HIV/AIDS Surveillance Report: U.S. HIV and AIDS cases reported through June 1999

Details

• Alternative Title:
  HIV/AIDS Surveillance Report; Mid-year Edition, Vol. 11, No. 1: U.S. HIV and AIDS cases reported through June 1999
• Corporate Authors:
  Centers for Disease Control and Prevention (CDC) (U.S.) ; National Center for HIV, STD, and TB Prevention. Division of HIV/AIDS Prevention — Surveillance and Epidemiology ; Division of HIV/AIDS Prevention. Surveillance Branch. Reporting and Analysis Section ; Division of HIV/AIDS Prevention. Statistics and Data Management Branch
• Description:
  Commentary: This report includes, in addition to cases reported through June 1999, AIDS incidence and deaths in 1998 (Figures 7-11 and Tables 26-28) and AIDS prevalence as of December 1998 (Tables 23-25). These data have been adjusted for reporting delays. AIDS incidence decreased 18% between 1996 and 1997. From 1997 to 1998, AIDS incidence decreased 11%, suggesting that the decrease in AIDS incidence is slowing. The slowing in the decrease in AIDS incidence is paralleled by a slowing in the decrease in the number of AIDS deaths. Deaths decreased 42% from 1996 to 1997, and 20% from 1997 to 1998. The number of persons living with AIDS continues to increase. At the end of 1997 there were 269,777 persons living with AIDS. By the end of 1998, there were 297,137 persons living with AIDS, a 10% increase.
  
  The decreases in AIDS incidence and the number of AIDS deaths, first noted in 1996, have been ascribed to the effect of new treatments. Although a substantial decline in AIDS incidence continues, the slowing rate of the decline may indicate that much of the benefit of new therapies has been realized. Most persons in care may now be receiving effective therapies. In addition, the duration of the effect of treatment may be limited for some persons. In 1996, decreases were noted in the number of deaths before they were noted in AIDS incidence because persons with the most advanced disease were the first to benefit from the new treatments. Persons with more advanced disease may experience improved health as a result of treatments for a shorter time than others do. Incomplete adherence to treatment schedules and viral resistance may also be contributing factors. Information on the diagnosis and treatment of persons with HIV will improve our understanding of the current HIV epidemic, and most of the persons who now have AIDS may be persons who first received a diagnosis of HIV infection when they became ill with AIDS, or who were not receiving treatment for HIV infection. Supplemental information will be collected on samples of AIDS cases and deaths in order to better understand the trends.
  
  From July 1998 through June 1999, a total of 47,083 AIDS cases were reported, compared with 54,140 and 64,597 cases reported in the two preceding 12 month periods, July 1997 through June 1998 and July 1996 through June 1997. Despite the continued decease in the number of cases reported, state and local health departments continue to report a large number of AIDS cases. Women account for 10,841 (23%) reported adult cases. Among women, blacks and Hispanics account for 80% of cases; among men, blacks and Hispanics account for 61% of cases.
  
  From January through June 1999, two additional states, Texas and Alaska, implemented HIV reporting by name. Although the HIV tables and the AIDS tables are presented side by side, they cannot be compared directly because the HIV tables represent only the states that currently report cases of HIV infection, whereas the AIDS tables represent all states and territories. Differences in distribution of risk, for example, may reflect differences between the epidemics in states that report HIV and those that do not. In addition, HIV surveillance data should be interpreted with knowledge of local practices because they are influenced by the availability of HIV test facilities and the proportion of HIV-infected persons who seek or defer testing. Finally, HIV data are affected by whether states reported prevalent HIV cases or just new diagnoses when they implemented HIV reporting. Persons are counted only once in the HIV/AIDS system, thus persons who are reported with HIV and with AIDS are counted only as AIDS cases.
  
  Women account for 32% of adult cases of HIV infection reported from July 1998 through June 1999. Among women, blacks and Hispanics account for 77% of cases; among men, blacks and Hispanics account for 58% of cases. Persons aged 13-24 account for 15% of reported HIV cases, and women account for 49% of cases in this age group. Risk information is difficult to interpret because of the high proportion of cases reported without risk. Several projects are under way to improve the risk information in the HIV data. In addition, a redistribution of risk, analogous to that for AIDS cases, will be applied in upcoming reports.
  
  Two states were conducting HIV reporting by unique identifier codes as of June 1999: Maryland and Massachusetts. Year-end data from these states and Illinois, which implemented HIV reporting by unique identifier on July 1, 1999, will be presented in a supplemental report in early 2000.
  
  CDC estimated that as of the end of 1996 approximately two thirds of HIV-infected persons had been tested confidentially (i.e., not anonymously). States where HIV has been reported long enough to capture most HIV-infected persons tested confidentially can determine the number of living persons reported with HIV infection. This information is useful in determining differences in demographic characteristics between persons with HIV and persons with AIDS and in planning for care. In addition, these states can estimate the total size of their HIV-infected population by adjusting this number to account for the untested population. Because HIV infection is diagnosed for persons each year, the proportion of infected persons with a diagnosis will continue to increase, as will the representativeness of HIV surveillance data.
  
  Declines in the number of children diagnosed with AIDS continue, as shown in Figure 11. Surveillance for pediatric HIV infection and exposure, in addition to surveillance for AIDS, is of critical importance in following closely the effect of prevention on the perinatal epidemic. Information on HIV infection status is available much sooner than information on an AIDS diagnosis because the infection status of most HIV exposed infants is known before the infants are 1 year of age. A diagnosis of AIDS, on the other hand, may not be made for several years. In addition, the onset of AIDS may be increasingly postponed by new antiretroviral treatments, a postponement that complicates the interpretation of AIDS incidence trends.
  
  CDC continues to work closely with states to implement and evaluate HIV reporting systems and to assist with the interpretation of data as the focus shifts from AIDS to HIV. As more states initiate HIV infection reporting, HIV surveillance will increasingly complement AIDS surveillance. The integrated HIV/AIDS surveillance system will provide information on the entire population of persons living with HIV infection who have been tested confidentially. This framework will offer a means of collecting additional data on representative samples of persons to provide the information required to understand the evolution of the epidemic.
  
  
• Content Notes:
  Publication date approximated.
• Subjects:
  Acquired Immunodeficiency Syndrome Acquired Immunodeficiency Syndrome / Epidemiology Data Interpretation, Statistical Epidemics Epidemiological Monitoring HIV Public Health Surveillance Statistics Tables
• Keywords:
  DHP_HIV_Reports
• Series:
  HIV Surveillance Report
• Subseries:
  HIVSR
• Publisher:
  Centers for Disease Control and Prevention (CDC) (U.S.)
• Document Type:
  Text
• Genre:
  Statistics ; Report
• Place as Subject:
  United States
• Rights:
  Public Domain
• CIO:
  National Center for HIV, STD, and TB Prevention (NCHSTP)
• Division:
  DHPSE - Division of HIV/AIDS Prevention — Surveillance and Epidemiology
• Topic:
  Diseases & Conditions
• Location:
  North America
• Pages in Document:
  42 pdf pages
• Volume:
  11
• Issue:
  1
• Citation:
  Suggested Citation: Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 1999;11(No. 1):[inclusive page numbers].
• Collection(s):
  Infectious Diseases
• Main Document Checksum:
  urn:sha-512:c9ba77157d65bd50d2e017b87df4a5a6e928a6a0fef5ae7658387fcf25db4889115cc73d3bcb501aac8b4be60cf420a8549f040909dfc804dc4c40c578b0c6bc
• Download URL:
  https://stacks.cdc.gov/view/cdc/149072/cdc_149072_DS1.pdf
• File Type:
  [PDF - 1004.83 KB ]