HIV/AIDS surveillance report : U.S. HIV and AIDS cases reported through June 1995
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HIV/AIDS surveillance report : U.S. HIV and AIDS cases reported through June 1995

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  • Journal Article:
    HIV/AIDS surveillance
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  • Description:
    Mid-year edition, Vol. 7, No. 1.

    Through June 1995, nearly half a million (476,899) persons have been reported with AIDS. The expanded AIDS surveillance case definition (implemented on January 1, 1993) continues to influence the pattern of AIDS diagnosis and reporting. In the first half of 1995, 37,142 AIDS cases were reported. Although this number exceeds the 23,896 cases reported in the first half of 1992, before the case definition was expanded, it is less than the 61,887 and 40,457 cases reported in the first halves of 1993 and 1994, respectively. Trends in reporting of AIDS cases are expected to continue to stabilize gradually over the next several reporting periods as the surge in cases caused by the expanded definition continues to wane.

    Analysis of the absolute numbers of cases reported each year, as presented in this report, continues to provide valuable information on the magnitude of the epidemic in affected communities. The data provide an important profile of young (13 to 24 years) men and women with HIV infection and AIDS, and demonstrate the need for prevention strategies appropriate for these age groups (see Tables 7 and 20). They also profile the characteristics of children with HIV and AIDS, in whom nearly all recent HIV infections occurred perinatally, and emphasize that, to prevent HIV in children, prevention programs need to assist women in reducing their risk of acquiring HIV infection by reducing high risk drug-injection or sexual activities (see Tables 6 and 19). These data will assist states in monitoring the impact of current recommendations to reduce HIV transmission to children through counseling, voluntary testing, and prenatal care services for women.

    The expansion of the case definition artifactually distorted the AIDS epidemic curve. Fluctuation in the number of reported cases in recent years has complicated the interpretation of trends in the absolute num- ber of reported cases. However, comparing proportions and relative rates over time permits trends to be monitored. For example, in the two most recent 12- month periods, about 10 percent of persons with AIDS were residents of small metropolitan areas (50,000 to 500,000 population), and about 6 percent were resi- dents of non-metropolitan areas (see Table 2). These percentages are consistent with those reported for 1992 (10 percent and 6 percent, respectively), before the case definition was expanded. They not only reflect the emergence of AIDS outside large metropolitan areas (500,000 or more population), but also illus- trate that the epidemic remains disproportionately concentrated in large metropolitan areas, where AIDS incidence rates are consistently 2 to 3 times higher than in small metropolitan areas, and about 5 times higher than in non-metropolitan areas.

    To monitor trends in the incidence of AIDS-defining opportunistic illnesses (AIDS-OIs), CDC is using ana- lytic methods that adjust for the case definition expansion by using comparable definitions over time. The estimated number of persons with AIDS-OIs diagnosed in 1994 (64,300) increased approximately 6 percent over the estimated number in 1993 (see Table 13). In addition, previously reported trends continued: the South and the Northeast accounted for the majority of the estimated number of persons with AIDS-OIs, and blacks and Hispanics accounted for a growing proportion of persons with AIDS-OIs (see Table 14). Although men who have sex with men accounted for the largest proportion of AIDS-OIs, the rate of growth has slowed; persons infected through injecting drug- use and their heterosexual partners accounted for an increasing proportion of persons with AIDS-OIs (see Table 15).

    AIDS surveillance data can detect recent shifts in the epidemic: because AIDS develops in a substantial number of HIV-infected persons within a year or two of infection, their characteristics are soon reflected in the surveillance data. For example, emerging trends among women, black and Hispanic minorities, per- sons in moderate- and small-sized metropolitan statistical areas and in the rural South, persons infected through heterosexual contact, minority homosexual/ bisexual men, and young men who have sex with men have all been detected through AIDS surveillance. In addition, timely data from 25 states on characteristics of adults/adolescents with HIV infection (not AIDS) have documented the impact of the epidemic among sexually active and drug-using adolescents at early stages of HIV disease and have highlighted the need for appropriate prevention interventions in these populations (see Table 20).

    National population-based HIV/AIDS surveillance data can be used to guide allocation of resources for HIV/AIDS prevention and control. State and local health departments provide surveillance information to assist prevention planning in local communities. Together with data from seroprevalence surveys, behavioral surveys, and vital statistics, HIV/AIDS surveillance data can assist communities in developing HIV needs assessments, health care planning, and community profiles for implementing and evaluating prevention interventions.

    Publication date is speculative.

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