Prevalence of HIV infection in the United States, 1984 to 1992.

OBJECTIVE To estimate the number of persons infected with the human immunodeficiency virus (HIV) living in the United States and the change in HIV infection prevalence since 1984. DESIGN We estimated HIV prevalence from 3 data sources. We estimated past HIV infection rates from a statistical procedure based on national acquired immunodeficiency syndrome (AIDS) case surveillance data and estimates of the time from HIV infection to AIDS diagnosis. We also analyzed HIV prevalence data from 2 national surveys, a survey of childbearing woman and a household survey of current health status. We used other data sources to adjust these survey estimates to include groups not covered in the surveys. RESULTS Approximately 0.3% of US residents (650,000-900,000 persons) were infected with HIV in 1992. Approximately 0.6% of men (including adolescent boys > or = 13 years of age) were infected, including approximately 2% of non-Hispanic black men and 1% of Hispanic men. Approximately 0.1% of women (including adolescent girls > or = 13 years of age) were infected, including approximately 0.6% of non-Hispanic black women. Approximately half of all infected persons were men who had sex with men, and one fourth were injecting drug users. The prevalence of HIV infection increased from 1984 to 1992, with a greater relative increase among women than men. CONCLUSIONS The 3 different data sources and methods are consistent in estimating that 650,000 to 900,000 persons were infected with HIV in the United States in 1992. Among adolescents and adults of both sexes, the proportion infected was substantially higher among non-Hispanic blacks and Hispanics than among non-Hispanic whites. HIV-related illness will be a major clinical and public health problem in the United States for years to come.

[1]  S. Chu,et al.  Pregnancy rates among women infected with human immunodeficiency virus , 1996, Obstetrics and gynecology.

[2]  H. Sheppard,et al.  HIV infection in homosexual and bisexual men 18 to 29 years of age: the San Francisco Young Men's Health Study. , 1994, American journal of public health.

[3]  Graham F. Medley,et al.  The treatment‐free incubation period of AIDS in a cohort of homosexual men , 1993, AIDS.

[4]  John W. Ward,et al.  1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. , 1993, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[5]  P. Rosenberg Backcalculation models of age-specific HIV incidence rates. , 1994, Statistics in medicine.

[6]  R Brookmeyer,et al.  Reconstruction and future trends of the AIDS epidemic in the United States. , 1991, Science.

[7]  M. Gwinn,et al.  Trends in HIV seroprevalence among persons attending sexually transmitted disease clinics in the United States, 1988-1992. , 1995, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[8]  S. Holmberg,et al.  The estimated prevalence and incidence of HIV in 96 large US metropolitan areas. , 1996, American journal of public health.

[9]  R. Coutinho,et al.  High mortality among HIV‐infected injecting drug users without AIDS diagnosis: implications for HIV infection epidemic modellers? , 1994, AIDS.

[10]  M Gwinn,et al.  Prevalence of HIV infection in childbearing women in the United States. Surveillance using newborn blood samples. , 1991, JAMA.

[11]  C. Reed,et al.  Spectrum of disease in persons with human immunodeficiency virus infection in the United States. , 1992, JAMA.

[12]  F. Wolak,et al.  A Procedure for Estimating the Unconditional Cumulative Incidence Curve and Its Variability for the Human Immunodeficiency Virus , 1994 .

[13]  M. Gwinn,et al.  Prevalence and incidence of vertically acquired HIV infection in the United States. , 1995, JAMA.

[14]  M H Gail,et al.  Backcalculation of flexible linear models of the human immunodeficiency virus infection curve. , 1991, Journal of the Royal Statistical Society. Series C, Applied statistics.

[15]  W. Blattner,et al.  HIV prevalence estimates and AIDS case projections for the United States: report based upon a workshop. , 1990, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[16]  L G Escobedo,et al.  Behavioral Risk Factor Surveillance, 1988. , 1990, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[17]  D. Vlahov,et al.  Update on the seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988-1994. , 1997, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[18]  M. Gwinn,et al.  Trends in human immunodeficiency virus seroprevalence among injection drug users entering drug treatment centers, United States, 1988-1993. , 1996, American journal of epidemiology.

[19]  Scope of the AIDS Epidemic in the United States , 1995, Science.

[20]  P. Rosenberg,et al.  Uncertainty in estimates of HIV prevalence derived by backcalculation. , 1990, Annals of Epidemiology.

[21]  Mitchell H. Gail,et al.  AIDS Epidemiology: A Quantitative Approach , 1994 .

[22]  R. Berkelman,et al.  Increasing frequency of heterosexually transmitted AIDS in southern Florida: artifact or reality? , 1993, American journal of public health.

[23]  J. Buehler,et al.  The completeness of AIDS case reporting, 1988: a multisite collaborative surveillance project. , 1992, American journal of public health.

[24]  P. Rosenberg,et al.  Mean square error of estimates of HIV prevalence and short-term AIDS projections derived by backcalculation. , 1991, Statistics in medicine.

[25]  D. Vlahov,et al.  Impact of HIV infection on non‐AIDS mortality among Italian injecting drug users , 1994, AIDS.