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U.S. AIDS Epidemic Worse Than Thought

40% Higher HIV Infection Rate; 56,300 Americans Infected Each Year
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 2, 2008 -- The U.S. AIDS epidemic is -- and has been -- much worse than we'd thought.

More than 56,000 Americans -- 40% more than previously known -- get a new infection with the HIV tests virus every year. And although that overall rate isn't going up, it hasn't gone down since it dropped to that level in the early 1990s from a peak of about 130,000 in the mid-1980s.

The new estimate, which ranges from 48,200 to 64,500 annual HIV infections, comes from the CDC's sophisticated new surveillance system, which includes name-based reporting of HIV tests and lab tests that show how long a person has carried the virus.

It's a wake-up call, says the head of the CDC's HIV/AIDS prevention effort, Richard Wolitski, PhD.

"These data underscore the critical importance of HIV infection and emphasize the toll it is having not only worldwide but in this country as well," Wolitski tells WebMD. "We need to recognize the HIV epidemic as the crisis that it is and ensure we are responding in a manner that matches the severity of the problem."

Who Gets HIV in America?

The new data prove what other CDC studies have suggested: New HIV infections are going up among gay and bisexual men. Gay/bisexual men get more than half of the new infections every year.

This is a slap in the face to prevention efforts by gay/bisexual men that slashed new infections from a peak of about 75,000 new infections a year in the mid 1980s to under 20,000 in the early 1990s. Since then, every two-year reporting period has seen steady backsliding. Now, more than 30,000 gay/bisexual men get a new HIV infection each year.

"A lot of people had mistakenly thought that HIV was not as severe a problem as it really is among gay and bisexual men," Wolitski says.

There's another huge disparity at work in the U.S. AIDS epidemic. Black Americans get seven times more new HIV infections than do white Americans. In 2006, nearly half of new HIV infections -- 45% -- were in non-Hispanic blacks.

"It is a very large and disturbing disparity," Wolitski says.

Race itself is not the risk. Wolitski points to factors and situations that disproportionately affect black Americans' HIV risk.

"Poverty, stigma, misperceptions of risk, disparities in rates of sexually transmitted diseases, and the destabilizing effects incarceration has on individuals, families, communities, and substance use -- all may be playing a role here," he says.

Black men who have sex with men are at particularly high risk. A 2005 CDC study showed that in some U.S. cities, 46% of black gay/bisexual men were infected with HIV. That's twice the 21% infection rate seen for white gay/bisexual men, and far higher than the 17% rate for gay/bisexual Hispanic men.

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