1 / 26

Understanding the US HIV/AIDS Crisis: Trends and Future Challenges

This presentation provides an update on the HIV epidemic in the United States, including historical context, new methods for estimating HIV incidence, demographic breakdown of new infections, implications for prevention, and CDC's response and challenges in prevention strategies.

edwinbrown
Download Presentation

Understanding the US HIV/AIDS Crisis: Trends and Future Challenges

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Update on the US HIV/AIDS Crisis: Current Trends, Future Challenges Kevin Fenton, MD, PhD National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention August 5, 2008 XVII International AIDS Conference

  2. Overview • The HIV epidemic in the United States • HIV Incidence • HIV Prevalence • Implications for HIV Prevention • Summary

  3.  The HIV epidemic in the United States

  4. Historical Context • Earlier estimates of HIV incidence were based on indirect methods • 40,000 – 80,000 in 1987-1992 (Rosenberg, 1995) • 40,000 new HIV infections (Karon, 2001)

  5. New methods for HIV incidence • Stratified Extrapolation Approach • Based on surveillance information, standard HIV testing, and new HIV testing technology • Used STARHS approach to distinguish recent from long-standing infections • Applied to a sample of newly HIV diagnosed individuals from 22 states in 2006 • Extended back calculation approach • Enabled a retrospective view of the evolution of HIV incidence since 1977 • Incorporates AIDS, HIV and HIV testing data from routine surveillance Hall et al. JAMA. Vol 300, No5. 2008

  6. In 2006, an estimated 56,300 (95%CI 48,200-64,500) new HIV infections occurred in the United States.* * Data from the Stratified Extrapolation Approach

  7. Estimated percentage of new HIV Infections, by Sex, 2006 N=56,300 Women 27% Men,73% *50 States and District of Columbia

  8. Estimated number of new HIV infections, by sex, 1977-2006* *50 States and District of Columbia Total Males Females

  9. Estimated percentage of new HIV Infections, by Transmission Category, 2006* N=56,300 Heterosexual contact,31% Men who have sex with men, 53% Men who have sex with men and inject drugs, 4% Injection drug users, 12% *50 States and District of Columbia

  10. Estimated number of new HIV infections by transmission category, 1977-2006 *50 States and District of Columbia MSM IDU HET

  11. Estimated percentage of new HIV Infections, by Race/Ethnicity, 2006* Asian/Pacific Islander, 2% American Indian/Alaska Native, 1% Hispanic 17% White35% Black45% N=56,300 *50 States and District of Columbia

  12. Estimated rates of new HIV Infections, 2006* Total Male: 34.3 per 100,000 Total female: 11.9 per 100,000 *50 States and District of Columbia

  13. Estimated number of new HIV infections, by race/ethnicity, 1977-2006* *50 States and District of Columbia White Black Hisp.

  14. Estimated number of new HIV infections, by race/ethnicity, 1977-2006* A/PI AI/AN *50 States and District of Columbia

  15. Estimated percentage of new HIV Infections, by Age, 2006* 50-99, 10% N=56,300 13-29 13-29, 34% 40-49, 25% 30-39, 31% *50 States and District of Columbia

  16. Estimated rates of new HIV Infections, by age, 2006* *50 States and District of Columbia

  17. Prevalent HIV infections • Number HIV infected 1,039,000 – 1,185,000 • Number unaware of their HIV infection252,000 - 312,000 (24%-27%) Source: Glynn M, Rhodes P. 2005 HIV Prevention Conference

  18. HIV Infection in the United States Household Population Aged 18–49 Years: 1999–2006 Mexican American* NH Black1 NH white 40-49 years2 30-39 years 18-29 years Female Male3 All Note: Nationally representative sample of the civilian, non-institutionalized household population. Source: CDC, NCHS, National Health and Nutrition Examination Survey, 1999-2006.

  19. AIDS Diagnoses and Deaths • Cumulative AIDS deaths: 565,000 • 2006 AIDS deaths: 14,000+ • AIDS diagnosis within one year of HIV diagnosis (33 states): 38% Source: CDC. HIV/AIDS Surveillance Report. 2007.

  20.  Implications for prevention

  21. HIV/AIDS Prevention in the United States: Challenges • One quarter of those with HIV infection undiagnosed • MSM remain at increased HIV risk; new infections increasing • African Americans and Hispanics bear heaviest burden • Limited access to effective prevention • Concern that the availability of effective treatments has led to complacency about HIV risk

  22. HIV/AIDS Prevention in the United States: Challenges • HIV/AIDS stigma persists • Changing patterns and distribution of substance abuse (e.g., meth) • Internet as means for meeting partners • Need more culturally competent interventions • Structural factors: poverty, homelessness, racism, homophobia

  23. HIV/AIDS Prevention in the United States: CDC Response • Expanding HIV testing • Expanding access to effective programs • Mobilizing at risk communities • Reassessing efforts for MSM, and other hardest hit communities • Conducting research on new interventions

  24. HIV/AIDS Prevention in the United States: CDC response • CDC is supportive of calls for a comprehensive national HIV plan. • Critical review of CDC’s HIV prevention portfolio by an independent panel of national experts. • Develop a strategic road map for HIV prevention, with measurable objectives, to 2020.

  25. Summary • HIV/AIDS continues to evolve in the US with a high burden among MSM of all races and African Americans, Hispanics. • Major challenges remain in meeting unmet need, increasing coverage of effective prevention interventions, and expanding the cadre of culturally competent interventions. • Renewed commitment to mobilizing communities, HIV testing, intensifying and targeting prevention efforts needed.

  26. Thank You National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention www.cdc.gov/nchhstp

More Related