Overview of US epidemic

Two senior CDC officials in charge of domestic HIV issues gave sweeping overviews of the epidemic. While they summarized what was reported earlier this year at the International AIDS Conference in Mexico City, they also pinpointed little-reported developments in both new HIV infections and testing initiatives.

Kevin Fenton, director of the National Center For HIV/AIDS at the CDC, said that of the estimated 56,300 new HIV infections in 2006, 53 percent were among men having sex with men (MSM). Then he drilled deeper into those statistics: Among white MSM, 35 percent were aged 30 to 39; among black MSM, 52 percent were aged 13 to 29; and among Hispanic MSM, 43 percent were aged 13 to 29.

``There are urgent threats and urgent realities,’’ Fenton said. ``… MSMs of all races remain at increased HIV risk, and HIV incidence in young MSMs is of particular concern among blacks and Hispanics.’’

Bernard Branson, another senior CDC official, spoke about the national initiatives to expand HIV testing. He pointed out a few successes: the numbers of people unaware of their HIV infection dropped to 21 percent in 2006, from 25 percent the year before; 22 percent of African Americans said they were tested in 2006, compared to 19 percent in 2002; the Veterans Administration repealed a regulation that prohibited widespread HIV testing; and 11 states in the last two years have removed requirements that people must sign informed consent forms before getting tested.

Branson also said noted two successes – one in New York, the other in Florida.

The New York Health and Hospitals Corporation, which has 4.9 million annual patient visits, testing has nearly tripled in three years. In fiscal year 2005, the system tested 58,785 patients; in fiscal year 2008, more than 160,900 were tested.

In Florida, which initiated HIV rapid tests in many settings, he noted that 2.4 percent of those tested in medical settings were HIV positive – and of those testing positive, 93 percent did not know that beforehand. He said that those testing positive in jails in Florida, 77 percent did not know they were infected.

But Branson also acknowledged that much needs to be done. ``Our strategies have not reached new populations’’ infected with high rates of HIV, he said. ``We haven’t been completely successful.’’