Epidemiology of human immunodeficiency virus in the United States

Abstract

The human immunodeficiency virus (HIV) epidemic emerged in the early 1980s with HIV infection as a highly lethal disease among men who have sex with men and among frequent recipients of blood product transfusions. Advances in the treatment of HIV infection have resulted in a fundamental shift in its epidemiology, to a potentially chronic and manageable condition. However, challenges in the prevention of this infection remain. In particular, increasing evidence suggests that transmission of drug-resistant virus is becoming more common and that the epidemic is having a profound impact on morbidity and mortality in ethnic and racial minority subgroups in the United States. New population-based data collection systems designed to describe trends in behaviors associated with HIV transmission and better methods for measuring the true incidence of transmission will better elucidate the characteristics of HIV infection in the United States and inform future public health policies.

FIG. 1.

Trends in annual age-adjusted (to 2000 U.S. population) rate of death due to HIV disease in the United States by sex for the period 1987-2002. For comparison with data for 1999 and later years, data for 1987-1988 were modified to account for ICD-10 rules instead of ICD-9 rules. (Reprinted from the CDC website [http://www.cdc.gov/hiv/graphics/mortalit.htm].)

FIG. 2.

Trends in age-adjusted (to 2000 U.S. population) annual rates of death due to HIV disease in the United States by race/ethnicity for the period 1990-2002. For comparison with data for 1999 and later years, data for 1987-1988 were modified to account for ICD-10 rules instead of ICD-9 rules. (Reprinted from the CDC website [http://www.cdc.gov/hiv/graphics/mortalit.htm].)

FIG. 3.

Trends in age-adjusted (to 2000 U.S. population) annual rates of death due to HIV disease in the United States by geographic region for the period 1987-2002. For comparison with data for 1999 and later years, data for 1987-1988 were modified to account for ICD-10 rules instead of ICD-9 rules. The age distribution of the U.S. population was used as the standard for age adjustment. (Reprinted from the CDC website [http://www.cdc.gov/hiv/graphics/mortalit.htm].)

FIG. 4.

Trends in age-adjusted (to 2000 U.S. population) annual rates of death due to HIV disease in the United States by age group for the period 1987-2002. For comparison with data for 1999 and later years, data for 1987-1988 were modified to account for ICD-10 rules instead of ICD-9 rules. (Reprinted from the CDC website [http://www.cdc.gov/hiv/graphics/mortalit.htm].)

FIG. 5.

Estimated numbers of AIDS cases, deaths, and persons living with AIDS in the United States for the period 1985-2004. Data have been adjusted for reporting delays. (Reprinted from the CDC website [http://www.cdc.gov/hiv/topics/surveillance/resources/slides/trends/index.htm].)

FIG. 6.

Estimated numbers and rates of HIV/AIDS diagnoses in 33 states for the period 2001-2004. EAPC, estimated annual percent change.

FIG. 7.

Estimated annual rates of HIV/AIDS diagnoses in 33 states by sex and race/ethnicity for the period 2001-2004. EAPC, estimated annual percent change; A/PI, Asian/Pacific Islander; AI/AN, American Indian/Alaska Native. Statistically significant percent changes are indicated with asterisks.

FIG. 8.

Estimated annual rates of HIV/AIDS diagnoses among males in 33 states by race/ethnicity for the period 2001-2004. EAPC, estimated annual percent change. Percentages of change were not statistically significant.

FIG. 9.

Estimated annual rates of HIV/AIDS diagnoses among females in 33 states by race/ethnicity for the period 2001-2004. EAPC, estimated annual percent change. Statistically significant percent changes are indicated with asterisks.

FIG. 10.

Annual distribution of AIDS cases in the United States by case definition category for the period 1981-2003.