Friday, November 18, 2005

HIV infections among homosexual and bisexual men in the United States rose 8 percent last year, after remaining relatively stable the three previous years, new federal data show.

The increase for the virus that causes AIDS compares with average annual declines of 4 percent among heterosexuals and 9 percent among intravenous-drug users from 2001 to 2004, according to a report in this week’s issue of the Centers for Disease Control and Prevention’s Morbidity & Mortality Weekly Report.

The CDC said the recent increase in diagnosed HIV infections among men who have sex with other men “may reflect increases in HIV incidence, consistent with reported increases in risk behaviors and syphilis, but it may also reflect an increase in HIV testing.”

“We don’t know for certain, but we’re concerned. That 8 percent increase [between 2003 and 2004] was consistent across all race groups,” Dr. Ron Valdiserri, acting director of the CDC’s National Center for HIV, STD and TB Prevention, said yesterday.

“By transmission category, men who have sex with men continued to account for the largest number of [HIV] diagnoses overall” between 2001 and 2004, comprising 44 percent of the total caseload and 61 percent of male infections, according to the report, which tracked trends in HIV/AIDS diagnoses in 33 states.

Of the 157,252 persons diagnosed with the virus in that period, 112,106 were men and 45,146 were women. More than 68,400 men acknowledged having had sex with other men.

“For the first time ever, this national total includes data from New York State, thus providing a more representative picture of the U.S. epidemic,” according to the report. It pointed out that New York’s HIV cases “account for over 20 percent of all new diagnoses reported during 2001 to 2004.”

Heterosexual contact was the transmission method in 34 percent of HIV diagnoses in that period. An additional 17 percent of the cases resulted from infection through intravenous-drug use.

Besides the 68,434 men infected through homosexual acts, 5,723 men who tested positive for HIV could have contracted the virus either through homosexual contact or intravenous-drug use, according to the report.

The analysis showed that diagnoses attributed to heterosexual exposure “varied considerably by race.” The rates ranged from a “low of 6 percent among whites to a high of 25 percent among blacks.”

From the start of the AIDS epidemic in 1981, the lion’s share of female HIV infections has been contracted through heterosexual sex. That was how 76 percent of women infected from 2001 to 2004 were exposed to the virus. Twenty-one percent contracted it through intravenous-drug use, and 3 percent from other causes. Black women have been particularly vulnerable, federal epidemiologists said.

The report also found that racial disparities in HIV infections “remain severe.” During the four years examined, 51 percent of HIV diagnoses were among blacks; 29 percent among whites; and 18 percent among Hispanics. The rest were among Asians and American Indians.

The rate of diagnosis among blacks fell by about 5 percent a year. Nonetheless, the rate among blacks remained 8.4 times higher than that of whites in 2004.

Specifically, the rate of HIV diagnosis among blacks was 76.3 per 100,000 in 2004; among whites, it was nine per 100,000.

The CDC report recommends greater HIV/AIDS-prevention efforts focusing on blacks and on homosexual and bisexual men.

It concludes that the inclusion of the New York data “greatly strengthens the analysis of the magnitude and direction of trends in HIV diagnoses” in the country today.

“However, a number of high-morbidity areas that lack long-standing confidential, name-based HIV reporting, including California and Illinois, are still not included,” but should be, the study said.

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