AEGiS-Miami Herald: U.S. HIV infection rate appears to hold steady: Public-health experts at the Centers for Disease Control released data indicating that the AIDS epidemic has stabilized. Several states still are not included, though.

Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.

U.S. HIV infection rate appears to hold steady: Public-health experts at the Centers for Disease Control released data indicating that the AIDS epidemic has stabilized. Several states still are not included, though.

Miami Herald - November 17, 2005
Fred Tasker - ftasker@herald.com

New HIV cases remained stable across a broad swath of the U.S. population from 2001 through 2004, with small decreases among blacks and small increases in gay and bisexual men, the Centers for Disease Control and Prevention said Thursday.

The new statistics, covering 33 states, are the most comprehensive ever released because for the first time they include New York state, which accounts for more than 20 percent of cases.

But the data still do not include California, Illinois and several other high-incidence states, so they remain incomplete. In 2002, California had 10 percent of U.S. AIDS cases, and Illinois had 5 percent. The number of HIV cases for the two states was not available.

It will be several years before all states report such HIV statistics, CDC officials said, because individual legislatures control such reporting, and some have not yet approved new rules.

FLORIDA RATE SLOWS

"The data are not complete, but they're the most complete picture to date of what's happening in the U.S. today," said Dr. Ronald O. Valdiserri, acting director of the CDC's National Center for HIV, STD and TB Prevention. "We hope eventually to have all states."

The rate of new cases in Florida declined slightly during the period, from 45 per 100,000 in 2001 to 42.6 per 100,000 in 2004, according to the state Department of Health.

Between 1999 and 2004, new HIV diagnoses fell by 24 percent among black men and 36 percent among black women. But blacks, who make up 14 percent of the state's population, still account for 51 percent of the state's new HIV cases.

In Florida, the number of new cases among gay and bisexual men increased from just over 2,000 to well over 2,500 between 2000 and 2002 but has remained steady since then.

HIV reporting has been incomplete because it includes only states that have conducted confidential, name-based HIV case reporting for at least four years. New York began such reporting in 2000, making it possible to chart trends from 2001 through 2004, the CDC said. Florida does

BEST DATA YET

Valdiserri said the new data still provide "the best indication we have of national direction of the HIV epidemic in various populations."

Among blacks, he said, new HIV cases declined by 5 percent per year between 2001 and 2004, possibly because aggressive new testing programs are getting more patients diagnosed and into treatment, making them less likely to spread the disease.

"But in 2004 that rate was still 8.4 times higher among African Americans than among whites," Valdiserri said. "We must remember the human impact and work to reduce this glaring disparity."

Among gay and bisexual men, Valdiserri said, new HIV diagnoses remained stable from 2001 through 2003, then jumped 8 percent between 2003 and 2004.

"The precise reasons are not entirely clear," he said.

Most infected men contracted HIV through sex with other men, Valdiserri said, while most women got it from heterosexual contact.

HARD TO COMPARE

The impact of adding New York statistics for the first time is clear in the fact that the new data show a small overall decline in new HIV diagnoses among injecting drug users (IDUs), but it is driven almost entirely by large decreases in New York.

Valdiserri also acknowledged an additional difficulty:

"The addition of New York state provides a more representative sample of U.S. diagnoses, but means it it not possible to directly compare the data and trends in this report to earlier reports."

"To improve the nation's ability to monitor the HIV epidemic, the CDC recommends that all states adopt confidential, name-based HIV reporting systems," the study said.

Herald medical writer Jacob Goldstein contributed to this report.
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