Subject: The 2nd 100,000 Cases of AIDS - USA
From: [email-masked] (ERIC OVERTON)
To: [email-masked]
Date: Mon, 24 Feb 1992 10:01:27 -0500 (EST)

The Second 100,000 Cases
         of Acquired Immunodeficiency Syndrome -- United States, June 
                              1981-December 1991
 
     The  first  cases  of  acquired  immunodeficiency  syndrome  (AIDS)  were 
reported in June 1981 (1).  From 1981 through December 1987, 50,000 AIDS cases 
had been reported to CDC,  and by August 1989, 100,000 cases had been reported 
(2).  From September 1989 through November 1991,  state and territorial health 
departments  reported  100,000  additional  cases.  By  December 31,  1991,  a 
cumulative total of 206,392 cases  had  been  reported  (Figure  1),  and  the 
cumulative  number  of reported deaths associated with AIDS was 133,232.  This 
report presents characteristics of the first and second 100,000  persons  with 
AIDS.  
     Overall,  most reported AIDS cases occurred among homosexual/bisexual men 
(i.e.,  men who reported sexual contact with other men) (59%)  and  injecting-
drug  users  (IDUs)  (22%).  Of  the  first  100,000 reported AIDS cases,  61% 
occurred among homosexual/bisexual men with no history of IDU, and 20%,  among 
female  or  heterosexual  male  IDUs.  In  comparison,  of  the second 100,000 
reported cases,  55% occurred among homosexual/bisexual men with no history of 
IDU, and 24% occurred among female or heterosexual male IDUs.  
     The second 100,000 cases reflect an increasing proportion of persons with 
AIDS  who  have  been reported to have had heterosexual exposure to persons at 
risk for human immunodeficiency virus (HIV) infection.  Of the  first  100,000 
persons with AIDS,  5% were attributed to heterosexual transmission,  compared 
with 7% among the second 100,000--a 44% increase.  Of  all  AIDS  cases  among 
women,  34% were attributed to heterosexual transmission,  and women accounted 
for 61% of all cases attributed to heterosexual  transmission.  Of  the  first 
100,000  persons  with  AIDS,  9% were women,  compared with 12% of the second 
100,000 persons.  The first 100,000 persons with AIDS included 1683  children, 
of whom 81% were born to mothers with or at risk for HIV infection; the second 
100,000  persons  with  AIDS included 1702 children,  of whom 87% were born to 
mothers with or at risk for HIV infection.  
     A disproportionate number of AIDS cases continue  to  be  reported  among 
blacks and Hispanics.  Of the first 100,000 reported cases, 27% occurred among 
blacks and 15% among Hispanics;  of the second 100,000 reported  cases,  these 
proportions increased to 31% and 17% for blacks and Hispanics, respectively.  
     The  proportion  of  AIDS  cases  related  to  transfusions  as a mode of 
exposure declined in both adults (2.5% to 1.9%) and  children  (11%  to  5.6%) 
from the first to the second 100,000 cases.  
 
Reported by:  Surveillance Br, Div of HIV/AIDS, National Center for Infectious 
Diseases, CDC.  
 
Editorial Note:The cumulative total of more than 200,000 reported  AIDS  cases 
emphasizes  the rapidly increasing magnitude of the HIV epidemic in the United 
States. The first 100,000 cases were reported during an 8-year period, whereas 
the second 100,000 cases were reported during a 2-year period.  
     The number and proportion of  AIDS  cases  associated  with  heterosexual 
transmission  of HIV has been increasing steadily.  Factors associated with an 
increased risk for heterosexual transmission include multiple sex partners and 
the presence of other sexually transmitted diseases. In the United States, men 
and women who have unprotected  sexual  contact,  particularly  with  partners 
known  to  have  risks  for  HIV  infection,  are  at  increased  risk for HIV 
infection.  A recent analysis of expected trends in AIDS cases in  the  United 
States  suggests  that  by  1995,   the  infection  rate  among  nondrug-using 
heterosexual men and women may be associated with a  doubling  of  AIDS  cases 
acquired through heterosexual transmission (3).  
     Of  the  estimated  1  million HIV-infected persons in the United States, 
approximately 20% have developed AIDS.  Approximately half of all persons  who 
have  been  diagnosed  with  HIV  infection  and  who  have evidence of severe 
immunosuppression (i.e.,  CD4+ counts less than 200 cells/uL) meet the current 
AIDS  surveillance  case definition (4).  Approximately 125,000 persons who do 
not have an AIDS-defining illness are estimated  to  have  a  CD4+  lymphocyte 
count  less  than  200  cells/uL  (CDC,  unpublished  data).  CDC has proposed 
expanding the AIDS surveillance case definition to  facilitate  more  complete 
reporting of all persons with severe HIV-related immunosuppression and who are 
at the highest risk for developing serious illnesses or death* (5).  

 
                              Notices to Readers
                 Special Reports on Awareness of AIDS and HIV
                    Among Racial and Ethnic Minority Groups
 
     CDC's National Center for  Health  Statistics  (NCHS)  has  released  two 
special  reports examining the awareness of acquired immunodeficiency syndrome 
(AIDS) and human immunodeficiency virus (HIV) among blacks  and  Hispanics  in 
the  United  States.  The reports,  based on data collected in 1990,  describe 
various aspects of AIDS-related knowledge and HIV-antibody testing experience. 
Differentials by age,  sex,  and educa tion are compared with those  from  the 
non-Hispanic white population.  
     Copies  of the reports,  AIDS Knowledge and Attitudes of Black Americans: 
United  States,  1990  (1)  and  AIDS  Knowledge  and  Attitudes  of  Hispanic 
Americans:  United  States,  1990  (2),  are available free of charge from the 
Scientific and Technical  Information  Branch,  NCHS,  CDC,  Room  1064,  6525 
Belcrest Road, Hyattsville, MD 20782; telephone (301) 436-8500.