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AIDS and Intravenous Drug Use - Prevalence

hiv reported race hispanic

Gender and Age Group

In 2003, 43,112 adults (including adolescents) were diagnosed with AIDS. (See Table 9.3.) Of this total, 9,449 got AIDS directly by injecting drug use (21.9%). In that same year, fifty-nine children under thirteen (so-called pediatric cases) were also diagnosed, substantially less than in 1992; all but one of them got the disease perinatally from infected mothers. (See Table 9.5 and Figure 9.1.) Among adult males, 6,353 diagnosed cases came as a result of injected drug use, second only to male-to-male sex among transmission categories. Another 1,877 men both had sex with another man and injected drugs. Among adult women, injected drug use was the most frequent transmission category, causing 3,096 of diagnosed cases. All told, in 2003, of a total of 43,171 new AIDS cases (adults and children combined), 11,326 cases (26.2%) had some linkage to injected drug use.

TABLE 9.3
Estimated number of AIDS cases, by year of diagnosis and selected characteristics, 1999–2003
SOURCE: "Table 3. Estimated Numbers of AIDS Cases, by Year of Diagnosis and Selected Characteristics of Persons, 1999-2003—United States," in HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States, 2003, Department of Health and Human Services, Centers for Disease Control and Prevention, December 2004, http://www.cdc.gov/hiv/stats/2003SurveillanceReport.pdf (accessed March 31, 2005)

Year of diagnosis
1999 2000 2001 2002 2003 Cumulative through 2003a
Age at diagnosis (years)
< 13 187 117 119 105 59 9,419
13-14 57 56 76 68 59 891
15-24 1,541 1,642 1,625 1,810 1,991 37,599
25-34 11,349 10,385 9,947 9,504 9,605 311,137
35-44 17,165 17,295 16,890 17,008 17,633 365,432
45-54 8,099 8,566 8,929 9,310 10,051 148,347
55-64 2,218 2,422 2,468 2,724 2,888 43,451
≥ 65 739 783 779 759 886 13,711
Race/ethnicity
White, not Hispanic 12,626 12,047 11,620 11,960 12,222 376,834
Black, not Hispanic 19,960 20,312 20,291 20,476 21,304 368,169
Hispanic 8,141 8,233 8,204 8,021 8,757 172,993
Asian/Pacific Islander 369 373 409 452 497 7,166
American Indian/Alaska Native 162 186 179 196 196 3,026
Transmission category
    Male adult or adolescent
    Male-to-male sexual contact 16,556 16,272 16,383 16,971 17,969 440,887
Injection drug use 7,710 7,425 6,772 6,406 6,353 175,988
    Male-to-male sexual contact and injection drug use 2,323 2,071 2,026 1,942 1,877 62,418
    Heterosexual contact 4,243 4,299 4,578 4,890 5,133 56,403
Otherb 328 319 315 308 281 14,191
Subtotal 31,159 30,387 30,074 30,517 31,614 749,887
    Female adult or adolescent
Injection drug use 3,448 3,498 3,269 3,024 3,096 70,558
    Heterosexual contact 6,350 7,011 7,119 7,380 8,127 93,586
Otherb 212 254 251 261 276 6,535
Subtotal 10,010 10,763 10,639 10,666 11,498 170,679
    Child ( < 13 yrs at diagnosis)
Perinatal 185 115 116 103 58 8,749
Otherc 3 2 3 3 1 670
Subtotal 187 117 119 105 59 9,419
Region of residence
Northeast 11,885 12,516 11,350 10,551 11,461 285,040
Midwest 4,069 4,139 4,094 4,337 4,498 91,926
South 17,224 16,757 17,693 18,482 19,609 337,409
West 6,892 6,661 6,468 6,843 6,667 186,100
U.S. dependencies, possessions, and associated nations 1,286 1,194 1,228 1,075 935 29,511
    Totald 41,356 41,267 40,833 41,289 43,171 929,985
Note: These numbers do not represent reported case counts. Rather, these numbers are point estimates, which result from adjustments of reported case counts. The reported case counts are adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor. The estimates do not include adjustment for incomplete reporting.
aIncludes persons with a diagnosis of AIDS from the beginning of the epidemic through 2003.
bIncludes hemophilia, blood transfusion, perinatal, and risk factor not reported or not identified.
cIncludes hemophilia, blood transfusion, and risk factor not reported or not identified.
dIncludes persons of unknown race or multiple races and persons of unknown sex. Cumulative total includes 1796 persons of unknown race or multiple races and 1 person of unknown sex. Because column totals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column total.

Throughout the entire history of the AIDS epidemic through 2003, of a total of 929,985 infections on record, 317,713 were drug-related infections, or 34.2%, according to the CDC's HIV/AIDS Surveillance Report.

Race/Ethnicity

MALES.

In 2003 Hispanic males and African-American males with AIDS were twice as likely to have been infected by injecting drug use (18% of cases among each of those groups) than white males (9%). (See Table 9.6.) In this and subsequent tabulations, whites and African-Americans exclude Hispanics, who may be of any race. Men having sex with men and also injecting drugs were proportionally most numerous among American Indians/Alaska Natives and whites.

FEMALES.

As noted above, a larger percentage of AIDS cases among women result from injecting drugs than is the case among men. In 2003 American

TABLE 9.4
AIDS cases, by race, age, and sex, 2003
SOURCE: "Table 5. Estimated Numbers of Cases and Rates (per 100,000 population) of AIDS, by Race/Ethnicity, Age Category, and Sex, 2003—50 States and the District of Columbia," in HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States, 2003, Department of Health and Human Services, Centers for Disease Control and Prevention, 2003, http://www.cdc.gov/hiv/stats/2003SurveillanceReport.htm (accessed March 31, 2005)

Adults or adolescents
Males Females Total Children ( < 13 yrs) Total
Race/ethnicity No. Rate No. Rate No. Rate No. Rate No. Rate
White, not Hispanic 10,450 12.8 1,725 2.0 12,175 7.2 9 0.0 12,184 6.1
Black, not Hispanic 13,624 103.8 7,551 50.2 21,174 75.2 40 0.5 21,214 58.2
Hispanic 6,087 40.3 1,744 12.4 7,831 26.8 7 0.1 7,839 20.0
Asian/Pacific Islander 408 8.3 86 1.6 494 4.8 0 0 494 4.0
American Indian/Alaska Native 150 16.2 46 4.8 196 10.4 0 0 196 8.1
    Total* 30,851 26.6 11,211 9.2 42,062 17.7 58 0.1 42,120 14.5
Note: These numbers do not represent reported case counts. Rather, these numbers are point estimates, which result from adjustments of reported case counts. The reported case counts are adjusted for reporting delays. The estimates do not include adjustment for incomplete reporting.
Data exclude cases from the U.S. dependencies, possessions, and associated nations, as well as cases in persons whose state or area of residence is unknown, because of the lack of census information by race and age categories for these areas. Rate is per 100,000 population.
*Includes persons of unknown race or multiple races. Total includes 193 persons of unknown race or multiple races. Because column totals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column total.

TABLE 9.5
Estimated number of pediatric AIDS cases, by race/ethnicity, year of diagnosis, and transmission category, 1999-2003
SOURCE: "Table 4. Estimated Numbers of AIDS Cases in Children < 13 Years of Age, by Year of Diagnosis and Transmission Category, 1999-2003—United States," in HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States, 2003, Department of Health and Human Services, Centers for Disease Control and Prevention, December 2004, http://www.cdc.gov/hiv/stats/2003SurveillanceReport.pdf (accessed March 31, 2005)

Year of diagnosis
1999 2000 2001 2002 2003 Cumulative through 2003a
Race/ethnicity
White, not Hispanic 18 12 15 13 9 1,620
Black, not Hispanic 133 86 78 68 40 5,562
Hispanic 34 17 24 22 7 2,128
Asian/Pacific Islander 1 2 2 1 0 56
American Indian/Alaska Native 0 0 0 0 0 30
Transmission category
Hemophilia/coagulation disorder 0 0 0 0 0 234
Mother with, or at risk for, HIV infection 185 115 116 103 58 8,749
Injection drug use 44 21 13 8 7 3,326
    Sex with injection drug user 26 13 8 4 6 1,541
    Sex with bisexual male 6 2 4 3 0 203
    Sex with person with hemophilia 2 0 1 0 0 37
    Sex with HIV-infected transfusion recipient 0 0 0 0 0 28
    Sex with HIV-infected person, risk factor not specified 49 36 35 37 17 1,490
    Receipt of blood transfusion, blood components, or tissue 1 2 2 2 0 156
    Has HIV infection, risk factor not specified 57 41 53 48 28 1,968
Receipt of blood transfusion, blood components, or tissue 0 1 0 1 0 391
Other/risk factor not reported or identified 3 1 3 2 1 45
    Totalb 187 117 119 105 59 9,419
Note: These numbers do not represent reported case counts. Rather, these numbers are point estimates, which result from adjustments of reported case counts. The reported case counts are adjusted for reporting delays and for redistribution of cases in persons initially reported without an identified risk factor. The estimates do not include adjustment for incomplete reporting.
aIncludes children with a diagnosis of AIDS, from the beginning of the epidemic through 2003.
bIncludes children of unknown race or multiple races. Cumulative total includes 24 children of unknown race or multiple races. Because column totals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column total.

Indian/Alaska Native women had the highest infection rate due to injecting drugs (39% of the racial category) followed by whites (29%). (See Table 9.7.) In the case of infection caused by sex with a drug-injecting male, white women were highest at 12%.

PEDIATRIC CASES.

Among the ninety cases (in the twenty-five states with confidential, name-based reporting) of HIV/AIDS in infants born to infected mothers in 2003, seven involved a mother who injected drugs, and another six involved mothers who had sex FIGURE 9.1
Estimated number of pediatric AIDS cases, 1992-2003
SOURCE: "Figure 1. Estimated Numbers of AIDS Cases in Children < 13 Years of Age, by Year of Diagnosis, 1992-2003—United States," in HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States, 2003, Department of Health and Human Services, Centers for Disease Control and Prevention, December 2004, http://www.cdc.gov/hiv/stats/2003SurveillanceReport.pdf (accessed March 31, 2005)
with injected drug users. In thirty-eight cases, the mother had sex with a person infected by HIV from an unknown source. Sixty-two of the ninety infants in reported cases were non-Hispanic African-Americans, while fifteen were white and eight were Hispanic. (See Table 9.8.)

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