ATLANTA—For the first time in history more than a million Americans are living with HIV. The Centers for Disease Control and Prevention ( CDC ) released that analysis on June 13 at the start of the 2005 National HIV Prevention Conference in Atlanta.
The CDC said as of December 2003 between 1,039,000 and 1,185,000 Americans were infected with the virus. The epidemic remains much as before, with men who have sex with men ( MSM ) constituting the largest single route of infection, some 45% of the total. High-risk heterosexual behavior accounts for 27% of infections; injection drug use 22%, and the dual risk of injection drug use and MSM add another 5%.
The CDC recently completed a behavioral survey of more than 14,000 MSM, conducted at 17 sites across the country. Alan Greenberg, MD, acting deputy director of the Division of HIV/AIDS Prevention at the CDC, presented preliminary data from five cities—Baltimore, Los Angeles, Miami, New York City, and San Francisco—involving 1,767 MSM involved in that study.
Some 25% were HIV+; 48% of whom were unaware that they were infected. 'These rates were higher in the youngest men, between the ages of 18 and 29, where over 70% were unaware that they were HIV+.' Overall, 67% of the Black MSM, 48% of the Hispanic MSM, and 18% of the white MSM were unaware of their infection until tested as part of the study.
'The high HIV prevalence rates among MSM, and in particular Black MSM, demonstrate the continued gravity of the epidemic in this population and are consistent with earlier data.'
'Despite 92% reporting that they had been tested previously, including 64% who had been tested within the past year, nearly half of HIV+ men were unaware of their infection, indicating the need for intensive HIV prevention services,' Greenberg said.
The CDC estimates that 40,000 new infections occur each year, a number that has remained unchanged for more than a decade. A 2001 strategic plan aimed to cut that number of new infections in half by the end of 2005.
'It is clear that we have not achieved that goal,' CDC's deputy director of the National Center for HIV, STD, and TB Prevention, Ronald O. Valdiserri, MD, acknowledge at a news conference when pressed on the issue. However, he was 'heartened by the fact that we haven't observed tremendous increases in incidence' in light of the increased prevalence of HIV.
Federal funding for HIV prevention has remained flat over that five-year period while many state governments have cut back their funding because of budgetary constraints. Many AIDS advocates hope that these numbers will be a wake up call for increased funding for prevention activities.