002 statistics on HIV infection from 29 states that required doctors to submit the names of diagnosed patients. HIV is the virus that causes AIDS; it's possible to have HIV and not AIDS, but not the other way around.

The list of states studied do not include several large ones, such as California, Illinois, New York and Texas. The latter two states have since instituted so-called "name reporting" of HIV cases.

The findings were released last year, the first time such a large study examined HIV infection, not the prevalence of AIDS itself. Thursday's report examines the heterosexual angle.

The report says 35 percent of the 101,877 HIV infections studied were acquired through heterosexual sex, either with an HIV-positive person or someone at increased risk of HIV infection, such as an intravenous drug user. Of the cases apparently acquired through heterosexual sex, 74 percent were black and just 15 percent were white; 64 percent were women.

Among people aged 13-19, a whopping 89 percent of heterosexually acquired HIV cases were among females.

"This data gives us a much broader and current picture of what is going on," says Frank Edward Myers III, an epidemiologist at Scripps Mercy Hospital in San Diego. "This data reflects what we have known about HIV in heterosexuals. It is a growing problem for women of color. The data still demonstrate that males are at lower risk for heterosexually acquired HIV."

It's easier for women to become infected with HIV during heterosexual sex because they are the "receiving" partners, Horberg says. "I also think that, for a lot of reasons, the men refuse to wear condoms, putting women at increased risk," he says.

Other factors contribute to the heterosexual cases. Researchers suspect a number of young black women become infected with HIV because their outwardly heterosexual boyfriends secretly seek sexual contact with men.

In terms of prevention, "the best things are use of condoms, education about safer sex for women, and greater emancipation and liberation of women so they can demand better, safer sex techniques," Horberg says.

He adds that anti-HIV microbicide creams now in development may help women protect themselves without having to rely on their male sex partners.

In related news, federal officials also released a report exploring how the Los Angeles County Department of Public Health used the Internet to track down the sex partners of two gay men infected with syphilis. The disease has spread rapidly through gay communities in several cities, and health officials say many infected men met each other through online chat rooms.

One of the men, an HIV-positive 32-year-old, was diagnosed with syphilis in December 2002. He reported having 134 sex partners over a six-month period; he met all of them through the Internet.

Health officials used 111 e-mail addresses and 23 phone numbers to track down most of the men. Twenty-nine of the men responded to e-mails warning them that their health may be in jeopardy.

In another case from January 2003, a 31-year-old man diagnosed with syphilis e-mailed 13 of 16 sex partners he'd met over the Internet. Seven responded and sought testing.

The report said the Internet presents "new challenges and opportunities for STD and HIV prevention and control."

More information

To learn more about HIV/AIDS and treatments, visit the U.S. Centers for Disease Control and Prevention or the National Institute of Allergy and Infectious Diseases .

SOURCES: Michael Horberg, director, HIV/AIDS policy, quality improvement and research, Kaiser Permanente Health Plan, Oakland, Calif.; Frank Edward Myers III, M.A., C.I.C., epidemiologist, Scripps Mercy Hospital, San Diego; Feb. 20, 2004, Morbidity and Mortality Weekly Report
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