CDC Report Shows High HIV Rates among Blacks and Men Who Have Sex with Men

By Liz Highleyman

At the XVII International AIDS Conference last month in Mexico City, officials with the U.S. Centers for Disease Control and Prevention (CDC) reported that a novel testing method revealed that the number of annual HIV infections was 40% higher than previously believed, with an estimated 56,300 new infections in 2006.

Now, in the September 12, 2008 issue of Morbidity and Mortality Weekly Report, CDC researchers have provided further details about the latest HIV infection statistics, confirming that the epidemic most heavily impacts African Americans and men who have sex with men (MSM).

For this report, the extrapolations were based on a total of 33,802 HIV diagnoses in 2006 (with or without AIDS, adjusted to 39,400 for reporting delays) among adults and adolescents aged 13 or older, reported to the CDC from 22 states with consistent name-based HIV reporting through June 2007.

While the researchers provided detailed information about new infections among whites, blacks, and Hispanics/Latinos, they could not do so for American Indians, Alaskan Natives, Asians, or Pacific Islanders because the total numbers of new infections in these groups (2.6% combined) were too small to produce reliable subgroup estimates.

Major Findings

• 73% of all new infections in 2006 occurred among men, compared with 27% among women.

• The HIV incidence rate among African American men was about 6 times higher than the rate among white men.

• The HIV infection rate among African American women was nearly 15 times higher than the rate among white women.

• 61% of new infections in women occurred among blacks, compared with 23% among whites and 16% among Hispanics/Latinas.

• Blacks overall (men and women combined) accounted for 46% of all new HIV infections, despite making up just 12% of the total U.S. population.

• Hispanics/Latinos accounted for 18% of all new HIV infections, though they comprise 15% of the total U.S. population.

• Among women, 80% of new infections were attributable to sexual contact with men.

• 53% of all new HIV infections (72% among men) were attributable to male-to-male sexual contact.

• Among white men, 81% of infections were linked to male-to-male sexual activity, compared with 72% among Hispanic/Latino men and 63% among black men.

• Since whites make up a larger proportion of the total population, white men accounted for the greatest percentage of new infections among MSM at 46%, compared with 35% for blacks and 19% for Hispanics/Latinos.

• Among white MSM, the infection rate was highest in the 30-39 age group, followed by the 40-49 age group.

• In contrast, among black and Hispanic/Latino MSM, a majority of new infections occurred in the 13-29 age group.

"Overall, levels for HIV infection in the U.S. are too high and the epidemic must not be allowed to continue on its current course," said Richard Wolitski, acting director of the CDC's Division of HIV/AIDS Prevention. "Clearly, much more must be done as many populations at risk are not being reached by our efforts."

In particular, he stated, "we must better tailor prevention efforts to meet the needs of MSM of all ages, and strengthen efforts to reach young black MSM to ensure that HIV does not become a rite of passage for successive generations of gay and bisexual men in our country."

Further, he added, "We must continue to strive to meet the prevention needs for black and Hispanic/Latina women who account for the majority of new HIV infections among women, and overall reduce the disproportionate burden of HIV among communities of color in the United States."

While studies have shown that black MSM as a group do not engage in riskier sexual or drug-use practices than white men, the higher proportion of HIV positive black men puts them at higher risk, since many black MSM mainly have sex with others of their own race. In addition, young black MSM also tended to have partners who are older, and therefore more likely to have already become infected.

According to Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, the study presents "a powerful reminder that the U.S. epidemic of HIV disease is far from over."

The CDC estimated that HIV prevention efforts have not reached 80% of MSM in 15 cities nationwide. The agency recommended increasing HIV testing programs and strategies to target prevention efforts toward people at high risk of HIV transmission.

At a Congressional hearing last week, however, CDC officials said the current level of prevention funding would have to double, adding about $5 billion more over 5 years, in order to reduce the number of new infections by half -- a sum that is increasingly unlikely given the country's current fiscal crisis.

• Updated CDC Fact Sheet on New HIV Infections

• Question and Answers about New Subpopulation Statistics

9/23/08

Sources

J Prejean, R Song, Q An, and others. Subpopulation estimates from the HIV incidence surveillance system -- United States, 2006. Morbidity and Mortality Weekly Report 57(36): 985-989. September 12, 2008. Full text.

R Wolitski. Centers for Disease Control and Prevention. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. Dear Colleague letter. September 12, 2008.

Kaiser Family Foundation. CDC releases subpopulation estimates from data on annual new HIV infections; new infections high among blacks, MSM. Kaiser Daily HIV/AIDS Report. September 12, 2008.

B Roehr. CDC: Double U.S. HIV prevention budget. Bay Area Reporter. September 18, 2008.