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African Americans and Men Who Have Sex with
Men Are Groups Most Affected by HIV
New Centers for
Disease Control and Prevention (CDC) estimates of HIV prevalence in
the United States indicate that between 1,039,000 and 1,185,000 people
were living with HIV in December 2003. The estimates provide the
clearest picture to date of the scope of the U.S. epidemic overall
and among specific racial and ethnic and risk groups.
The new estimates
indicate that HIV continues to have the greatest impact among African
Americans and MSM.
At the end of 2003, blacks accounted for 47 percent of people estimated
to be living with HIV in the U.S.; whites accounted for 34 percent
and Hispanics for 17 percent. Asian/Pacific Islanders and American
Indians/Alaska Natives each represented roughly
1 percent of the HIV-positive population.
By transmission
category, MSM remained the most heavily affected group,
accounting for 45 percent of people living with HIV. Individuals
infected through high-risk heterosexual contact comprised 27 percent,
and those infected through injection drug use accounted for 22 percent
of the HIV-positive population. Roughly three-quarters (74%) of
Americans estimated to be living with HIV are male.
The
study suggests that the make-up of the HIV-positive population may
begin to shift in coming years, as non-Hispanic blacks, females,
and individuals infected through high-risk heterosexual contact
account for a higher proportion of infections among people living
with HIV (not AIDS) than among those already living with AIDS.
The last estimate
of HIV prevalence, released in 2002, suggested that at the end of
2000, between 850,000 and 950,000 people were living with HIV.
These estimates, however, did not include breakdowns by racial and
ethnic or risk groups. Besides updating the prevalence estimates,
researchers also examined the proportion of the HIV-positive population
aware of their infection status.
Results indicate
that as of 2003, between 24 and 27 percent of individuals living
with HIV infection remained undiagnosed. As improved treatments
have increased the lifespan of HIV-positive persons in recent years,
overall prevalence has steadily increased in the U.S. (Presentation
T1-B1101).
A separate
CDC analysis suggests that undiagnosed HIV infection continues to
play a significant role in the extremely high rates of infection
among African-American
MSM. Consistent with earlier research, black MSM in a new five-city
study were more than twice as likely to be infected with HIV as
other MSM, and were less likely to be aware of their infection.
Forty-six percent of black MSM in the study were HIV-positive, compared
to 21 percent of white MSM and 17 percent of Hispanic MSM.
Among HIV-infected
MSM, 67 percent of black men, 48 percent of Hispanic men, and 18
percent of white men were unaware of their infection before study
participation, underscoring the need to reach MSM with testing and
prevention services. The study surveyed 1,767 MSM over age 18 at
public venues in Baltimore, Los Angeles, Miami, New York City, and
San Francisco between June 2004 and April 2005 (Plenary session,
“New Approaches to Tracking the HIV Epidemic in the U.S.”).
Other CDC data
point to the continuing impact of HIV on young African-American
MSM across the nation. Researchers examined trends in new HIV diagnoses
(with or without AIDS) among persons 13 to 24 years of age between
1994 and 2003 in 25 U.S. states with longstanding, name-based HIV
reporting.
Results indicate
that new diagnoses declined significantly among young women, but
rose among young men. Among 13- to 24-year-old females, new HIV
diagnoses fell 20 percent over the 10-year period. HIV diagnoses
also declined among young men for the first few years of the period
(by 30% from 1994 to 1998); but the decline was offset by a 41 percent
increase from 1999 to 2003. The increase among young men was driven
by a 47 percent rise in diagnoses among MSM ages 20-24, 60 percent
of whom were black.
While
researchers were unable to determine if the increases in HIV diagnoses
among young men were the result of increased testing or an actual
increase in new infections, the findings are consistent with other
recent data suggesting a possible resurgence of HIV among young
MSM (Presentation M1-B0802).
“These new
data underscore the need to deploy the full spectrum of HIV prevention
strategies to confront today’s epidemic,” said Dr. Ronald O. Valdiserri,
co-chair of the 2005 National HIV Prevention Conference and deputy
director of CDC’s HIV, STD and TB prevention programs. “HIV-positive
individuals are living longer than ever before, and we must reach
them with services that can help them stay healthy and protect others
from infection. Reaching at-risk populations with HIV testing and
providing infected and at-risk individuals with effective, ongoing
prevention services will be critical to reduce the number of new
infections.”
06/15/05
Source
US Centers for Disease Control and Prevention
(CDC).
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