U.S. Reports Rise in HIV Cases

CDC sees 5% increase since 1999; gays, blacks, Latinos at most jeopardy

WEDNESDAY, Nov. 26, 2003 (HealthDayNews) -- The most extensive statistics of their kind suggest that the number of people diagnosed with the AIDS virus in the United States has risen by 5 percent since 1999, with gay men, blacks and Latinos most at risk.

For the most part, HIV -- the virus that causes AIDS -- continues to mostly strike homosexual men and heterosexual women. Six out of every 10 infected men are gay or bisexual, while 70 percent of the infected women apparently got the disease through sex with men, according to a new government report issued Wednesday.

AIDS infection rates are notoriously difficult to track. States routinely report cases of full-blown AIDS to the federal government, but the statistics provide no information about the rate of new infections because it can take infected people years to develop the disease. The time lag is even longer because powerful drugs are keeping AIDS at bay in HIV-positive patients.

Until recently, states had a crazy quilt of different laws about collecting data on people newly diagnosed with HIV infection. However, federal laws now require states to report HIV infections along with AIDS cases.

The new analysis of HIV infections, conducted by the U.S. Centers for Disease Control and Prevention, is the most wide-ranging in the history of the AIDS epidemic. It examines 29 states that tracked the infections from 1999-2002, but many large states -- including California, Texas, Illinois, Massachusetts and New York -- aren't included. And those diagnosed may have been infected years ago.

Even so, the statistics provide a useful glimpse at the current state of the epidemic, says Dr. Ronald O. Valdiserri, a deputy director in charge of sexually transmitted disease studies at the CDC.

Federal researchers analyzed reports of 102,590 people diagnosed with HIV from 1999-2002.

Their results show that blacks continue to account for more than half the diagnoses (55 percent).

They also show that the overall diagnosis rate rose by 5.1 percent during the three-year period, but jumped by 26 percent among Latinos, 17 percent among gay and bisexual men, and 8 percent among whites.

While the Latino increase appears highest, Hispanics overall have 11.5 percent of the diagnosed cases. Men who have sex with men made up four out of every 10 diagnoses. Thirty-five percent of patients were apparently infected through heterosexual sex.

Combined with reports that syphilis rates are going up among gay men, the diagnosis rates paint a dismal picture about the future, Valdiserri says.

"For the past few years, the CDC has been very concerned about a number of indicators suggesting that we might be headed toward [an] increase of HIV among men who have sex with men. We've tried to sound this alarm repeatedly," he says.

And the federal statistics are apparently incomplete in one other critical way.

"We also know that there are significant numbers of people, perhaps as many as 280,000, who are infected with HIV and don't even know it," Valdiserri says.

In a prepared statement Wednesday, CDC director Dr. Julie Gerberding noted, "These new findings strongly support three key realities of today's epidemic: the HIV epidemic in this country is not over; more often than not the face of HIV in this country is black or Latino; and gay and bisexual men in several communities are facing a possible resurgence of HIV infection."

Health officials say tracking HIV cases is the best way to keep tabs on the epidemic. The number of AIDS deaths in the United States has actually gone down over the past several years, but that is because drugs are keeping people alive longer, not because fewer people are getting infected.

The CDC estimates that between 850,000 and 950,000 Americans are now living with HIV.

Officials hope to soon do an even better job of tracking new infections. New technology is expected to give them a better idea about when newly diagnosed HIV patients were infected with the virus.

Why are sexually transmitted disease rates going up, especially among gay men? Valdiserri says it's a worldwide phenomenon, affecting Western Europe and Australia as well.

"We're seeing more and more AIDS complacency, more and more reversion to unsafe sex or higher risk sexual behaviors," he says.

And the latest worldwide numbers, in fact, bring more bad news. AIDS will kill an estimated 3 million people this year, while as many as 46 million are infected with HIV, mostly in Africa, according to a United Nations report released Tuesday.

More information

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

SOURCES: Ronald O. Valdiserri, M.D., deputy director, HIV, STD and TB prevention center, U.S. Centers for Disease Control and Prevention, Atlanta; Nov. 26, 2003, statement, Julie Gerberding, M.D., director, U.S. Centers for Disease Control and Prevention; Nov. 28, 2003, Morbidity and Mortality Weekly Report
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