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HIV Infection — United States, 2008 and 2010

	Supplement Volume 62, Supplement, No. 3 November 22, 2013 PDF of this issue

HIV Infection — United States, 2008 and 2010

Supplements

November 22, 2013 / 62(03);112-119

Anna Satcher Johnson, MPH

Linda Beer, PhD

Catlainn Sionean, PhD

Xiaohong Hu, MS

Carolyn Furlow-Parmley, PhD

Binh Le, MD

Jacek Skarbinski, MD

H. Irene Hall, PhD

Hazel D. Dean, ScD

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC

Corresponding author: Anna Satcher Johnson, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. Telephone: 404-639-2050; E-mail: ats5@cdc.gov.

Introduction

At the end of 2009, approximately 1.1 million persons in the United States were living with human immunodeficiency virus (HIV) infection (1), with approximately 50,000 new infections annually (2). The prevalence of HIV continues to be greatest among gay, bisexual, and other men who have sex with men (MSM), who comprised approximately half of all persons with new infections in 2009 (2). Disparities also exist among racial/ethnic minority populations, with blacks/African Americans and Hispanics/Latinos accounting for approximately half of all new infections and deaths among persons who received an HIV diagnosis in 2009 (2,3). Improving survival of persons with HIV and reducing transmission involve a continuum of services that includes diagnosis, linkage to and retention in HIV medical care, and ongoing HIV prevention interventions (4).
The HIV analysis and discussion that follows is part of the second CDC Health Disparities and Inequalities Report (CHDIR) and updates information presented in the first CHDIR (5). The 2011 CHDIR (6) was the first CDC report to assess disparities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health-care access. The topic presented in this report is based on criteria that are described in the 2013 CHDIR Introduction (7). The purposes of this HIV infection report are to discuss and raise awareness of differences in the characteristics of people with HIV infection and to prompt actions to reduce these disparities

Methods

To estimate the number of adults aged ≥18 years who received a diagnosis of HIV infection during 2008 and 2010, CDC analyzed data reported through June 2011 to the National HIV Surveillance System (NHSS). CDC funds and assists state and local health departments to collect case information on persons with an HIV diagnosis. Health departments report deindentified data to CDC, which are compiled for national analyses. Analysis of HIV case surveillance data was limited to the 46 states that had reported HIV cases since at least January 2007 to allow for estimation of diagnoses rates: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Rates per 100,000 population were calculated for 2008 and 2010 by age, sex, and race/ethnicity, with population denominators based on postcensal estimates for 2009 from the U.S. Census Bureau (8). Household income and educational attainment were not calculated because these data are not collected by NHSS. Geographic location was not calculated because estimates of HIV diagnoses among persons in all 50 states and the District of Columbia were unable to be calculated at the time of this analysis. Analysis of transmission categories was limited to all men and MSM because denominator data for transmission categories other than MSM were unavailable (9); the category of all men was used as the referent group. To compute estimated MSM population denominators used for calculating HIV diagnosis rates, CDC applied the estimated proportion of men in the United States who reported ever having male-to-male sex (6.9%; 95% confidence interval [CI]: 5.1%–8.6%) to postcensal estimated populations for men (9). Analyses were adjusted for reporting delays (i.e., the time between diagnosis and report) and for missing risk factor information but not for underreporting (3).