The estimated overall rate of new HIV infections in the United States has remained stable at approximately 50,000 over the past 3 years – but infection rates increased significantly among young men who have sex with men and in young, black MSM, in particular, according to a report from the Centers for Disease Control and Prevention.
The findings were presented Aug. 3 in a teleconference and published online in the journal PLoS ONE (2011 Aug. 3;6:e17502 [doi:10.1371/journal.pone.0017502]).
The estimated overall yearly number of new cases of HIV infection between 2006 and 2009 in males and females aged 13 years and older was 48,600 in 2006, 56,000 in 2007, 47,800 in 2008, and 48,100 in 2009, according to lead study author Joseph Prejean, Ph.D., of the CDC’s Division of HIV/AIDS Prevention.
The CDC study’s estimates were based on incidence surveillance data from 16 states and two cities.
Overall, the rates of new infections were not significantly different for most subgroups when analyzed by age, race, and transmission category. But, "gay and bisexual men of all races remain most affected by HIV in the United States," Dr. Prejean said. "MSM represented 61% of all new cases in 2009," he added.
The incidence of new HIV infections among black MSM aged 13-29 years increased by 48% during the study period, from 4,400 in 2006 to 6,500 in 2009.
"We don’t have all the answers about what might be driving this trend, but we do know that individual risk factors alone do not account for it," Dr. Prejean said. "We think there are more complex factors at work."
For example, young black men have higher rates of syphilis, which can increase the risk of HIV transmission, he said. In addition, many young black men have limited access to care and often face stigma associated with homosexuality, he added.
Overall, black and Hispanic men and women had significantly higher rates of HIV infection, compared with whites, and these trends did not change significantly over the study period.
"HIV is preventable, and we need to do more to prevent it," CDC Director Thomas Frieden said during the teleconference. Approximately 1.2 million people in the United States are infected with HIV, and 1 in 5 doesn’t know he or she is infected, he added.
Dr. Frieden emphasized that knowing one’s HIV status is key to reducing HIV infection rates, and he encouraged doctors to promote routine HIV testing.
HIV testing "is something that we go through, and that we encourage patients to go through. It is like other medical tests," said Dr. Frieden. "That doesn’t mean that anyone should be tested against their will or without their knowledge," he added. But data have shown that when HIV testing is part of the routine, testing rates go up and detection rates for previously undiagnosed infection go up, he said.
"Physicians also need to link people to [HIV] care," Dr. Frieden said. "One concerning trend is that one-third of people who test positive for HIV don’t appear to be entering care promptly."
The CDC recommends that all Americans aged 13-64 years receive an HIV test at least once during their lives, said Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Those people with ongoing risks or concerns are encouraged to get tested more frequently, he said.
There are many types of point-of-care testing available to make it easier for physicians to talk with patients about HIV and provide testing at the local level, Dr. Fenton added.
The CDC funded the study, and the authors said they had no financial conflicts to disclose. Read the complete article online at PLoS ONE.