According to data collected from 2001 to 2004, black adults and adolescents accounted for 51% of new HIV infections in the United States.  These startling statistics, which come from 33 states that have used name-based reporting of HIV and AIDS cases since 2001, were published by the U.S. Centers for Disease Control (CDC) in the March 9 issue of its Morbidity and Mortality Weekly Report (MMWR).

Of the estimated 184,991 adult and adolescent HIV infections diagnosed between 2001 and 2005, more occurred among blacks (51%) than among all other racial/ethnic populations combined. Most (62%) new HIV/AIDS diagnoses were among persons between the ages of 25 and 44; in this age group, blacks accounted for 48% of new HIV/AIDS diagnoses.

A take-home message of the CDC report is that new interventions and mobilization of the broader community are needed to reduce the disproportionate impact of HIV/AIDS on blacks in the United States.

In the report, cases of HIV or AIDS were analyzed together as HIV/AIDS (i.e., HIV infection with or without AIDS) and counted by year of diagnosis. Cases were classified according to the usual transmission categories, including male-to-male sexual contact (i.e., among men who have sex with men [MSM]); injection-drug use (IDU), MSM with IDU; high-risk heterosexual contact (i.e., with a person of the opposite sex known to be HIV infected or at high risk for HIV/AIDS [e.g., MSM or injection-drug user]); and “other” (e.g., hemophilia or blood transfusion), along with all risk factors not reported or not identified.

The estimated number of HIV/AIDS diagnoses for each racial/ethnic population by transmission category was calculated. For 2005, estimated diagnosis rates per 100,000 population were calculated for each racial/ethnic population, and rate ratios (RRs) comparing other populations with whites were determined.

In addition, estimated HIV and AIDS prevalence rates for blacks living with HIV or AIDS at the end of 2005 were calculated. Prevalence estimates were derived from reported cases and adjusted for delays in reporting and deaths.  Estimated HIV and AIDS prevalence rates per 100,000 population were calculated for each state and the District of Columbia (DC).

Although adult and adolescent blacks accounted for 13% of the population in the 33 states from 2001 to 2005, they accounted for 50.5% of the 184,991 new HIV/AIDS diagnoses; whites accounted for 72% of the population, but accounted for 29.3% of diagnoses. Hispanics accounted for 13% of the population and 18.2% of diagnoses.

Among racial/ethnic populations, blacks accounted for the largest percentages of cases diagnosed in both males (43.9%) and females (67.2%).

Blacks also had the largest percentage of HIV/AIDS diagnoses in all age groups and in the IDU and high-risk heterosexual transmission categories. Among men and women with IDU and persons with high-risk heterosexual contact, more than half were black (men: 53.8% and 65.7%, respectively; women: 58.8% and 69.5%, respectively). More MSM with HIV/AIDS diagnoses were white (42.7%), with smaller proportions of blacks (36.2%) and Hispanics (19.0%).

Between 2001 and 2005, adults aged 25 to 44 years accounted for a majority of HIV/AIDS diagnoses regardless of racial/ethnic population. Among persons aged 25 to 34 and 35 to 44 years, blacks accounted for the greatest proportion of cases (48.0% and 47.5%, respectively). By geographic region, blacks accounted for the majority of diagnoses in the South (54.3%) and Northeast (52.0%).

Black males accounted for more new HIV/AIDS diagnoses than males of any other racial/ethnic population in the South (47.5%) and Northeast (46.1%). Among females, blacks accounted for the majority of HIV/AIDS diagnoses in the South (71.5%), Northeast (64.4%), and Midwest (63.5%), compared with other racial/ethnic populations.

Among black males and females, the age distribution of persons who had HIV/AIDS diagnosed varied by transmission category.

By transmission category, most HIV/AIDS diagnoses of black male adults and adolescents were classified as MSM (51.7%), followed by high-risk heterosexual contact (25.2%), IDU (17.9%), MSM with IDU (4.6%), and other (0.6%).

Most HIV/AIDS diagnoses among black female adults and adolescents were classified as high-risk heterosexual contact (80.4%), followed by IDU (18.2%), and other (1.3%).

In 2005, the estimated annual HIV/AIDS diagnosis rate among black males was 127.6 per 100,000 population and among black females was 61.4 per 100,000, both higher than the rates for all other racial/ethnic populations.

Among males, the annual HIV/AIDS diagnosis black/white RR of 6.9 was higher than the Hispanic/white RR of 3.1. Among females, the black/white RR was 20.5, and the Hispanic/white RR was 5.4.

In 2005, overall estimated HIV (i.e., without AIDS) and AIDS prevalence rates were higher among blacks than among all other racial/ethnic populations.

Among blacks, the estimated HIV prevalence (in 33 states) was 515 per 100,000 population, ranging from 109 (Alaska) to 858 (New Jersey); the estimated AIDS prevalence (in the 50 states and DC) was 639 per 100,000 population and ranged from 79 (Wyoming) to 3,179 (DC).

Based on these statistics, the CDC stresses a central key message: that new interventions and mobilization of the broader community are needed to reduce the disproportionate impact of HIV/AIDS on blacks in the United States.

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