New Study Shows Overall Increase in HIV Diagnoses

African Americans, Latinos, Gay and Bisexual Men most affected

The most comprehensive analysis of US HIV cases completed to date reveals that new HIV diagnoses in 29 states increased in 2002, the Centers for Disease Control and Prevention announced today. Overall, new diagnoses in these states rose by 5.1 per cent over the four-year period 1999 to 2002. The increases underscore the urgent need for public awareness and action as countries around the globe observe World AIDS Day.

The new analysis of 102,590 people diagnosed with HIV in the 29 states between 1999 and 2002 shows that African-Americans continued to account for more than half (55%) the new diagnoses. Additionally, significant increases in new HIV diagnoses were observed among Latinos (26% increase) and non-Hispanic whites (8% increase). HIV diagnoses increased 17 per cent among gay and bisexual men, and 7 per cent among men overall. The study found no significant changes in the number of new HIV diagnoses among Asian/Pacific Islanders or Native Americans. The analysis was published in the November 28 issue of Morbidity and Mortality Weekly Report (MMWR).

“Fighting HIV in America is as urgent on World AIDS Day in 2003 as it was more than two decades ago when the epidemic began,” said Dr. Julie Gerberding, CDC director. “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.”

“Stigma and discrimination – themes for this year’s World AIDS Day – help perpetuate the HIV epidemic around the world and here in our own country, said Dr. Harold Jaffe, director of CDC’s HIV prevention programs. “These obstacles deter people from getting tested and prevent HIV-infected people from receiving treatment. They also increase the already heavy burden of HIV in communities of color.”

The 29 states included in the analysis have conducted confidential, name-based HIV case reporting since 1999. The study is based on reported new HIV diagnoses, which is the point at which an individual learns of his/her HIV infection, not necessarily the point at which a person became infected. Increases in HIV diagnoses do not always reflect increases in new infections because numbers showing new diagnoses include individuals who were recently infected as well as those who were infected long ago but only recently tested and diagnosed.

Study authors believe, however, the data suggest that the rise in new HIV diagnoses likely represents actual new infections and not a greater amount of testing. Increases in HIV testing can lead to increased numbers of people being diagnosed with HIV. The study authors note, however, that more people who had progressed to AIDS before their HIV diagnoses might have been detected if increased testing were a major factor, and this was not the case in this study.

“Even with this still-incomplete picture of HIV infection in America, it’s clear that we still face enormous challenges in continuing to confront the AIDS epidemic,” Dr. Jaffe said. “Foremost among these challenges is working to encourage HIV-positive persons in our country, who are unaware of their infections, to seek testing, treatment and prevention counseling. CDC announced a new initiative in April of this year aimed at increasing opportunities for testing, counseling and treatment for these individuals.”

Through its new “Advancing HIV Prevention” initiative, CDC is working with communities, government groups and health care providers across the nation to help at-risk individuals learn of their HIV status, better understand ways of preventing HIV infection, and, if infected, receive treatment and care. At-risk populations include people infected with HIV, those not infected, and those who are unsure of their status. A new rapid HIV test which can provide preliminary results in as little as 20 minutes is central to this effort.

CDC estimates that between 850,000 and 950,000 Americans are now living with HIV. This is the greatest number since the epidemic began more than two decades ago. It is estimated that one fourth of the people living with HIV, approximately 180,000 to 280,000 people, remain unaware of their infections. An estimated 40,000 new HIV infections continue to occur in the US each year.

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