- Category: HIV/AIDS Epidemiology & Mortality
- Published on Tuesday, 28 June 2011 06:40
- Written by Liz Highleyman
More than 1.1 million people in the U.S. were living with HIV at the end of 2008, with 20% not knowing their status. But the burden is unevenly distributed, with 50% of cases among gay men and higher incidence among African-Americans.
The first report of what would come to be known as AIDS was published in the Center for Disease Control and Prevention's Morbidity and Mortality Weekly Report on June 5, 1981.
Three decades later, the CDC has produced an extended surveillance overview of HIV/AIDS from 1981 through 2008, published in the June 3, 2011, Morbidity and Mortality Weekly Report.
CDC investigators analyzed data collected through the end of 2010 by the National HIV Surveillance System. AIDS cases have been reported by name since the early years of the epidemic. Due to concerns about confidentiality and discrimination, some states reported HIV infections anonymously or confidentially for many years, but now all states report new HIV diagnoses by name.
During the first 14 years after the epidemic became apparent, "sharp increases" were reported in the number of new AIDS diagnoses among people age 13 and older, rising from 318 in 1981 to a high of 75,457 in 1992. Deaths among people with AIDS rose from 451 in 1981 to 50,628 in 1995.
After the advent of highly active antiretroviral therapy (HAART) in the mid-1990s, AIDS diagnoses and deaths "declined substantially" from 1995 through 1998. AIDS diagnoses fell 45% between 1993 and 1998, while AIDS deaths decreased by more than 60% from 1995 to 1998. Rates then remained roughly stable from 1999 through 2008, with an average of approximately 38,000 new AIDS diagnoses and 17,500 deaths per year.
Yet despite the decline in AIDS cases and deaths over the course of the epidemic, an estimated 1,178,350 people were living with HIV at the end of 2008. Of these, it is estimated that 20% -- or about 236,400 individuals -- remain undiagnosed and potentially unaware of their status.
This report emphasizes the disparity of the HIV/AIDS burden in the U.S.: while the HIV prevalence was 238 per 100,000 people among whites and 593 per 100,000 among Hispanics/Latinos, it rose to 1819 per 100,000 among blacks/African-Americans. Nearly 50% of people living with HIV were men who have sex with men.
"These findings underscore the importance of the National HIV/AIDS Strategy focus on reducing HIV risk behaviors, increasing opportunities for routine testing, and enhancing use of care," the report authors concluded.
Centers for Disease Control and Prevention. L Torian, M Chen, P Rhodes, et al. HIV Surveillance -- United States, 1981-2008. Morbidity and Mortality Weekly Report 60(21):689-693 (free full text). June 3, 2011.