Less than 1% of U.S. Adults Have HIV, but Rate Is Higher among Blacks

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New household survey data show that about 0.5% of all U.S. adults aged 18-49 years are infected with HIV, but rates are much higher among certain subgroups, according to the latest epidemiological data from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS), reported in a January 2008 data brief.

The report includes data from the 1999-2006 National Health and Nutrition Examination Survey (NHANES), a periodic cross-sectional health survey of the general population accompanied by physical exams and blood tests. NCHS used data from 11,928 people and extrapolated these numbers to derive estimates for the entire U.S. population.

Findings

• The overall U.S. HIV prevalence rate among adults aged 18-49 years during the survey period was 0.47%.

• In absolute numbers, this equates to approximately 618,000 individuals (range 447,000-841,000).

• By sex, for all racial/ethnic groups combined, the prevalence rates were:
• Men: 0.72%;
• Women: 0.22%.
• Older adults were more likely to have HIV than younger adults:
• 40-49 years: 0.61%;
• 30-39 years: 0.55%;
• 18-29 years: 0.25%.
• HIV prevalence also varied significantly by race/ethnicity:
• Non-Hispanic blacks: 2.01%;
• Mexican-Americans: 0.30%;
• Non-Hispanic whites: 0.23%.
• Among blacks, the HIV prevalence was higher in men (2.64%) than in women (1.49%).

• The highest HIV prevalence was found among black men aged 40-49 years, reachning nearly 4%.

• Individuals with herpes simplex type 2 (HSV-2) were 15 times more likely to also be infected with HIV.

• This was especially true among blacks, who had a much higher HSV-2 prevalence rate (46.6%) compared with the population at large (15.3%).

• Unsurprisingly, people with HIV were much more likely than uninfected individuals to have a low CD4 cell count.

• During 1999-2006, coinciding with advent of the HAART era, 23.0% of HIV positive individuals had a CD4 count below 200 cells/mm3, while 34.4% had 500 cells/mm3 or more.

Report co-author Gerry McQuillan said the results indicate that the prevalence of HIV is "basically stable" in the U.S. household-based population.

Advocates expect that forthcoming data from the CDC (now undergoing rigorous analysis) will show that HIV incidence, or new infections, has increased in recent years, from 40,000 to perhaps as high as 55,000. The current report did not provide information on incident infections

A limitation of household surveys such as NHANES is that they do not include groups such as the homeless, incarcerated individuals, and active duty military personnel, some of whom are more likely to have HIV infection than the population at large.

02/01/08

Reference
G McQuillan and D Kruszon-Moran. HIV Infection in the United States Household Population Aged 18-49 Years: Results from 1999-2006. Centers for Disease Control and Prevention National Center for Health Statistics. NCHS Data Brief. January 2008.