# Presentation: 658506

## Healthy People 2010 Focus Area 13: HIV Progress ReviewAugust 30, 2007

## HIV/AIDS
More than 1 million persons estimated to be living with HIV in 2003:
Of those, approximately one quarter did not know that they were infected    
Federal spending on HIV related medical care in 2005: $11.6 billion
Lifetime cost of care: $385,200* 

**HIV/AIDS**
- More than 1 million persons estimated to be living with HIV in 2003:
- Of those, approximately one quarter did not know that they were infected
- Federal spending on HIV related medical care in 2005: $11.6 billion
- Lifetime cost of care: $385,200*** **

- Note:  * From the time entering HIV care, projected life expectancy for a person with an initial CD4+ cell count less than 350 cells/μL is 24.2 years, and the lifetime cost of care for such a person’s treatment is $385,200 when rebates and other discounts on HIV medications are taken into consideration.
- Sources: Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003,  National HIV Prevention Conference, June 2005, Atlanta., Abstract 595; Schackman, BR, Gebo KA, Walensky, RP et. al., The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States. *Medical Care*, Volume 44, Number 11, November 2006.** **

## AIDS  
Estimated new cases diagnosed in 2005:   40,608  
Cumulative cases diagnosed (as of 12/2005): 952,629
Number of deaths in 2005: 16,316 
Cumulative deaths (as of 12/2005):  530,756

- Estimated new cases diagnosed in 2005:   40,608
- Cumulative cases diagnosed (as of 12/2005): 952,629
- Number of deaths in 2005: 16,316
- Cumulative deaths (as of 12/2005):  530,756

**HIV/AIDS in the United States**

- Source: HIV/AIDS Surveillance Report, CDC/NCHHSTP.

## Highlighted Objectives

_**HIV/AIDS Incidence & Deaths**_
**13-01.****	****New AIDS cases**
**13-02.****	****New AIDS cases among men who have sex with men**
**13-03.****	****New AIDS cases among persons who inject drugs**
**13-04.****	****New AIDS cases among men who have sex with men & inject drugs**
**13-05.    New HIV cases **** **
**13-14.****	****Deaths due to HIV infection**
**13-17b.****	****Perinatally-acquired AIDS****  **
_**HIV/AIDS Treatment**_
**13-13c.****	****Treatment according to guidelines – Any antiretroviral therapy**
**13-13d. ****	****Treatment according to guidelines – Highly active antiretroviral therapy**

**Highlighted Objectives**

- Improving

- Getting worse

- Little or no change *****

- Target met

- * Percent of targeted change achieved is between -10% and 10%.

- Developmental

## Estimated AIDS Incidence,  

- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

**Estimated AIDS Incidence,  **
**Prevalence, and Deaths**

**Year of diagnosis or death**

**0**

**50**

**100**

**150**

**200**

**250**

**300**

**350**

**400**

**450**

- 1985

- 1987

- 1989

- 1991

- 1993

- 1995

- 1997

- 1999

- 2001

- 2003

- 2005

**Number of new cases/deaths**
**In thousands**

**P**

**r**

**e**

**v**

**a**

**l**

**e**

**n**

**c**

**e**

** **

**(**

**i**

**n**

** **

**t**

**h**

**o**

**u**

**s**

**a**

**n**

**d**

**s**

**)**

**0**

**10**

**20**

**30**

**40**

**50**

**60**

**70**

**80**

**90**

**Incidence**

**Prevalence**

**Deaths**

## Estimated Prevalence of Persons

- Note. Rates are shown for the five areas with the highest and lowest rates.  Data have been adjusted for reporting delays.
- *Includes persons whose area of residence is unknown or missing.
- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

**Estimated Prevalence of Persons**
** ****Living with AIDS, 2005**** **

- <100

- 100 - 150

- 150

- >

- Total rate=174.5*

- Rate per
- 100,000 population

**23.2**

**12.6**

**24.2**

**20.2**

**19.0**

## Reported AIDS Cases by Region and

**Rate per 100,000 population **

**MSA of >500,000**

**Northeast**
**Midwest**
**South**
**West**

**Reported AIDS Cases by Region and**
** ****Metropolitan Size , 2005**

**MSA of 50,000 - 500,000**

**Non-metropolitan areas**

- Note: MSA = Metropolitan statistical area.
- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

## New AIDS Cases

- Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may
- be any race.
- Source: HIV Surveillance System, CDC/NCHHSTP.

**White**

**Black**

**Hispanic**

**Asian**

**Total**

**New AIDS Cases**

**Obj. 13-1**

**American Indian**

**   ****Decrease Desired**

**2010 Target: 1.0**

**0**

**20**

**40**

**60**

**80**

**100**

**1998**

**1999**

**2000**

**2001**

**2002**

**2003**

**2004**

**2005**

## Distribution of New AIDS Cases

**Distribution of New AIDS Cases**

- Note: Data are for persons 13 years and over.** **Less than 1% of new AIDS cases were reported in Asian/Pacific Islanders and
-  American Indian/Alaska Natives during this time period. The categories black and white exclude persons of Hispanic origin.
- Persons of Hispanic origin may be any race.** ** Data have been adjusted for reporting delays.
- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

**Black**

**Hispanic**

**White**

**1987**

**1985**

**1989**

**1991**

**1993**

**1995**

**1997**

**1999**

**2003**

**2005**

**2001**

**Year of diagnosis**

**0**

**10**

**20**

**30**

**40**

**50**

**60**

**70**

## New AIDS Cases by 

**Number of Cases per 100,000 population**

**Total  **

**Asian  **

**White**

**American Indian**

**Hispanic **

**Black**

**Total**

**Asian  **

**White**

**American Indian**

**Hispanic **

**Black**

**New AIDS Cases by **
**Gender and Race/Ethnicity, 2005**

- Note: Data are for persons 13 years and over. ** **American Indian includes Alaska Native. Black and white exclude
- persons of Hispanic origin. Persons of Hispanic origin may be any race.
- Source: HIV/AIDS Reporting System, CDC / NCHHSTP.

_**Females**_

_**Males**_

**   ****Decrease Desired**

**2010 Target: 1**

**Obj. 13-1**

**0**

**30**

**40**

**50**

**10**

**20**

**60**

**90**

**100**

**70**

**80**

## New AIDS Cases by 

**New AIDS Cases by **
**Transmission Category **

- Note: * Includes hemophelia, blood transfusion, perinatal exposure, and risk factors not reported or identified. Data are for
- persons aged 13 years and over.  Data have been adjusted for reporting delays and cases without risk factor information
- were proportionally redistributed.
- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

**Females**

**Males**

**Men who have sex with men (MSM)**

**MSM & IDU**

**Injection drug use (IDU)**

**Heterosexual contact**

**Other/Unknown***

**70%**

**10%**

**4%**

**16%**

**<1%**

**41%**

**1985**

**2005**

**1985**

**2005**

**7%**

**1%**

**58%**

**27%**

**55%**

**18%**

**27%**

**70%**

**2%**

**18%**

**16%**

**Obj. 13-2, 13-3, 13-4**

## Perinatally Acquired AIDS

**Perinatally Acquired AIDS**

- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

**Obj. 13-17b**

**   ****Decrease Desired**

**2010 Target: 1.0**

- Number of new cases

**0**

**20**

**40**

**60**

**80**

**100**

**120**

**2002**

**2003**

**2004**

**2005**

##  Deaths due to HIV/AIDS, 2004

**Female**

**Hispanic**

** ****Deaths due to HIV/AIDS, 2004**

- Note: I = 95% Confidence interval.** **HIV deaths are defined by ICD-10 codes B20 - B24.** **Data are age-adjusted to the 2000 standard population. American
- Indian includes Alaska Native. Persons of Hispanic origin may be any race. Education estimates are based on persons aged 25-64 years.
- Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Total**

**White**

**American Indian**

**Asian**

**Black**

**Male**

**High School**

**At least some college**

**Less than High School**

**Obj. 13-14**

**   ****Decrease Desired**

**2010 Target: 0.7**

**Age-adjusted death rate per 100,000 standard population**

## Deaths due to HIV/AIDS by 

**Health Service Area, 2000-2004**

- Note: HIV deaths are defined by ICD-10 codes B20 - B24. Data are age-adjusted to the 2000 standard population.
- The 5 legend categories represent the following percentage of Health Service Areas (from lowest to highest): 10%, 20%, 40%, 20%, 10%.
- Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

**Obj. 13-14**

- 0.0

- < 1.0

- 1.0 - 2.9

- 3.0 - 5.9

- 6.0 - 20.5

**Age adjusted rate per 100,000 population**

**2010 Target: 0.7**

## New HIV/AIDS Cases

- Note:  Data are for persons 13 years and over.  A 2010 target has not been set.  Data are from 33 states with confidential
- name-based HIV infection surveillance since at least 2001. Data have been adjusted for reporting delays.
- Source: HIV/AIDS Reporting System, CDC/ NCHHSTP.

**Number of cases**

**2001**

**2002**

**2005**

**2004**

**Year of diagnosis**

**2003**

**Obj. 13-5**

## Distribution of 

**Male to male sexual contact and Injection drug use**

**Injection Drug Use**

**Heterosexual contact ***

**Distribution of **
**HIV/AIDS by Transmission Category **

**Year of diagnosis**

**Percent of cases**

**2001**

**2002**

**2003**

**2004**

**2005**

- Note. Data are for persons 13 years and over.**  **Data are from 33 states with confidential name-based HIV infection reporting since at least 2001.
- Data have been adjusted for reporting delays and cases without risk factor information were proportionally redistributed.
- * Heterosexual contact with a person known to have or to be at high risk for HIV infection.
- Source: HIV/AIDS Reporting System, CDC/NCHHSTP.

**Obj. 13-2, 13-3, 13-4**

**0**

**10**

**20**

**30**

**40**

**50**

**60**

**Notes:**
(Describe slide)

## Persons at Risk for HIV/AIDS, 2002

**Percent **

**Sex-related**

**Sex or **
**drug-related**

**Drug-related**

**Sex or drug- related or STD**

**Persons at Risk for HIV/AIDS, 2002**

**Female**

**Male**

- Note: I = 95% Confidence interval.  Data are for persons 15 to 44 years of age. Black and white exclude persons of Hispanic origin.
- Persons of Hispanic origin may be any race.
- Source: National Survey for Family Growth, Advance Data No. 377, CDC/NCHS.

**Type of Risk**

## HIV Testing, 2002

**HIV Testing, 2002**

- Note: I = 95% Confidence interval.  Data are for persons 15 to 44 years of age who had an HIV test, excluding tests done as part of blood donation.
- Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race.
- *This includes persons indicating that they had five or more sex partners in the last year, exchange of sex for money or drugs, had sex with an injecting drug user, had male-to-male sex, or injected drugs themselves.
- Source: National Survey for Family Growth, Advance Data No. 363, CDC/NCHS.

**Persons Tested in Past 12 Months**

**Total**

**Male**

**Female**

**Hispanic**

**White**

**Black**

**PersonsEver  Tested**

**High Risk* Persons Tested in Past 12 Months**

**0**

**10**

**20**

**30**

**40**

**50**

**60**

**70**

## Highly Active Antiretroviral Treatment, 2003

**Highly Active Antiretroviral Treatment, 2003**

- NOTE: Data are for HIV infected persons 13 years and over.  Data are from over 100 clinical sites in 11 U.S. cities. American Indian includes Alaska Native.
- Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race.  Persons were asked to select only one race category;
- selection of more than one race was not an option.
- Source: Adult and Adolescent Spectrum of HIV Disease (ASD) Surveillance Project, CDC / NCHHSTP.

**Percent **

**Obj. 13-13 d**

**Female**

**Male**

**Asian**

**Black**

**   ****Increase Desired**

**2010 Target: 95**

**Total**

**American Indian**

**White**

**Hispanic**

## Status of HIV/AIDS Objectives

- 13-1. New AIDS cases
- 13-2. AIDS among men who have sex with men
- 13-3 AIDS among persons who inject drugs
- 13-4. AIDS among men who have sex with men
-          and who inject drugs
- 13-5. New HIV cases
- 13-6a. Condom use by partner – Females
- 13-6b. Condom use – Males
- 13-7. Knowledge of serostatus
- 13-8. HIV/AIDS counseling and education for
-          persons in substance abuse treatment
- 13-9. HIV/AIDS, STD, and TB education in State
-           prisons
- 13-10. HIV counseling and testing in State Prisons
- 13-11. HIV testing in TB patients
- 13-12. Screening for STDs and immunization for
-             hepatitis B

- 13-13. Treatment according to guidelines
- 	a. Viral load testing
- 	b. Tuberculin skin testing
- 	c. Any antiretroviral therapy
- 	d. Highly active antiretroviral 		    therapy
- 	e. Pneumocystis carinii pneumonia 	    prophylaxis
- 	f. Mycobacterium avium complex 	   	   prophylaxis
- 13-14. HIV infection deaths
- 13-15. Interval between HIV infection and
-            AIDS diagnosis
- 13-16. Interval between AIDS diagnosis and
-            death from AIDS
- 13-17a. Perinatally acquired HIV/AIDS
-               diagnosed
- 13-17b. Perinatally acquired AIDS
- 13-18. HIV diagnosed in adolescent and young
-             females

- Deleted at the Midcourse

**Status of HIV/AIDS Objectives**

- Improving

- Getting worse

- Little or no change*

- Baseline only

- Target met

- ^

- ^

- ^

- ^

- ^

- * Percent of targeted change achieved is between -10% and 10%.

## Over two thirds (10/14) of the measurable objectives and subojectives are moving toward or have met their HP2010 targets.
AIDS among persons who inject drugs and perinatally acquired AIDS have met their targets.
AIDS incidence and death have leveled off since 1998.
Disparities by race/ethinicity, age, gender, education and geographic location persist  

- AIDS among persons who inject drugs and perinatally acquired AIDS have met their targets.
- AIDS incidence and death have leveled off since 1998.
- Disparities by race/ethinicity, age, gender, education and geographic location persist

**Summary**

## Progress review data and slides

**Progress review data and slides**
**are available on the web at:**

**http://www.cdc.gov/nchs/hphome.htm**