At the end of 2003, the CDC estimates that there were 351,614 persons living with HIV/AIDS in the 33 areas which have a history of confidential name-based HIV reporting³. However, the true number of people in the USA with HIV/AIDS is thought to be between 1,039,000 and 1,185,000 million⁴. The discrepancy between these figures is due to several factors including: [Editor notes in blue text]

• reporting of persons diagnosed with HIV has not yet been implemented in all areas⁵ [i.e. 18 states don't have testing]
• anonymous tests, including home tests, are excluded from case reports [How does one reliably calculate the number of positive from negative results from those who test at home?]
• one in every four people living with HIV is unaware of their infection.⁶ [Creative estimating.]

³ Since 1999, the following 33 areas have had laws or regulations requiring confidential name-based HIV infection reporting: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming, and the US Virgin Islands. Since July 1997, Florida has had confidential name-based HIV infection reporting only for new diagnoses.

⁴ Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003. National HIV Prevention Conference; June 2005; Atlanta.
⁵ According to the number of AIDS cases reported to the CDC, the 33 areas with confidential name-based reporting of HIV infection represent approximately 43% of the US epidemic.
⁶ Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003. National HIV Prevention Conference; June 2005; Atlanta.

______

Dr. Glynn, in the article below, describes her estimates as "robust." The article below states, "Researchers based these estimates on various data sources and used projections that assumed a constant number of new HIV infections and AIDS deaths annually since 1998." (Underling emphasis added by FAIR) Clearly, the dramatic decline of AIDS deaths in California's newly infected patients of 97 percent and 95 percent in New York indicates utilizing an assumption of a constant number of AIDS deaths is inappropriate and places further into question the reliability of these estimates.

Note the sponsors of the “National HIV Prevention Conference” here.

 About 1 million Americans living with
 HIV

 Between 24% and 27% of people with HIV do not know that they
 are infected.

 by Tara Grassia
 Staff Writer 

  July 2005 

   ATLANTA — At the end of 2003, roughly 1 million Americans were living with HIV; blacks and gay
   and bisexual men were the most severely affected, according to HIV research data presented at
   the 2005 National HIV Prevention Conference.

   About one-fourth of those do not know they have HIV, said M. Kathleen Glynn, DVM, MPVM,
   epidemiologist, division of HIV/AIDS prevention, CDC. Modeling results also indicated that blacks and
   men who have sex with men (MSM) remain the most affected populations; women and high-risk
   heterosexuals, however, do not fall far behind compared with years past.

   “We have to equip them with the knowledge and services needed to stay healthy and help protect
    others from infection,” she told Infectious Disease News.

   Glynn provided attendees with new figures based on refined estimation methods. These data
   currently provide the clearest picture, to date, of the scope of the epidemic overall and among
   specific racial, ethnic and risk groups, she said.

“  Efforts must be continued to ensure that persons at risk for HIV find out their serostatus and are
   appropriately linked to care and prevention services,” the researchers wrote in their abstract. “These
   results show that HIV/AIDS surveillance data, representing persons diagnosed with HIV infection, can
   be used to provide robust estimates of the overall HIV prevalence in the United States.”

   HIV/AIDS prevalence

   Since the CDC’s last HIV estimates, released
   in  2002, more data have become available
   about HIV diagnoses before progression to
   AIDS. Glynn and colleagues used this
   information and two different modeling
   methods to determine HIV prevalence across
   the nation. However, both methods used
   HIV/AIDS surveillance data reported to the
   CDC through June 2004.

   The researchers found with method A that
   there were an estimated 925,000 to 1.025
   million people living with HIV/AIDS at the
   end of 2003. Of these, 366,000 were living
   with HIV, 395,000 had AIDS and 164,000
   to 264,000 were unaware of their sero-
   status, according to the abstract.

   Using a back-calculation model, Method B’s
   results indicated that overall HIV estimated
   prevalence was 1.039 million to 1.185
   million. Of these, 417,000 people were
   living with HIV, 415,000 had AIDS and
   252,000 to 312,000 were undiagnosed.

   Researchers were also able to examine the
   magnitude of the epidemic within specific
   populations.

   Almost half (47%) of those estimated to be living with HIV were black. White people accounted for
   34% of those living with HIV, and 17% were Hispanic. Asian/Pacific Islanders and American
   Indians/Alaska Natives each represented about 1% of the HIV population.

   By risk group, the researchers found that 45% were MSM, followed by an estimated 27% who
   acquired the disease through high-risk heterosexual contact and 22% from injection drug use. MSM
   and injection drug users accounted for 5%.

   Males represented 74% of the HIV population. However, according to Glynn, this makeup may begin
   to change.

“  More diverse populations are affected [by HIV] than ever before – and there are a wide range of
   factors influencing transmission in different groups,” Glynn said. “The solution will require culturally
   appropriate and carefully tailored approaches.”

    In years to come

   The modeling methods also revealed a pattern about how the HIV population may change in the
   future.

   Glynn and colleagues evaluated the total diagnosed population into those that progressed to AIDS
   and those in earlier stages of disease and found that females, non-Hispanic blacks and those who
   acquire HIV through high-risk heterosexual contact currently account for a higher proportion of
   hose living with HIV than they do among those living with AIDS.

“  Treatment successes have brought new challenges. While advances in treatment are a godsend for
   HIV-positive individuals — resulting in longer, healthier lives – this also means there is a growing
   population in need of services,” she said.

   Likewise, Glynn added that increased prevalence means an increased opportunity for HIV transmission
   and an increased need for HIV testing and prevention services and programs. Efforts to reduce HIV
   cases must be designed to meet the needs of all populations.

“  The medical and public health community have to help people maintain safe behaviors over a lifetime,
   not just in a crisis mode,” she said.

   Although future prevalence trends depend on trends in new infections, diagnoses, disease and
   deaths, these findings suggest that these populations may comprise an even greater percentage
   of HIV-positive people in years to come.

   Therefore, in addition to updating overall prevalence estimates, Glynn and colleagues sought to
   determine how many individuals living with HIV are unaware of their serostatus.

   Results indicated that, as of 2003, between 24% and 27% of individuals living with HIV
   remained undiagnosed. Researchers said they believe these estimates point to an increased need
   for HIV testing, prevention and treatment services to slow the U.S. HIV/AIDS epidemic.

    A need for surveillance

   National AIDS case surveillance has been conducted throughout the United States since the 1980s
   and is used to generate an active picture of the AIDS epidemic to provide information about people
   living with AIDS, Glynn said.

   However, there is no national HIV surveillance system that monitors and tracks HIV diagnoses,
   despite the fact that “comprehensive national HIV surveillance data are critical,” she said. If
   available, such data could be used to estimate the number of people living with HIV/AIDS, both
   diagnosed and undiagnosed.

   The researchers stressed that the estimation methods include uncertainty, and, like all estimates, are
   only as good as the data upon which they are based.

   Previous estimates stated that 850,000 to 950,000 people were living with HIV at the end of 2000,
   approximately 25% of whom did not know they were infected. Researchers based these estimates
   on various data sources and used projections that assumed a constant number of new HIV
   infections and AIDS deaths annually since 1998.

   Newer back-calculation methods take advantage of the increasing availability of information on HIV
   detection before progression to AIDS.

   The wide range for the prevalence estimates and the estimates for the proportion of individuals
   who remain undiagnosed is largely the result of continued gaps in data on HIV diagnoses across
   the nation.

   CDC officials said that continued efforts toward a national tracking system are critical to improve
   the precision of future HIV prevalence estimates and to accurately monitor the course of the
   HIV epidemic, Glynn said. It is also important to direct prevention efforts to those populations in
   greatest need.

   For more information:

  Glynn L. Estimated HIV prevalence in the United States at the end of 2003. Plenary session
  T1-B1101.
  Presented at the 2005 National HIV Prevention Conference. June 12-15, 2005. Atlanta.

  From Infectious Disease News:
  http://www.infectiousdiseasenews.com/200507/frameset.asp?article=americans.asp

Home | The Facts | $Your Disease$ | Quiz | Newsletter | In The News | Speeches
Join FAIR | FAIR Concept | Coma Life| Donate Please | Links | Contact FAIR | Privacy Policy

Copyright © 2008 The FAIR Foundation. All rights reserved
 Webmaster     
. . .   . . . . . . . .    . . . . . . . .   . . . .    .   .