AIDS Testing

United States HIV & AIDS Statistics Summary

AIDS Testing is important for the control of the disease spread. As of the end of the June 2001, 793,026 AIDS cases in the USA had been reported to the Centers for Disease Control and Prevention (CDC).

Of these,

• 79% were men
• 21% were women
• 1% were children less than 13 years of age
• 41% were in whites
• 38% in blacks
• 20% in Hispanics
• <1% in Asians and Pacific Islanders
• <1% in American Indians and Alaska Natives
• 46% were in men who have sex with men (MSM),
• 25% in injecting drug users
• 11% in persons infected heterosexually
• 1% in persons infected through blood or blood products  

In June 1981, the first cases of what is now known as AIDS were reported in the United States. In the 1980's, there were rapid increases in the number of AIDS cases and deaths of people with AIDS. Cases peaked with the 1993 expansion of the case definition and then declined. The most dramatic declines in cases and deaths have occurred since 1996, with the widespread use of antiretroviral therapy. Persons with AIDS are surviving longer and are contributing to steady increases in the number of people living with AIDS.

Historically, many states have only reported AIDS cases, but more states are implementing HIV cases reporting in response to the changing epidemic and the need for information on persons with HIV infection as a result of AIDS testing. This identification of HIV infections and AIDS cases enables state and local areas to estimate the size of the population living with HIV/AIDS and to predict the services and resources needed. It is anticipated that all states will be reporting cases to the CDC within the next two years.

Through June 2001 there were 455,750 persons reported to the CDC as living with HIV infection or AIDS. These reports only include persons diagnosed with HIV infection in States with integrated HIV/AIDS surveillance systems and persons diagnosed with AIDS in all States and Territories. In 1999, CDC estimated that 800,000 to 900,000 persons in the U.S were living with HIV or AIDS. The difference in these values is due to several factors, including the fact that:

• Reporting of persons diagnosed with HIV has not yet been implemented in all States and Territories
• Anonymous tests are excluded from case reports
• Many people are unaware of their HIV status

During the 1990s, the epidemic shifted steadily toward a growing proportion of AIDS cases in blacks and Hispanics and in women, and toward a decreasing proportion in MSM, although this group remains the largest single exposure group. Blacks and Hispanics, among whom AIDS rates have been markedly higher than among whites, have been disproportionately affected since the early years of the epidemic. In absolute numbers, blacks have outnumbered whites in new AIDS diagnoses and deaths since 1996, and in the number of people living with AIDS since 1998.

The proportion of women with AIDS has increased steadily, and the proportion infected heterosexually has also increased, surpassing (in 1994) the proportion infected through injection drug use. Midway through the 1990s, effective therapies became available, and as early as 1996 their effect on decreases in AIDS incidence and on deaths were detected through surveillance at the population level. As deaths have decreased, AIDS prevalence has steadily increased, a trend that will continue as long as the number of people with a new AIDS diagnosis exceeds the number of people dying each year.

From July 2000 to June 2001 194 pediatric AIDS cases were reported. Of these, 90% were acquired parentally. The number of estimated pediatric AIDS cases diagnosed each year has declined since 1992. The decline in pediatric AIDS incidence is associated with the implementation of Public Health Service guidelines. The guidelines include universal counseling and voluntary HIV testing of pregnant women and the use of zidovudine by HIV-infected pregnant women and their newborn infants. Pediatric HIV surveillance will play an important role, helping to gauge the extent to which intensified prevention efforts contribute to reduce transmission.

From July 2000 to June 2001 22,011 newly diagnosed cases of HIV infection (not AIDS) were reported from 36 areas. Of the HIV reports received in 2000, 68% were among adult men, 31% were among adult women, and 1 % among children under 13 years of age. Recent HIV reports represent a mixture of people with recent infection and others who may have been infected in the past but only now being diagnosed.

Sources:

U.S. Department of Health and Human Services

Public Health Service

Centers for Disease Control and Prevention
National Center for HIV, STD and TB Prevention

UNAIDS Joint United Nations Program on HIV/AIDS, "AIDS Epidemic Update December 2001 " and " Report on the global HIV/AIDS epidemic December 2001".