CDC: HIV infections higher than reported

By Jen Colletta
PGN Staff Writer
© 2008 Philadelphia Gay News

Federal health officials announced last weekend that the average number of new HIV infections in America is about 40-percent higher than previously reported.

For the past 12 years, the Centers for Disease Control and Prevention has estimated that there have been about 40,000 new HIV infections each year.

In a new study published Wednesday in the Journal of the American Medical Association, however, the CDC now reports that about 56,300 new infections occurred in 2006.

The CDC stated the discrepancy can be accounted for by better testing and reporting methods, as opposed to an actual upswing in the number of HIV cases.

The report also found that gay and bisexual men and African-American men and women contract the disease at much higher rates than other populations.

About 53 percent of new infections in 2006 were transmitted by men who have sex with men (MSM). Approximately 31 percent of newly infected individuals contracted the disease through high-risk heterosexual contact; 12 percent through injection drug use; and 4 percent through MSM and/or injection drug use.

The number of MSM transmissions has increased over the past few years, while the percentage of new HIV infections within the heterosexual and injection-drug-user communities has decreased.

When addressing the reasoning for the higher incidence among gay and bisexual men, the report stated, “Many factors probably contribute to high risk of HIV among MSM, including the challenge of maintaining safer-sex behaviors, the assumption that one is HIV-negative, underestimates of personal risk factors and stigma, which may prevent access to needed services and may lead to substance abuse and depression.”

In addition to the MSM population, the disease affects African Americans at a disproportionately high rate.

Although African Americans comprise only 13 percent of the American population, they accounted for 45 percent of the new HIV infections in 2006. About 35 percent of new HIV patients were white; 17 percent were Hispanic; and 3 percent came from other ethnic backgrounds.

Walt Senterfitt, board co-chair of the Community HIV/AIDS Mobilization Project, said the new data points to the need for a targeted HIV prevention and treatment plan for sexual and racial minorities.

“A substantial number of black people infected every year are gay or bisexual, and a substantial proportion of gay and bisexual men infected are black,” Senterfitt said. “The heaviest impact is at the nexus of the two — being both black and a man who has sex with men. Yet this population is significantly marginalized, even stigmatized within both larger populations of which it is an integral part. A national AIDS strategy must tackle this fundamental challenge.”

The new statistics stemmed from the CDC’s utilization of the serologic testing algorithm for recent HIV seroconversion (STARHS) to determine which positive HIV testing results are reflective of actual new infections, contracted within the previous five months. The CDC applied the STARHS method to HIV diagnoses reports from 22 states that employ named-based HIV-reporting systems to determine which of these represent new infections.

Using a method called extended back-calculation, the CDC also conducted an analysis of HIV trends since the early ’90s and determined that the actual number of new infections has remained steady, oscillating slightly between 55,000-58,000.

“This is the most reliable estimate we’ve had since the beginning of the epidemic,” said Dr. Julie Gerberding, director of the CDC.

Gerberding noted that other countries may begin to adopt the new CDC data-collection methods, which she said the agency has been working to implement for seven years.

The CDC data comes just days after President Bush signed the reauthorization of a nearly $50-billion program to fight AIDS overseas and also while about 25,000 researchers, community leaders, legislators and HIV/AIDS activists are gathered in Mexico City for the International AIDS Conference.

In his address to the conference, former President Bill Clinton called the CDC report a “wake-up call” for Americans.

“Even as we fight the epidemic globally, we must focus at home,” he said.

He urged the audience of several thousand on Aug. 4 to become as involved as possible in the fight against HIV/AIDS.

“AIDS is a big dragon ... [that] must be slain by millions and millions of foot soldiers.”

Jen Colletta can be reached at jen@epgn.com.