Articles

HIV Study: Rate Down for Blacks; CDC Warns that Progress Elusive

By M.A.J. McKenna
Atlanta Journal-Constitution
Nov. 18, 2005

The rate at which African-Americans are diagnosed with HIV has declined slightly every year for four years, the Centers for Disease Control and Prevention said Thursday in a rare piece of good news on the HIV/AIDS epidemic in the United States.

But the health agency hedged the announcement with warnings, cautioning that blacks remain the hardest hit of all population groups --- with a rate of new diagnoses more than eight times higher than the white rate --- and that some other groups, such as men of all races who have sex with other men, are seeing their rates increase.

"New HIV diagnoses continue to disproportionately and severely impact African-Americans, both men and women," said Dr. Ron Valdiserri, acting director of the CDC's National Center for HIV, STD and TB Prevention. "We must remember the human impact behind these numbers and continue to work together to reduce this glaring disparity."

The numbers, released in the CDC's weekly health bulletin, come from an analysis of HIV tests reported to health departments between 2001 and 2004 in 33 states, which do not include Georgia.

Biggest News is Bad

The analysis is the CDC's best attempt to understand the growth of the U.S. epidemic. The agency had tracked the epidemic through AIDS cases, but that measure became less useful as drug regimens lengthened the time between infection with the HIV virus and the development of AIDS.

So the agency turned instead to HIV test results. The analysis released Thursday uses results only from states that have recorded diagnoses by patients' names, rather than by anonymous codes, for at least four years.

Georgia only began tracking HIV diagnoses by name in January 2004 and has not yet released a name-based analysis. California, which uses codes and has resisted name-based reporting, also is not included.

"This is the best indication we have of the national direction of the HIV epidemic," Valdiserri said.

Overall, the CDC said, the growth of the national epidemic has flattened, as shown in similar rates of new diagnoses reported over the survey's four years: 22.8 diagnoses per 100,000 members of the population in 2001 vs. 20.7 per 100,000 in 2004, a difference that the agency said was not statistically significant.

In some groups the rate of new diagnoses declined. Among African-Americans it fell from 88.7 per 100,000 in 2001 to 76.3 per 100,000 in 2004, a drop the agency said was statistically significant.

There were also reductions in HIV diagnoses among heterosexuals and users of injection drugs, but the CDC was cautious in analyzing those, warning that the numbers may have been skewed by the first-time inclusion of New York state and New York City in the data.

New York accounted for more than 20 percent of all HIV diagnoses in the study, the CDC said. The New York state government has funded needle exchange programs --- which reduce the rate of infection by giving injection drug users free, clean hypodermics --- for more than a decade, but such programs are rare nationwide.

The biggest news in the study, the CDC said, was not the individual small reductions among groups, but the lack of any meaningful reduction in rates among HIV's most common victims, racial minorities and men who have sex with men.

Black Rate 8 Times White

African-Americans --- who among racial groups had 51 percent of all new diagnoses --- had a new diagnosis rate 8.4 times higher than that of whites and 2.5 times higher than that among Hispanics, said Dr. Lisa Lee of the CDC.

"That is the piece I would call the real bad news --- that rates among African-Americans are still incredibly high," said Dr. Carlos Del Rio, an HIV researcher and professor of medicine and infectious disease at the Emory University School of Medicine who was not involved with the CDC analysis.

Among men who have sex with men --- who accounted for 44 percent of all new diagnoses, with an additional 4 percent attributed to men who have sex with men and also use injection drugs --- the rate of HIV findings rose a sharp 8 percent in one year, from 2003 to 2004.

The CDC cautioned that the numbers might reflect greater success in testing more men rather than an increase in infections. But the agency conceded that other recent research findings --- including a report last week that showed syphilis on the increase for the fourth straight year --- suggest that the rate of HIV infection among men who have sex with men may in fact be rising.

Copyright 2005 the Atlanta Journal-Constitution. For more information: www.ajc.com.

Fair Use Notice

This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of environmental, political, human rights, economic, democracy, scientific, and social justice issues, etc. We believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.

For more information, visit: http://www.law.cornell.edu/uscode/17/107.shtml. If you wish to use copyrighted material from this site for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner.