# Presentation: 754673

## Slide 1

**Notes:**
The proportion of AIDS cases among female adults and adolescents (age ≥13 years) increased from 7% in 1985 to 27% in 2006.AIDS incidence among female adults and adolescents rose steadily through 1993, when the AIDS surveillance case definition was expanded, and leveled off at approximately 13,000 AIDS cases each year from 1993 through 1996. In 1996, incidence among women and adolescent girls began to decline, primarily because of the success of antiretroviral therapies. Cases have leveled since 2000.The data have been adjusted for reporting delays.

## Slide 2

**Notes:**
For female adults and adolescents, in 2006 the AIDS diagnosis rate (AIDS cases per 100,000) for blacks (not Hispanic) (40.4) was 21 times as high as that for whites (not Hispanic) (1.9).  
The estimated number of AIDS cases diagnosed among females in 2006 was similar for Hispanics and whites, but the rate for Hispanics (9.5) was 5 times as high as that for whites.
Relatively few cases were diagnosed among Asian/Pacific Islander and American Indian/Alaska Native females, although the rate for American Indian/Alaska Natives (3.6) was nearly twice the rate for white females.
The data have been adjusted for reporting delays.

## Slide 3

**Notes:**
CDC estimates that 73% of the 9,801 AIDS cases diagnosed among female adults and adolescents in 2006 were attributed to high-risk heterosexual contact: 11% of these cases were from high-risk heterosexual contact with an injection drug user and 62% from sexual contact with high-risk partners such as bisexual men or HIV-infected men with unidentified risk factors.Of the cases in female adults and adolescents, 24% were attributed to injection drug use and 2% to other or unidentified risk factors.Data have been adjusted for reporting delays and cases without risk factor information were proportionally redistributed. 

## Slide 4

**Notes:**
Most of the AIDS cases diagnosed in 2006 among females age 13 years or older were attributed to high-risk heterosexual contact.Of AIDS cases among women age 35 and older, approximately 30% were attributed to injection drug use, compared with 10% of cases in females aged 13-19 years, 15% in women aged 20-24 years, and 19% in women age 25-34. Among females age 13-19 years, 36% were exposed to HIV through perinatal transmission, and are included in the “other/not identified” transmission category.Data have been adjusted for reporting delays and cases without risk factor information were proportionally redistributed. 

## Slide 5

**Notes:**
Rates of reported AIDS cases per 100,000 female adults and adolescents are shown for each state, the District of Columbia, and U.S. dependent areas. The highest rates were found in the District of Columbia, the U.S. Virgin Islands, Maryland, New York, and Florida. Rates were lowest in states in the Midwest. 
The District of Columbia is a metropolitan area, use caution when comparing its AIDS rate to state AIDS rates.Rates were not calculated for states reporting fewer than 5 AIDS cases in females in 2006. 

## Slide 6

**Notes:**
From 2002 through 2006, an estimated 48,936 AIDS cases diagnosed among female adults and adolescents were attributed to either injection drug use or high-risk heterosexual contact. High-risk heterosexual contact accounted for the majority of AIDS cases among females, particularly in the South.Most AIDS cases were among female adults and adolescents who reside in the Northeast and South.
Data have been adjusted for reporting delays and cases without risk factor information were proportionally redistributed.
Regions of residence are defined as follows:
Northeast—Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, VermontMidwest—Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, WisconsinSouth—Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West VirginiaWest—Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming

## Slide 7

**Notes:**
Most reported AIDS cases among female adults and adolescents were among those who resided in the South and the Northeast.The majority of cases were among black (not Hispanic) female adults and adolescents in the South, Northeast, and Midwest regions. In the West, there was less disparity in the AIDS case counts among white (not Hispanic), black, and Hispanic female adults and adolescents.Data are not shown for Asian/Pacific Islander and American Indian/Alaska Native female adults and adolescents because the numbers reported in 2006, when stratified by region of residence, were small.
Regions of residence are defined as follows:
Northeast—Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, VermontMidwest—Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, WisconsinSouth—Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West VirginiaWest—Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming

## Slide 8

**Notes:**
In 2006, there were 52,303 female adults and adolescents 15 to 44 years of age reported to be living with HIV infection (not AIDS) in the 45 states and 5 U.S. dependent areas with confidential name-based HIV infection reporting for adults and adolescents. These women are of childbearing age and in the years of highest fertility. In most states with HIV surveillance, the number of reported HIV infected female adults and adolescents who have not progressed to AIDS exceeds the number of female adults and adolescents with AIDS (see slide 9). Together these numbers indicate the burden of HIV and the number of persons in need of HIV-related medical and social services for themselves and to prevent transmission of HIV to their children. States with integrated HIV and AIDS surveillance data may be better able to target programs and services to reduce transmission to newborns.
The numbers presented here are an underestimate of female adults and adolescents living with HIV, since many reside in states without integrated HIV/AIDS surveillance. In addition, there may be many infected females who have not been tested or not reported in areas with relatively new HIV infection surveillance systems (e.g. California). 
In 2006, the following 45 states and 5 U.S. dependent areas conducted HIV case surveillance and reported cases of HIV infection in adults, adolescents, and children to CDC: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, Wyoming, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.

## Slide 9

**Notes:**
In 2006, there were 53,564 female adults and adolescents 15 to 44 years of age reported to be living with AIDS in the United States and dependent areas. These women are of childbearing age and in the years of highest fertility. In most states with HIV surveillance, the number of reported HIV infected female adults and adolescents who have not progressed to AIDS exceeds the number of female adults and adolescents with AIDS (see slide 8). Together these numbers indicate the burden of HIV and the number of persons in need of HIV-related medical and social services for themselves and to prevent transmission of HIV to their children. States with integrated HIV and AIDS surveillance data may be better able to target programs and services to reduce transmission to newborns.

## Slide 10

**Notes:**
Among female adults and adolescents diagnosed with HIV/AIDS in 2006, 80% of the 9,252 HIV/AIDS cases were attributed to high-risk heterosexual contact, 19% to injection drug use and 1% to other or unidentified risk factors.The following 33 states have had laws or regulations requiring confidential name-based HIV infection surveillance since at least 2003: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
Data have been adjusted for reporting delays and cases without risk factor information were proportionally redistributed.

## Slide 11

**Notes:**
The pie chart on the left illustrates the distribution of HIV/AIDS cases diagnosed among female adults and adolescents in 2006 in 33 states by racial/ethnic group. The pie chart on the right shows the distribution of the female population of the 33 states in 2006.  
In 2006, black (not Hispanic) females made up 13% of the female population but accounted for 65% of HIV/AIDS cases among females. Hispanic females made up 11% of the female population but accounted for 15% of HIV/AIDS cases among females. Whites (not Hispanic) made up 71% of the female adult and adolescent population but accounted for 18% of HIV/AIDS cases among females. 
The following 33 states have had laws or regulations requiring confidential name-based HIV infection surveillance since at least 2003: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
The data have been adjusted for reporting delays.

## Slide 12

**Notes:**
The majority of HIV/AIDS cases diagnosed in 2006 among females age 13 years or older were attributed to high-risk heterosexual contact.Approximately one-fifth of cases among women age 35 years and older were attributed to injection drug use, compared with 13% of cases in females age 13–19 years, 16% in women age 20–24 years, and 16% in women age 25-34 years.The following 33 states have had laws or regulations requiring confidential name-based HIV infection surveillance since at least 2003: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
The data have been adjusted for reporting delays and cases without risk factor information were proportionally redistributed.

## Slide 13

**Notes:**
In the 33 states with confidential name-based HIV infection reporting, the diagnosis rate of HIV/AIDS among female adults and adolescents was 11.5 per 100,000 population in 2006. The rate for female adults and adolescents diagnoses with HIV/AIDS ranged from zero per 100,000 in North Dakota and Wyoming to 24.3 per 100,000 in Florida.The following 33 states have had laws or regulations requiring confidential name-based HIV infection surveillance since at least 2003: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
The data have been adjusted for reporting delays.

## Slide 14

**Notes:**
For female adults and adolescents, the rate (HIV/AIDS cases per 100,000) for non-Hispanic blacks (56.2) was nearly 20 times higher than that for non-Hispanic whites (2.9).  
The estimated number of HIV/AIDS cases diagnosed in 2006 was similar for Hispanics and non-Hispanic whites, but the rate for Hispanics (15.1) was more than 5 times higher than the rate for non-Hispanic whites.
Relatively few cases were diagnosed among Asian/Pacific Islander and American Indian/Alaska Native females, although the rates for both groups were higher than the rate for non-Hispanic white females.
The following 33 states have had laws or regulations requiring confidential name-based HIV infection reporting since at least 2003: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
The data have been adjusted for reporting delays.