11. HIV Prevalence in the United States, 2000

Abstract

E-mail Abstract Author

Add To Itinerary

Session

Search Abstracts

Program

Session 5 Oral Abstract Session
Epidemiology and Infection Control
Session Time: Monday, 10 am - 12:30 pm
Room 6C

10:00 11.

HIV Prevalence in the United States, 2000
P. L. Fleming*, R. H. Byers, P. A. Sweeney, D. Daniels, J. M. Karon, and R. S. Janssen
CDC, Atlanta, GA

Background: As of 1992, back-calculation methods estimated >1 million cumulative HIV infections, incidence of > 40,000 per year, HIV prevalence of 650,000-900,000. Since HAART in 1996, deaths declined and persons with HIV/AIDS survived longer. In 1998, the HIV prevalence estimate was 800,000-900,000. Estimates of national prevalence, proportion diagnosed and needing care help establishing priorities and funding for HIV care.
Methods: National surveillance data through June 2001 were adjusted for reporting delays. We adjusted 1998 HIV prevalence estimates by the difference between AIDS incidence and deaths in 1999-2000. A Poisson regression model estimated prevalent diagnosed HIV cases from AIDS cases in 25 HIV reporting states. Predicted HIV cases were compared to observed HIV cases; the best fitting model was applied to AIDS data to estimate prevalent diagnosed HIV cases in the United States. The proportions with no reported CD4 count after HIV diagnosis from 12 states with lab-based reporting of HIV and CD4 tests were applied to prevalence estimates to approximate lack of care/treatment.
Results: During 1999 and 2000, respectively, AIDS incidence was 40,800 and 40,200 and AIDS deaths were 17,200 and 15,300. Assuming stable HIV incidence, the number of persons living with HIV/AIDS increased about 50,000 and prevalence increased to 850,000-950,000. This prevalence range, plus 450,000 observed deaths, suggests cumulative HIV incidence is 1.3-1.4 million. In 2000, there were 340,000 prevalent AIDS cases. States reporting HIV (not AIDS) cases had an estimated 130,000 prevalent HIV (not AIDS) cases. Our model estimated that 330,000 persons were diagnosed with HIV (not AIDS) nationwide in 2000; about 670,000 persons have been diagnosed with HIV/AIDS. The proportion who know their status is 670,000/850,000 to 670,000/950,000 (about 75%). Of 340,000 persons with AIDS, an estimated 7% had no reported CD4 count as of June 2001. Of 330,000 persons with HIV (not AIDS), an estimated 61% had no reported CD4 count. Thus, of 670,000 persons diagnosed with HIV/AIDS, about one-third may not be receiving ongoing care. Together with 180,000-280,000 undiagnosed persons, about 400,000-500,000 HIV-infected persons (i.e. 42-59% of 850,000-950,000 infected persons) may be un-tested, un-treated, or both.
Conclusions: HIV prevalence is likely to increase <3% per year if current trends continue. The proportion of infected persons who know their status is increasing; three-quarters have been diagnosed, but a large proportion may not be in ongoing care.

Š2002 9^th Conference on Retroviruses and Opportunistic Infections