Date: Wed, 20 Sep 1995 20:45:19 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 CDC HIV/AIDS Surveillance Report, Vol. 7, No. 1. Mid-Year Edition U.S. HIV and AIDS cases reported through June 1995 Report Description The U.S. HIV and AIDS case data presented below are extracted from the "HIV/AIDS Surveillance Report," published each quarter by the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30333. In addition to the data presented here, the printed copy of the report contains maps and figures. Single copies of the printed report are available from: CDC National AIDS Clearinghouse P.O. Box 6003 Rockville, MD 20849-6003 (800) 458-5231 or (301) 217-0023 (800) 243-7012 (TTY/TDD) Suggested citation: Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 1995;7(no.1). About this report Through June 1995, nearly half a million (476,899) persons have been reported with AIDS. The expanded AIDS surveillance case definition (implemented on January 1, 1993) continues to influence the pattern of AIDS diagnosis and reporting. In the first half of 1995, 37,142 AIDS cases were reported. Although this number exceeds the 23,896 cases reported in the first half of 1992, before the case definition was expanded, it is less than the 61,887 and 40,457 cases reported in the first halves of 1993 and 1994, respectively. Trends in reporting of AIDS cases are expected to continue to stabilize gradually over the next several reporting periods as the surge in cases caused by the expanded definition continues to wane. Analysis of the absolute numbers of cases reported each year, as presented in this report, continues to provide valuable information on the magnitude of the epidemic in affected communities. The data provide an important profile of young (13 to 24 years) men and women with HIV infection and AIDS, and demonstrate the need for prevention strategies appropriate for these age groups (see Tables 7 and 20). They also profile the characteristics of children with HIV and AIDS, in whom nearly all recent HIV infections occurred perinatally, and emphasize that, to prevent HIV in children, prevention programs need to assist women in reducing their risk of acquiring HIV infection by reducing high risk drug-injection or sexual activities (see Tables 6 and 19). These data will assist states in monitoring the impact of current recommendations to reduce HIV transmission to children through counseling, voluntary testing, and prenatal care services for women. The expansion of the case definition artifactually distorted the AIDS epidemic curve. Fluctuation in the number of reported cases in recent years has complicated the interpretation of trends in the absolute number of reported cases. However, comparing proportions and relative rates over time permits trends to be monitored. For example, in the two most recent 12-month periods, about 10 percent of persons with AIDS were residents of small metropolitan areas (50,000 to 500,000 population), and about 6 percent were residents of non-metropolitan areas (see Table 2). These percentages are consistent with those reported for 1992 (10 percent and 6 percent, respectively), before the case definition was expanded. They not only reflect the emergence of AIDS outside large metropolitan areas (500,000 or more population), but also illustrate that the epidemic remains disproportionately concentrated in large metropolitan areas, where AIDS incidence rates are consistently 2 to 3 times higher than in small metropolitan areas, and about 5 times higher than in non- metropolitan areas. To monitor trends in the incidence of AIDS-defining opportunistic illnesses (AIDS-OIs), CDC is using analytic methods that adjust for the case definition expansion by using comparable definitions over time. The estimated number of persons with AIDS- OIs diagnosed in 1994 (64,300) increased approximately 6 percent over the estimated number in 1993 (see Table 13). In addition, previously reported trends continued: the South and the Northeast accounted for the majority of the estimated number of persons with AIDS-OIs, and blacks and Hispanics accounted for a growing proportion of persons with AIDS-OIs (see Table 14). Although men who have sex with men accounted for the largest proportion of AIDS- OIs, the rate of growth has slowed; persons infected through injecting drug-use and their heterosexual partners accounted for an increasing proportion of persons with AIDS-OIs (see Table 15). AIDS surveillance data can detect recent shifts in the epidemic: because AIDS develops in a substantial number of HIV- infected persons within a year or two of infection, their characteristics are soon reflected in the surveillance data. For example, emerging trends among women, black and Hispanic minorities, persons in moderate- and small-sized metropolitan statistical areas and in the rural South, persons infected through heterosexual contact, minority homosexual/bisexual men, and young men who have sex with men have all been detected through AIDS surveillance. In addition, timely data from 25 states on characteristics of adults/adolescents with HIV infection (not AIDS) have documented the impact of the epidemic among sexually active and drug-using adolescents at early stages of HIV disease and have highlighted the need for appropriate prevention interventions in these populations (see Table 20). National population-based HIV/AIDS surveillance data can be used to guide allocation of resources for HIV/AIDS prevention and control. State and local health departments provide surveillance information to assist prevention planning in local communities. Together with data from seroprevalence surveys, behavioral surveys, and vital statistics, HIV/AIDS surveillance data can assist communities in developing HIV needs assessments, health care planning, and community profiles for implementing and evaluating prevention interventions. Suggested Reading CDC. AIDS among racial/ethnic minorities - United States, 1993. MMWR 1994;43:644-47,653-55. CDC. Update: trends in AIDS diagnosis and reporting under the expanded surveillance definition for adolescents and adults - United States, 1993. MMWR 1994;43:826-31. CDC. Update: acquired immunodeficiency syndrome - United States, 1994. MMWR 1995;44:64-67. CDC. Update: AIDS among women - United States, 1994. MMWR 1995;44:81-84. Erratum: MMWR 1995;44:135. CDC. Update: trends in AIDS among men who have sex with men - United States, 1989-1994. MMWR 1995;44:401-04. Date: Wed, 20 Sep 1995 21:12:51 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 2 Table 1. AIDS cases and annual rates per 100,000 population, by state, reported July 1993 through June 1994, July 1994 through June 1995;1 and cumulative totals, by state and age group, through June 1995, United States July 1993 - July 1994 - June 1994 June 1995 State of residence No. Rate No. Rate Alabama 556 13.3 566 13.4 Alaska 74 12.4 79 13.0 Arizona 645 16.4 559 13.7 Arkansas 289 11.9 288 11.7 California 14,388 46.1 10,989 35.0 Colorado 880 24.7 718 19.6 Connecticut 1,303 39.8 1,066 32.5 Delaware 263 37.7 313 44.3 District of Columbia 1,575 272.0 1,220 214.0 Florida 7,750 56.5 9,377 67.2 Georgia 2,240 32.5 2,284 32.4 Hawaii 318 27.3 263 22.3 Idaho 55 5.0 57 5.0 Illinois 2,748 23.5 2,785 23.7 Indiana 723 12.7 524 9.1 Iowa 99 3.5 145 5.1 Kansas 266 10.5 284 11.1 Kentucky 300 7.9 311 8.1 Louisiana 1,226 28.6 1,124 26.0 Maine 137 11.1 139 11.2 Maryland 2,235 45.1 2,951 58.9 Massachusetts 2,024 33.6 1,396 23.1 Michigan 1,080 11.4 1,071 11.3 Minnesota 392 8.7 413 9.0 Mississippi 411 15.6 414 15.5 Missouri 815 15.6 696 13.2 Montana 30 3.6 24 2.8 Nebraska 106 6.6 111 6.8 Nevada 444 32.1 413 28.3 New Hampshire 90 8.0 116 10.2 New Jersey 5,220 66.4 4,764 60.3 New Mexico 163 10.1 228 13.8 New York 15,122 83.3 12,578 69.2 North Carolina 1,295 18.6 1,015 14.4 North Dakota 27 4.2 7 1.1 Ohio 1,359 12.3 1,188 10.7 Oklahoma 346 10.7 266 8.2 Oregon 577 19.0 506 16.4 Pennsylvania 2,815 23.4 2,678 22.2 Rhode Island 277 27.7 291 29.2 South Carolina 1,170 32.2 995 27.2 South Dakota 17 2.4 20 2.8 Tennessee 851 16.7 883 17.1 Texas 5,841 32.4 5,153 28.0 Utah 136 7.3 153 8.0 Vermont 81 14.1 32 5.5 Virginia 1,369 21.1 1,150 17.6 Washington 1,182 22.5 933 17.5 West Virginia 78 4.3 114 6.3 Wisconsin 401 7.9 366 7.2 Wyoming 20 4.3 13 2.7 Subtotal 81,809 31.7 74,029 28.4 Guam 1 0.7 - - Pacific Islands, U.S. - - - - Puerto Rico 2,616 72.5 2,582 71.0 Virgin Islands, U.S. 38 36.8 62 59.7 Total2 84,577 32.3 76,802 29.1 Cumulative totals Adults/ Children State of residence adolescents <13 years old Total Alabama 3,266 52 3,318 Alaska 301 4 305 Arizona 4,047 19 4,066 Arkansas 1,725 25 1,750 California 82,937 460 83,397 Colorado 4,914 26 4,940 Connecticut 6,321 140 6,461 Delaware 1,338 11 1,349 District of Columbia 7,593 115 7,708 Florida 47,076 1,062 48,138 Georgia 13,203 140 13,343 Hawaii 1,667 13 1,680 Idaho 303 2 305 Illinois 15,306 171 15,477 Indiana 3,538 28 3,566 Iowa 794 8 802 Kansas 1,508 9 1,517 Kentucky 1,671 13 1,684 Louisiana 6,995 92 7,087 Maine 644 6 650 Maryland 11,613 224 11,837 Massachusetts 9,874 163 10,037 Michigan 6,728 75 6,803 Minnesota 2,529 17 2,546 Mississippi 2,156 37 2,193 Missouri 5,934 41 5,975 Montana 176 2 178 Nebraska 639 7 646 Nevada 2,368 20 2,388 New Hampshire 560 7 567 New Jersey 26,562 600 27,162 New Mexico 1,175 4 1,179 New York 86,318 1,704 88,022 North Carolina 5,828 81 5,909 North Dakota 64 - 64 Ohio 7,044 82 7,126 Oklahoma 2,301 17 2,318 Oregon 3,151 13 3,164 Pennsylvania 13,822 207 14,029 Rhode Island 1,324 15 1,339 South Carolina 4,817 58 4,875 South Dakota 91 4 95 Tennessee 4,222 37 4,259 Texas 32,732 270 33,002 Utah 1,074 20 1,094 Vermont 243 3 246 Virginia 6,829 125 6,954 Washington 6,394 22 6,416 West Virginia 536 6 542 Wisconsin 2,323 23 2,346 Wyoming 121 - 121 Subtotal 454,695 6,280 460,975 Guam 14 - 14 Pacific Islands, U.S 2 - 2 Puerto Rico 14,937 320 15,257 Virgin Islands, U.S. 234 9 243 Total2 470,288 6,611 476,899 1See Technical Notes for a discussion of the impact of the 1993 AIDS surveillance case definition for adults and adolescents (implemented January 1, 1993) on the number of cases reported in the two most recent 12-month reporting periods. 2Totals include 408 persons whose state of residence is unknown. Date: Wed, 20 Sep 1995 21:42:59 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 3 Table 2. AIDS cases and annual rates per 100,000 population, by metropolitan area with 500,000 or more population, reported July 1993 through June 1994, July 1994 through June 19951 and cumulative totals, by area and age group, through June 1995, United States. July 1993 - July 1994 - June 1994 June 1995 Metropolitan area of residence No. Rate No. Rate Akron, Ohio 62 9.2 47 6.9 Albany-Schenectady, N.Y. 146 16.7 169 19.3 Albuquerque, N.Mex. 79 12.5 108 16.7 Allentown, Pa. 98 16.1 94 15.4 Ann Arbor, Mich. 38 7.5 36 7.0 Atlanta, Ga. 1,499 46.4 1,600 48.0 Austin, Tex. 528 56.6 388 40.3 Bakersfield, Calif. 129 21.5 76 12.5 Baltimore, Md. 1,478 60.5 2,058 83.7 Baton Rouge, La. 175 31.6 168 30.1 Bergen-Passaic, N.J. 788 60.7 614 47.1 Birmingham, Ala. 193 22.3 158 18.1 Boston, Mass. 1,754 30.8 1,217 21.2 Buffalo, N.Y. 104 8.7 107 9.0 Charleston, S.C. 187 35.6 152 29.1 Charlotte, N.C. 260 21.1 220 17.5 Chicago, Ill. 2,381 31.3 2,479 32.3 Cincinnati, Ohio 225 14.3 220 13.9 Cleveland, Ohio 343 15.4 474 21.3 Columbus, Ohio 360 25.5 191 13.4 Dallas, Tex. 1,171 41.2 1,422 49.1 Dayton, Ohio 106 11.1 52 5.4 Denver, Colo. 676 38.4 569 31.7 Detroit, Mich. 659 15.3 778 18.1 El Paso, Tex. 82 12.7 116 17.4 Fort Lauderdale, Fla. 1,130 83.7 1,609 116.3 Fort Worth, Tex. 321 22.4 550 37.6 Fresno, Calif. 155 18.8 123 14.7 Gary, Ind. 74 12.0 97 15.6 Grand Rapids, Mich. 85 8.7 69 7.0 Greensboro, N.C. 169 15.5 206 18.6 Greenville, S.C. 232 26.9 143 16.4 Harrisburg, Pa. 106 17.5 89 14.6 Hartford, Conn. 587 52.4 393 35.2 Honolulu, Hawaii 224 25.9 191 21.8 Houston, Tex. 2,082 58.0 1,337 36.6 Indianapolis, Ind. 413 28.6 216 14.8 Jacksonville, Fla. 347 36.1 478 49.2 Jersey City, N.J. 777 140.6 887 160.6 Kansas City, Mo. 352 21.6 304 18.5 Knoxville, Tenn. 106 17.1 89 14.1 Las Vegas, Nev. 343 33.9 337 31.3 Little Rock, Ark. 98 18.4 96 17.9 Los Angeles, Calif. 4,786 52.4 3,979 43.5 Louisville, Ky. 130 13.3 142 14.5 Memphis, Tenn. 308 29.6 334 31.6 Miami, Fla. 2,924 146.0 2,980 147.2 Middlesex, N.J. 361 34.2 392 36.7 Milwaukee, Wis. 218 15.0 212 14.6 Minneapolis-Saint Paul, Minn. 334 12.6 369 13.7 Mobile, Ala. 86 17.0 104 20.3 Monmouth-Ocean City, N.J. 335 32.8 351 33.9 Nashville, Tenn. 241 23.1 289 27.0 Nassau-Suffolk, N.Y. 573 21.7 552 20.8 New Haven, Conn. 612 37.6 580 35.7 New Orleans, La. 701 53.8 612 46.8 New York, N.Y. 13,431 156.7 10,780 125.6 Newark, N.J. 2,136 110.8 1,741 90.0 Norfolk, Va. 371 24.5 392 25.6 Oakland, Calif. 968 44.6 745 34.1 Oklahoma City, Okla. 141 14.2 100 9.9 Omaha, Nebr. 70 10.6 77 11.6 Orange County, Calif. 569 22.6 543 21.4 Orlando, Fla. 430 32.2 747 54.9 Philadelphia, Pa. 2,258 45.7 2,039 41.2 Phoenix, Ariz. 431 18.0 393 15.9 Pittsburgh, Pa. 269 11.2 329 13.7 Portland, Oreg. 443 26.9 398 23.7 Providence, R.I. 261 28.6 273 29.9 Raleigh-Durham, N.C. 266 28.4 186 19.3 Richmond, Va. 258 28.5 227 24.8 Riverside-San Bernardino, Calif. 976 34.0 830 28.6 Rochester, N.Y. 193 17.7 218 20.0 Sacramento, Calif. 434 30.3 356 24.7 Saint Louis, Mo. 442 17.5 382 15.1 Salt Lake City, Utah 119 10.3 126 10.7 San Antonio, Tex. 636 45.2 384 26.7 San Diego, Calif. 1,221 46.7 952 36.2 San Francisco, Calif. 3,433 209.6 2,163 131.4 San Jose, Calif. 479 31.0 291 18.7 San Juan, P.R. 1,553 82.0 1,542 80.6 Sarasota, Fla. 183 35.8 170 32.8 Scranton, Pa. 36 5.6 49 7.7 Seattle, Wash. 770 35.7 658 30.2 Springfield, Mass. 265 44.3 185 31.1 Stockton, Calif. 135 26.4 48 9.3 Syracuse, N.Y. 96 12.7 120 15.9 Tacoma, Wash. 127 20.1 82 12.8 Tampa-Saint Petersburg, Fla. 778 36.4 830 38.5 Toledo, Ohio 52 8.5 47 7.7 Tucson, Ariz. 165 23.2 118 16.1 Tulsa, Okla. 117 15.8 81 10.9 Ventura, Calif. 79 11.4 72 10.2 Washington, D.C. 2,742 62.1 2,160 48.3 West Palm Beach, Fla. 586 62.9 864 90.5 Wichita, Kans. 72 14.3 98 19.3 Wilmington, Del. 219 41.0 256 47.5 Youngstown, Ohio 33 5.5 35 5.8 Metropolitan areas with 500,000 or more population 70,974 44.0 63,710 39.1 Central counties 69,653 47.1 62,408 41.9 Outlying counties 1,321 9.6 1,302 9.3 Metropolitan areas with 50,000 to 500,000 population 8,400 17.7 7,905 16.5 Central counties 7,891 18.7 7,402 17.4 Outlying counties 509 9.9 503 9.6 Non-metropolitan areas 4,699 8.9 4,617 8.6 Total2 84,577 32.3 76,802 29.1 Cumulative totals Metropolitan Adults/ Children area of residence adolescents <13 years old Total Akron, Ohio 311 - 311 Albany-Schenectady, N.Y. 938 20 958 Albuquerque, N.Mex. 649 2 651 Allentown, Pa. 450 5 455 Ann Arbor, Mich. 246 5 251 Atlanta, Ga. 9,537 74 9,611 Austin, Tex. 2,486 16 2,502 Bakersfield, Calif. 516 3 519 Baltimore, Md. 7,590 161 7,751 Baton Rouge, La. 785 13 798 Bergen-Passaic, N.J. 3,488 59 3,547 Birmingham, Ala. 1,020 14 1,034 Boston, Mass. 8,777 143 8,920 Buffalo, N.Y. 854 10 864 Charleston, S.C. 913 10 923 Charlotte, N.C. 1,191 12 1,203 Chicago, Ill. 13,406 152 13,558 Cincinnati, Ohio 1,151 12 1,163 Cleveland, Ohio 2,101 32 2,133 Columbus, Ohio 1,504 8 1,512 Dallas, Tex. 8,124 34 8,158 Dayton, Ohio 615 8 623 Denver, Colo. 4,000 18 4,018 Detroit, Mich. 4,690 55 4,745 El Paso, Tex. 482 2 484 Fort Lauderdale, Fla. 7,466 173 7,639 Fort Worth, Tex. 2,092 21 2,113 Fresno, Calif. 729 8 737 Gary, Ind. 401 2 403 Grand Rapids, Mich. 463 3 466 Greensboro, N.C. 976 12 988 Greenville, S.C. 823 2 825 Harrisburg, Pa. 483 5 488 Hartford, Conn. 2,158 36 2,194 Honolulu, Hawaii 1,237 10 1,247 Houston, Tex. 11,904 104 12,008 Indianapolis, Ind. 1,721 11 1,732 Jacksonville, Fla. 2,738 61 2,799 Jersey City, N.J. 4,321 99 4,420 Kansas City, Mo. 2,770 11 2,781 Knoxville, Tenn. 401 4 405 Las Vegas, Nev. 1,850 19 1,869 Little Rock, Ark. 643 9 652 Los Angeles, Calif. 28,850 188 29,038 Louisville, Ky. 737 8 745 Memphis, Tenn. 1,521 12 1,533 Miami, Fla. 14,835 373 15,208 Middlesex, N.J. 2,163 60 2,223 Milwaukee, Wis. 1,263 14 1,277 Minneapolis-Saint Paul, Minn. 2,235 14 2,249 Mobile, Ala. 665 9 674 Monmouth-Ocean City, N.J. 1,865 48 1,913 Nashville, Tenn. 1,310 14 1,324 Nassau-Suffolk, N.Y. 4,119 75 4,194 New Haven, Conn. 3,650 98 3,748 New Orleans, La. 4,106 50 4,156 New York, N.Y. 74,312 1,547 75,859 Newark, N.J. 10,621 262 10,883 Norfolk, Va. 1,658 43 1,701 Oakland, Calif. 5,615 32 5,647 Oklahoma City, Okla. 1,055 2 1,057 Omaha, Nebr. 454 2 456 Orange County, Calif. 3,775 24 3,799 Orlando, Fla. 3,320 57 3,377 Philadelphia, Pa. 10,699 173 10,872 Phoenix, Ariz. 2,904 11 2,915 Pittsburgh, Pa. 1,599 10 1,609 Portland, Oreg. 2,650 8 2,658 Providence, R.I. 1,242 14 1,256 Raleigh-Durham, N.C. 1,205 19 1,224 Richmond, Va. 1,430 19 1,449 Riverside-San Bernardino, Cal. 4,252 41 4,293 Rochester, N.Y. 1,124 8 1,132 Sacramento, Calif. 2,142 21 2,163 Saint Louis, Mo. 2,927 26 2,953 Salt Lake City, Utah 942 14 956 San Antonio, Tex. 2,438 22 2,460 San Diego, Calif. 6,758 39 6,797 San Francisco, Calif. 21,795 33 21,828 San Jose, Calif. 2,146 11 2,157 San Juan, P.R. 9,351 209 9,560 Sarasota, Fla. 876 18 894 Scranton, Pa. 269 3 272 Seattle, Wash. 4,673 13 4,686 Springfield, Mass. 967 19 986 Stockton, Calif. 450 12 462 Syracuse, N.Y. 697 7 704 Tacoma, Wash. 511 7 518 Tampa-Saint Petersburg, Fla. 5,116 73 5,189 Toledo, Ohio 351 7 358 Tucson, Ariz. 859 6 865 Tulsa, Okla. 702 6 708 Ventura, Calif. 509 2 511 Washington, D.C. 13,426 200 13,626 West Palm Beach, Fla. 4,203 152 4,355 Wichita, Kans. 428 2 430 Wilmington, Del. 1,043 9 1,052 Youngstown, Ohio 209 - 209 Metropolitan areas with 500,000 or more population 398,022 5,604 403,626 Central counties 390,951 5,501 396,452 Outlying counties 7,071 103 7,174 Metropolitan areas with 50,000 to 500,000 population 45,419 623 46,042 Central counties 42,662 570 43,232 Outlying counties 2,757 53 2,810 Non-metropolitan areas 24,740 369 25,109 Total2 470,288 6,611 476,899 1See Technical Notes for a discussion of the impact of the 1993 AIDS surveillance case definition for adults and adolescents (implemented January 1, 1993) on the number of cases reported in the two most recent 12-month reporting periods. 2Totals include 2,122 persons whose area of residence is unknown. Date: Wed, 20 Sep 1995 22:10:09 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 4 Table 3. AIDS cases by age group, exposure category, and sex, reported July 1993 through June 1994, July 1994 through June 1995;1 and cumulative totals, by age group and exposure category, through June 1995, United States. Males Females July 1993- July 1994- July 1993- July 1994- Adult/ June 1994 June 1995 June 1994 June 1995 adolescent exposure category No. (%) No. (%) No. (%) No. (%) Men who have sex w/men 38,504 (55) 32,448 (52) - - - - Injecting drug use 17,468 (25) 14,728 (24) 6,343 (45) 5,421 (39) Men who have sex w/men and inject drugs 4,765 ( 7) 3,609 ( 6) - - - - Hemophilia/ coagulation disorder 583 ( 1) 430 ( 1) 19 ( 0) 23 ( 0) Heterosexual contact: 2,914 ( 4) 2,974 ( 5) 5,685 (40) 5,204 (38) Sex w/ injecting drug user 1,004 903 2,299 1,893 Sex w/ bisexual male - - 441 346 Sex w/person w/hemophilia 3 6 61 57 Sex w/transfusion recipient w/HIV infection 61 65 82 57 Sex w/HIV- infected person, risk not specified 1,846 2,000 2,802 2,851 Receipt of blood transfusion, blood components, or tissue3 468 ( 1) 382 ( 1) 361 ( 3) 305 ( 2) Other/risk not reported or ident4 4,745 ( 7) 7,414 (12) 1,734 (12) 2,885 (21) Adult/adolescent subtotal 69,447(100) 61,985(100) 14,142(100) 13,838 (100) Totals2 July 1993- July 1994- Cumulative Adult/adolescent June 1994 June 1995 total exposure category No. (%) No. (%) No. (%) Men who have sex w/men 38,504 (46) 32,448 (43) 244,235 (52) Injecting drug use 23,811 (28) 20,149 (27) 118,694 (25) Men who have sex w/men and inject drugs 4,765 ( 6) 3,609 ( 5) 31,024 ( 7) Hemophilia/coagulation disorder 602 ( 1) 453 ( 1) 3,872 ( 1) Heterosexual contact: 8,600 (10) 8,178 (11) 35,683 ( 8) Sex w/injecting drug user 3,303 2,796 17,118 Sex w/bisexual male 441 346 1,999 Sex w/person w/hemophilia 64 63 299 Sex w/transfusion recipient w/HIV infection 143 122 692 Sex w/HIV-infected person, risk not specified 4,649 4,851 15,575 Receipt of blood transfusion, blood components, or tissue3 829 ( 1) 687 ( 1) 7,128 ( 2) Other/risk not reported or identified4 6,479 ( 8) 10,301 (14) 29,652 ( 6) Adult/adolescent subtotal 83,590 (100) 75,825 (100) 470,288 (100) Pediatric (<13 years old) Males Females July 1993- July 1994- July 1993- July 1994- June 1994 June 1995 June 1994 June 1995 exposure category No. (%) No. (%) No. (%) No. (%) Hemophilia/ coagulation disorder 16 ( 3) 11 ( 2) 1 ( 0) - - Mother with/ at risk for HIV infection4 443 (92) 419 (88) 478 (95) 462 (92) Injecting drug use 153 120 160 136 Sex w/injecting drug user 74 70 71 69 Sex w/bisexual male 5 10 5 10 Sex w/person w/hemophilia 1 1 - 1 Sex w/transfusion recipient w/HIV infection 3 1 1 3 Sex w/HIV- infected person, risk not specified 70 91 85 89 Receipt of blood transfusion, blood components, or tissue 12 2 10 5 Has HIV infection, risk not specified 125 124 146 149 Receipt of blood transfusion, blood components, or tissue 17 ( 4) 23 ( 5) 13 ( 3) 14 ( 3) Other/risk not reported or identified4 6 ( 1) 24 ( 5) 13 ( 3) 24 ( 5) Pediatric subtotal 482 (100) 477 (100) 505 (100) 500 (100) Total 69,929 62,462 14,647 14,338 Totals2 Pediatric July 1993- July 1994- Cumulative (<13 years old) June 1994 June 1995 total exposure category No. (%) No. (%) No. (%) Hemophilia/ coagulation disorder 17 ( 2) 11 ( 1) 226 ( 3) Mother with/ at risk for HIV infection4 921 (93) 881 (90) 5,925 (90) Injecting drug use 313 256 2,471 Sex w/injecting drug user 145 139 1,107 Sex w/bisexual male 10 20 120 Sex w/person w/hemophilia 1 2 24 Sex w/transfusion recipient w/HIV infection 4 4 27 Sex w/HIV- infected person, risk not specified 155 180 676 Receipt of blood transfusion, blood components, or tissue 22 7 140 Has HIV infection, risk not specified 271 273 1,360 Receipt of blood transfusion, blood components, or tissue 30 ( 3) 37 ( 4) 359 ( 5) Other/risk not reported or identified4 19 ( 2) 48 ( 5) 101 ( 2) Pediatric subtotal 987 (100) 977 (100) 6,611 (100) Total 84,577 76,802 476,899 1See Technical Notes for a discussion of the impact of the 1993 AIDS surveillance case definition for adults and adolescents (implemented January 1, 1993) on the number of cases reported in the two most recent 12-month reporting periods. 2Includes 4 persons whose sex is unknown. 3Thirty-three adults/adolescents and 2 children developed AIDS after receiving blood screened negative for HIV antibody. Ten additional adults developed AIDS after receiving tissue, organs, or artificial insemination from HIV-infected donors. Three of the 10 received tissue, organs, or artificial insemination from a donor who was negative for HIV antibody at the time of donation. See N Engl J Med 1992;326:726-32. 4See Table 11 and Figure 6 for a discussion of the "other" exposure category. "Other" also includes 25 persons who acquired HIV infection perinatally but were diagnosed with AIDS after age 13. These 25 persons are tabulated under the adult/adolescent, not pediatric, exposure category. Date: Wed, 20 Sep 1995 22:37:45 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 5 Table 4. Male adult/adolescent AIDS cases by exposure category and race/ethnicity, reported July 1994 through June 1995, and cumulative totals, through June 1995, United States. White, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 19,837 (71) 162,549 (77) Injecting drug use 2,943 (11) 17,915 ( 8) Men who have sex with men and inject drugs 1,840 ( 7) 16,651 ( 8) Hemophilia/coagulation disorder 323 ( 1) 3,008 ( 1) Heterosexual contact: 584 ( 2) 2,663 ( 1) Sex with injecting drug user 185 1,164 Sex with person with hemophilia 4 16 Sex with transfusion recipient with HIV infection 30 110 Sex with HIV-infected person, risk not specified 365 1,373 Receipt of blood transfusion, blood components, or tissue 208 ( 1) 2,797 ( 1) Risk not reported or identified1 2,127 ( 8) 6,273 ( 3) Total 27,862 (100) 211,856 (100) Black, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 7,543 (34) 48,167 (40) Injecting drug use 7,652 (35) 44,054 (36) Men who have sex with men and inject drugs 1,219 ( 6) 9,388 ( 8) Hemophilia/coagulation disorder 54 ( 0) 365 ( 0) Heterosexual contact: 1,667 ( 8) 6,653 ( 5) Sex with injecting drug user 185 1,164 Sex with person with hemophilia 2 4 Sex with transfusion recipient with HIV infection 18 90 Sex with HIV-infected person, risk not specified 1,128 3,527 Receipt of blood transfusion, blood components, or tissue 119 ( 1) 829 ( 1) Risk not reported or identified1 3,744 (17) 11,561 (10) Total 21,998 (100) 121,017 (100) Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 4,568 (40) 30,303 (45) Injecting drug use 4,049 (36) 25,742 (38) Men who have sex with men and inject drugs 498 ( 4) 4,691 ( 7) Hemophilia/coagulation disorder 41 ( 0) 304 ( 0) Heterosexual contact: 700 ( 6) 2,647 ( 4) Sex with injecting drug user 193 931 Sex with person with hemophilia - 6 Sex with transfusion recipient with HIV infection 16 66 Sex with HIV-infected person, risk not specified 491 1,644 Receipt of blood transfusion, blood components, or tissue 43 ( 0) 450 ( 1) Risk not reported or identified1 1,426 (13) 3,914 ( 6) Total 11,325 (100) 68,051 (100) Asian/Pacific Islander July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 347 (72) 2,263 (78) Injecting drug use 26 ( 5) 132 ( 5) Men who have sex with men and inject drugs 16 ( 3) 92 ( 3) Hemophilia/coagulation disorder 8 ( 2) 46 ( 2) Heterosexual contact: 16 ( 3) 57 ( 2) Sex with injecting drug user 3 17 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection 1 4 Sex with HIV-infected person, risk not specified 12 36 Receipt of blood transfusion, blood components, or tissue 9 ( 2) 89 ( 3) Risk not reported or identified 61 (13) 223 ( 8) Total 483 (100) 2,902 (100) American Indian/Alaska Native July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 106 (54) 618 (61) Injecting drug use 39 (20) 135 (13) Men who have sex with men and inject drugs 33 (17) 175 (17) Hemophilia/coagulation disorder 2 ( 1) 24 ( 2) Heterosexual contact: 3 ( 2) 17 ( 2) Sex with injecting drug user 2 8 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - 1 Sex with HIV-infected person, risk not specified 1 8 Receipt of blood transfusion, blood components, or tissue 2 ( 1) 6 ( 1) Risk not reported or identified 13 ( 7) 35 ( 3) Total 198 (100) 1,010 (100) Cumulative totals2 July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 32,448 (52) 244,235 (60) Injecting drug use 14,728 (24) 88,121 (22) Men who have sex with men and inject drugs 3,609 ( 6) 31,024 ( 8) Hemophilia/coagulation disorder 430 ( 1) 3,755 ( 1) Heterosexual contact: 2,974 ( 5) 12,049 ( 3) Sex with injecting drug user 903 5,154 Sex with person with hemophilia 6 26 Sex with transfusion recipient with HIV infection 65 272 Sex with HIV-infected person, risk not specified 2,000 6,597 Receipt of blood transfusion, blood components, or tissue 382 ( 1) 4,183 ( 1) Risk not reported or identified 7,414 (12) 22,095 ( 5) Total 61,985 (100) 405,462 (100) 1See Figure 6. 2Includes 626 men whose race/ethnicity is unknown. Date: Wed, 20 Sep 1995 23:05:15 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 6 Table 5. Female adult/adolescent AIDS cases by exposure category and race/ethnicity, reported July 1994 through June 1995, and cumulative totals, through June 1995, United States. White, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 1,238 (40) 6,739 (43) Hemophilia/coagulation disorder 15 ( 0) 78 ( 1) Heterosexual contact: 1,167 (38) 5,786 (37) Sex with injecting drug user 455 2,639 Sex with bisexual male 142 934 Sex with person with hemophilia 41 211 Sex with transfusion recipient with HIV infection 26 229 Sex with HIV-infected person, risk not specified 503 1,773 Receipt of blood transfusion, blood components, or tissue 117 ( 4) 1,596 (10) Risk not reported or identified1 535 (17) 1,371 ( 9) Total 3,072 (100) 15,570 (100) Black, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 3,119 (40) 17,601 (50) Hemophilia/coagulation disorder 5 ( 0) 25 ( 0) Heterosexual contact: 2,664 (34) 11,767 (33) Sex with injecting drug user 892 5,891 Sex with bisexual male 127 717 Sex with person with hemophilia 10 37 Sex with transfusion recipient with HIV infection 20 105 Sex with HIV-infected person, risk not specified 1,615 5,017 Receipt of blood transfusion, blood components, or tissue 125 ( 2) 834 ( 2) Risk not reported or identified1 1,934 (25) 5,145 (15) Total 7,847 (100) 35,372 (100) Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 1,030 (37) 6,043 (45) Hemophilia/coagulation disorder 3 ( 0) 13 ( 0) Heterosexual contact: 1,330 (47) 5,846 (44) Sex with injecting drug user 531 3,341 Sex with bisexual male 68 297 Sex with person with hemophilia 5 20 Sex with transfusion recipient with HIV infection 8 69 Sex with HIV-infected person, risk not specified 718 2,119 Receipt of blood transfusion, blood components, or tissue 55 ( 2) 436 ( 3) Risk not reported or identified1 391 (14) 955 ( 7) Total 2,809 (100) 13,293 (100) Asian/Pacific Islander July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 13 (22) 59 (18) Hemophilia/coagulation disorder - - 1 ( 0) Heterosexual contact: 24 (40) 144 (44) Sex with injecting drug user 7 43 Sex with bisexual male 5 41 Sex with person with hemophilia 1 3 Sex with transfusion recipient with HIV infection 2 15 Sex with HIV-infected person, risk not specified 9 42 Receipt of blood transfusion, blood components, or tissue 8 (13) 68 (21) Risk not reported or identified 15 (25) 53 (16) Total 60 (100) 325 (100) Asian/Pacific Islander July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 13 (22) 59 (18) Hemophilia/coagulation disorder - - 1 ( 0) Heterosexual contact: 24 (40) 144 (44) Sex with injecting drug user 7 43 Sex with bisexual male 5 41 Sex with person with hemophilia 1 3 Sex with transfusion recipient with HIV infection 2 15 Sex with HIV-infected person, risk not specified 9 42 Receipt of blood transfusion, blood components, or tissue 8 (13) 68 (21) Risk not reported or identified 15 (25) 53 (16) Total 60 (100) 325 (100) American Indian/Alaska Native July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 15 (47) 84 (49) Hemophilia/coagulation disorder - - - - Heterosexual contact: 14 (44) 63 (36) Sex with injecting drug user 7 36 Sex with bisexual male 4 8 Sex with person with hemophilia - 2 Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 3 17 Receipt of blood transfusion, blood components, or tissue - - 10 ( 6) Risk not reported or identified 3 ( 9) 16 ( 9) Total 32 (100) 173 (100) Cumulative totals2 July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 5,421 (39) 30,573 (47) Hemophilia/coagulation disorder 23 ( 0) 117 ( 0) Heterosexual contact: 5,204 (38) 23,633 (36) Sex with injecting drug user 1,893 11,964 Sex with bisexual male 346 1,999 Sex with person with hemophilia 57 273 Sex with transfusion recipient with HIV infection 57 420 Sex with HIV-infected person, risk not specified 2,851 8,977 Receipt of blood transfusion, blood components, or tissue 305 ( 2) 2,945 ( 5) Risk not reported or identified 2,885 (21) 7,554 (12) Total 13,838 (100) 64,822 (100) 1See Figure 6. 2Includes 89 women whose race/ethnicity is unknown. Date: Wed, 20 Sep 1995 17:48:37 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 7 Table 6. Pediatric AIDS cases by exposure category and race/ethnicity, reported July 1994 through June 1995, and cumulative totals, through June 1995, United States White, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 9 ( 6) 156 (13) Mother with/at risk for HIV infection: 115 (80) 868 (71) Injecting drug use 32 373 Sex with injecting drug user 20 162 Sex with bisexual male 5 44 Sex with person with hemophilia 1 15 Sex with transfusion recipient with HIV infection 1 10 Sex with HIV-infected person, risk not specified 24 87 Receipt of blood transfusion, blood components, or tissue 1 39 Has HIV infection, risk not specified 31 138 Receipt of blood transfusion, blood components, or tissue 16 (11) 178 (15) Risk not reported or identified1 4 ( 3) 14 ( 1) Total 144 (100) 1,216 (100) Black, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 1 ( 0) 32 ( 1) Mother with/at risk for HIV infection: 528 (92) 3,578 (95) Injecting drug use 149 1,470 Sex with injecting drug user 70 541 Sex with bisexual male 8 41 Sex with person with hemophilia - 5 Sex with transfusion recipient with HIV infection 1 9 Sex with HIV-infected person, risk not specified 111 440 Receipt of blood transfusion, blood components, or tissue 4 73 Has HIV infection, risk not specified 185 999 Receipt of blood transfusion, blood components, or tissue 8 ( 1) 80 ( 2) Risk not reported or identified1 36 ( 6) 68 ( 2) Total 573 (100) 3,758 (100) Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 1 ( 0) 34 ( 2) Mother with/at risk for HIV infection: 228 (92) 1,424 (91) Injecting drug use 73 609 Sex with injecting drug user 48 395 Sex with bisexual male 7 33 Sex with person with hemophilia 1 4 Sex with transfusion recipient with HIV infection 2 8 Sex with HIV-infected person, risk not specified 42 138 Receipt of blood transfusion, blood components, or tissue 2 27 Has HIV infection, risk not specified 53 210 Receipt of blood transfusion, blood components, or tissue 12 ( 5) 91 ( 6) Risk not reported or identified1 6 ( 2) 17 ( 1) Total 247 (100) 1,566 (100) Asian/Pacific Islander July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder - - 3 ( 8) Mother with/at risk for HIV infection: 5 (63) 24 (63) Injecting drug use - 4 Sex with injecting drug user 1 3 Sex with bisexual male - 2 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 2 6 Receipt of blood transfusion, blood components, or tissue - 1 Has HIV infection, risk not specified 2 8 Receipt of blood transfusion, blood components, or tissue 1 (13) 9 (24) Risk not reported or identified 2 (25) 2 ( 5) Total 8 (100) 38 (100) American Indian/Alaska Native July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder - - 1 ( 5) Mother with/at risk for HIV infection: 2 (100) 18 (95) Injecting drug use 1 9 Sex with injecting drug user - 4 Sex with bisexual male - - Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified - 1 Receipt of blood transfusion, blood components, or tissue - - Has HIV infection, risk not specified 1 4 Receipt of blood transfusion, blood components, or tissue - - - - Risk not reported or identified - - - - Total 2 (100) 19 (100) Cumulative totals2 July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 11 ( 1) 226 ( 3) Mother with/at risk for HIV infection: 881 (90) 5,925 (90) Injecting drug use 256 2,471 Sex with injecting drug user 139 1,107 Sex with bisexual male 20 120 Sex with person with hemophilia 2 24 Sex with transfusion recipient with HIV infection 4 27 Sex with HIV-infected person, risk not specified 180 676 Receipt of blood transfusion, blood components, or tissue 7 140 Has HIV infection, risk not specified 273 1,360 Receipt of blood transfusion, blood components, or tissue 37 ( 4) 359 ( 5) Risk not reported or identified 48 ( 5) 101 ( 2) Total 977 (100) 6,611 (100) 1See Figure 6, footnote 1. 2Includes 14 children whose race/ethnicity is unknown. Date: Wed, 20 Sep 1995 23:34:02 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 8 Table 7. AIDS cases in adolescents and adults under age 25, by sex and exposure category, reported July 1993 through June 1994, July 1994 through June 1995;1 and cumulative totals through June 1995, United States. 13-19 years old July 1993- July 1994- Cumulative June 1994 June 1995 total Male exposure category No. (%) No. (%) No. (%) Men who have sex with men 75 (29) 82 (32) 471 (33) Injecting drug use 15 ( 6) 16 ( 6) 92 ( 6) Men who have sex with men and inject drugs 10 ( 4) 10 ( 4) 68 ( 5) Hemophilia/coagulation disorder 112 (43) 89 (35) 613 (43) Heterosexual contact: 10 ( 4) 10 ( 4) 36 ( 3) Sex with injecting drug user 3 1 13 Sex with person with hemophilia - 1 1 Sex with transfusion recipient with HIV infection - - - Sex with HIV-infected person, risk not specified 7 8 22 Receipt of blood transfusion, blood components, or tissue 15 ( 6) 11 ( 4) 60 ( 4) Risk not reported or identified2 21 ( 8) 39 (15) 97 ( 7) Male subtotal 258 (100) 257 (100) 1,437 (100) 20-24 years old July 1993- July 1994- Cumulative June 1994 June 1995 total Male exposure category No. (%) No. (%) No. (%) Men who have sex with men 1,250 (60) 1,029 (60) 8,613 (63) Injecting drug use 275 (13) 207 (12) 1,727 (13) Men who have sex with men and inject drugs 178 ( 9) 112 ( 7) 1,486 (11) Hemophilia/coagulation disorder 85 ( 4) 55 ( 3) 501 ( 4) Heterosexual contact: 95 ( 5) 108 ( 6) 456 ( 3) Sex with injecting drug user 26 37 196 Sex with person with hemophilia - - 1 Sex with transfusion recipient with HIV infection 2 2 11 Sex with HIV-infected person, risk not specified 67 69 248 Receipt of blood transfusion, blood components, or tissue 17 ( 1) 10 ( 1) 99 ( 1) Risk not reported or identified2 171 ( 8) 200 (12) 717 ( 5) Male subtotal 2,071 (100) 1,721 (100) 13,599 (100) 13-19 years old July 1993- July 1994- Cumulative June 1994 June 1995 total Female exposure category No. (%) No. (%) No. (%) Injecting drug use 18 (11) 14 ( 7) 122 (16) Hemophilia/coagulation disorder 2 ( 1) 3 ( 2) 9 ( 1) Heterosexual contact: 93 (55) 89 (48) 397 (53) Sex with injecting drug user 32 27 186 Sex with bisexual male 5 6 22 Sex with person with hemophilia 1 3 10 Sex with transfusion recipient with HIV infection - - 1 Sex with HIV-infected person, risk not specified 55 53 178 Receipt of blood transfusion, blood components, or tissue 7 ( 4) 13 ( 7) 57 ( 8) Risk not reported or identified 49 (29) 68 (36) 162 (22) Female subtotal 169 (100) 187 (100) 747 (100) Total 427 444 2,184 20-24 years old July 1993- July 1994- Cumulative June 1994 June 1995 total Female exposure category No. (%) No. (%) No. (%) Injecting drug use 223 (27) 183 (22) 1,351 (33) Hemophilia/coagulation disorder 2 ( 0) 2 ( 0) 12 ( 0) Heterosexual contact: 455 (54) 423 (51) 2,093 (50) Sex with injecting drug user 189 129 1,058 Sex with bisexual male 31 23 165 Sex with person with hemophilia 13 6 41 Sex with transfusion recipient with HIV infection 2 3 12 Sex with HIV-infected person, risk not specified 220 262 817 Receipt of blood transfusion, blood components, or tissue 12 ( 1) 10 ( 1) 98 ( 2) Risk not reported or identified 149 (18) 209 (25) 592 (14) Female subtotal 841 (100) 827 (100) 4,146 (100) Total 2,912 2,548 17,745 1See Technical Notes for a discussion of the impact of the 1993 AIDS surveillance case definition for adults and adolescents (implemented January 1, 1993) on the number of cases reported in the two most recent 12-month reporting periods. 2See Figure 6. Date: Thu, 21 Sep 1995 00:14:03 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 9 Table 8. AIDS cases by sex, age at diagnosis, and race/ethnicity, reported through June 1995, United States White, not Black, not Male Hispanic Hispanic Hispanic Age at diagnosis No. (%) No. (%) No. (%) (years) Under 5 401 ( 0) 1,593 ( 1) 630 ( 1) 5-12 288 ( 0) 270 ( 0) 193 ( 0) 13-19 649 ( 0) 468 ( 0) 288 ( 0) 20-24 6,054 ( 3) 4,641 ( 4) 2,735 ( 4) 25-29 29,889 (14) 16,854 (14) 10,851 (16) 30-34 49,941 (23) 27,096 (22) 16,750 (24) 35-39 47,371 (22) 28,321 (23) 15,311 (22) 40-44 34,274 (16) 20,518 (17) 10,332 (15) 45-49 20,271 (10) 10,877 ( 9) 5,608 ( 8) 50-54 10,900 ( 5) 5,863 ( 5) 2,923 ( 4) 55-59 6,082 ( 3) 3,236 ( 3) 1,677 ( 2) 60-64 3,514 ( 2) 1,746 ( 1) 908 ( 1) 65 or older 2,911 ( 1) 1,397 ( 1) 668 ( 1) Male subtotal 212,545 (100) 122,880 (100) 68,874 (100) Asian/Pacific American Indian/ Male Islander Alaska Native Total1 Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 15 ( 1) 9 ( 1) 2,651 ( 1) 5-12 8 ( 0) 1 ( 0) 761 ( 0) 13-19 18 ( 1) 13 ( 1) 1,437 ( 0) 20-24 99 ( 3) 48 ( 5) 13,599 ( 3) 25-29 384 (13) 210 (21) 58,268 (14) 30-34 646 (22) 272 (27) 94,836 (23) 35-39 630 (22) 199 (20) 91,986 (22) 40-44 509 (17) 142 (14) 65,883 (16) 45-49 281 (10) 63 ( 6) 37,156 ( 9) 50-54 154 ( 5) 30 ( 3) 19,899 ( 5) 55-59 90 ( 3) 15 ( 1) 11,128 ( 3) 60-64 42 ( 1) 11 ( 1) 6,230 ( 2) 65 or older 49 ( 2) 7 ( 1) 5,040 ( 1) Male subtotal 2,925 (100) 1,020 (100) 408,874 (100) White, not Black, not Female Hispanic Hispanic Hispanic Age at diagnosis No. (%) No. (%) No. (%) (years) Under 5 406 ( 3) 1,606 ( 4) 596 ( 4) 5-12 121 ( 1) 289 ( 1) 147 ( 1) 13-19 140 ( 1) 482 ( 1) 119 ( 1) 20-24 980 ( 6) 2,217 ( 6) 910 ( 6) 25-29 2,825 (18) 5,885 (16) 2,488 (18) 30-34 3,695 (23) 8,692 (23) 3,412 (24) 35-39 3,043 (19) 8,140 (22) 2,766 (20) 40-44 1,850 (11) 5,085 (14) 1,663 (12) 45-49 953 ( 6) 2,208 ( 6) 852 ( 6) 50-54 565 ( 4) 1,166 ( 3) 479 ( 3) 55-59 445 ( 3) 660 ( 2) 303 ( 2) 60-64 326 ( 2) 422 ( 1) 151 ( 1) 65 or older 748 ( 5) 415 ( 1) 150 ( 1) Female subtotal 16,097 (100) 37,267 (100) 14,036 (100) Total2 228,644 160,148 82,910 Asian/Pacific American Indian/ Female Islander Alaska Native Total1 Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 9 ( 3) 9 ( 5) 2,634 ( 4) 5-12 6 ( 2) - - 565 ( 1) 13-19 4 ( 1) 1 ( 1) 747 ( 1) 20-24 16 ( 5) 18 (10) 4,146 ( 6) 25-29 36 (11) 36 (20) 11,280 (17) 30-34 70 (21) 44 (24) 15,936 (23) 35-39 61 (18) 35 (19) 14,075 (21) 40-44 50 (15) 19 (10) 8,676 (13) 45-49 28 ( 8) 8 ( 4) 4,054 ( 6) 50-54 16 ( 5) 4 ( 2) 2,233 ( 3) 55-59 10 ( 3) 4 ( 2) 1,424 ( 2) 60-64 16 ( 5) 3 ( 2) 918 ( 1) 65 or older 18 ( 5) 1 ( 1) 1,333 ( 2) Female subtotal 340 (100) 182 (100) 68,021 (100) Total2 3,265 1,202 476,899 1Includes 630 males, 99 females, and 1 person with unknown sex whose race/ethnicity is unknown. 2Includes 4 persons whose sex is unknown. Date: Thu, 21 Sep 1995 00:50:00 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 9. AIDS cases, case-fatality rates,1 and deaths, by half-year and age group, through June 1995, United States Adults/adolescents Cases diagnosed Case-fatality Deaths occurring Half-year during interval rate during interval Before 1981 86 90.7 30 1981 Jan.-June 104 90.4 37 July-Dec. 203 92.1 83 1982 Jan.-June 428 93.2 151 July-Dec. 725 91.6 295 1983 Jan.-June 1,343 94.2 525 July-Dec. 1,700 94.2 945 1984 Jan.-June 2,667 93.6 1,423 July-Dec. 3,494 93.7 2,015 1985 Jan.-June 5,120 92.7 2,869 July-Dec. 6,529 93.1 3,973 1986 Jan.-June 8,647 92.1 5,185 July-Dec. 10,210 92.3 6,696 1987 Jan.-June 13,476 91.1 7,798 July-Dec. 14,860 89.4 8,233 1988 Jan.-June 17,283 87.5 9,671 July-Dec. 17,769 87.3 11,032 1989 Jan.-June 20,799 84.1 12,694 July-Dec. 21,131 82.8 14,592 1990 Jan.-June 23,901 80.0 14,995 July-Dec. 23,403 77.7 15,952 1991 Jan.-June 27,836 73.7 16,993 July-Dec. 29,924 69.3 18,861 1992 Jan.-June 36,048 61.3 19,247 July-Dec. 38,962 54.4 20,416 1993 Jan.-June 40,147 41.3 20,571 July-Dec. 32,818 34.0 21,503 1994 Jan.-June 32,090 24.2 22,091 July-Dec. 25,577 15.8 21,475 1995 Jan.-June 13,008 7.8 11,112 Total2 470,288 62.1 291,815 Children <13 years old Cases diagnosed Case-fatality Deaths occurring Half-year during interval rate during interval Before 1981 8 75.0 1 1981 Jan.-June 10 80.0 2 July-Dec. 6 83.3 6 1982 Jan.-June 15 93.3 10 July-Dec. 16 87.5 4 1983 Jan.-June 32 100.0 14 July-Dec. 44 90.9 16 1984 Jan.-June 52 88.5 26 July-Dec. 63 87.3 24 1985 Jan.-June 108 81.5 47 July-Dec. 137 85.4 72 1986 Jan.-June 143 83.2 68 July-Dec. 195 77.9 97 1987 Jan.-June 228 78.1 121 July-Dec. 269 73.6 171 1988 Jan.-June 262 68.3 137 July-Dec. 348 65.5 179 1989 Jan.-June 368 64.4 173 July-Dec. 345 67.5 194 1990 Jan.-June 386 60.6 193 July-Dec. 402 54.0 199 1991 Jan.-June 400 52.0 174 July-Dec. 389 48.1 218 1992 Jan.-June 473 44.4 190 July-Dec. 425 47.3 219 1993 Jan.-June 413 37.8 244 July-Dec. 396 36.9 254 1994 Jan.-June 345 26.7 271 July-Dec. 243 20.6 215 1995 Jan.-June 90 8.9 112 Total2 6,611 55.3 3,658 1Case-fatality rates are calculated for each half-year by date of diagnosis. Each 6-month case-fatality rate is the number of deaths ever reported among cases diagnosed in that period (regardless of the year of death), divided by the number of total cases diagnosed in that period, multiplied by 100. For example, during the interval January through June 1982, AIDS was diagnosed in 428 adults/adolescents. Through June 1995, 399 of these 428 were reported as dead. Therefore, the case fatality rate is 93.2 (399 divided by 428, multiplied by 100). The case-fatality rates shown here may be underestimates because of incomplete reporting of deaths. Reported deaths are not necessarily caused by HIV-related disease. 2Death totals include 352 adults/adolescents and 7 children known to have died, but whose dates of death are unknown. Date: Wed, 20 Sep 1995 18:15:36 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 11. Health-care workers with documented and possible occupationally acquired AIDS/HIV infection, by occupation reported through June 1995, United States1. Documented Possible occupational occupational transmission (2) transmission (3) Occupation No. No. Dental worker, including dentist - 6 Embalmer/morgue technician - 2 Emergency medical technician/ paramedic - 9 Health aide/attendant 1 11 Housekeeper/maintenance worker 1 7 Laboratory technician, clinical 15 14 Laboratory technician, nonclinical 3 0 Nurse 16 23 Physician, nonsurgical 6 10 Physician, surgical - 4 Respiratory therapist 1 2 Technician, dialysis 1 2 Technician, surgical 2 1 Technician/therapist, other than those listed above - 4 Other health-care occupations - 2 Total 46 97 1Health-care workers are defined as those persons, including students and trainees, who have worked in a health-care, clinical, or HIV laboratory setting at any time since 1978. See MMWR 1992;41:823-25. 2Health-care workers who had documented HIV seroconversion after occupational exposure or had other laboratory evidence of occupational infection: 40 had percutaneous exposure, 4 had mucocutaneous exposure, 1 had both percutaneous and mucocutaneous exposures, and 1 had an unknown route of exposure. Forty-one exposures were to blood from an HIV-infected person, 1 to visibly bloody fluid, 1 to an unspecified fluid, and 3 to concentrated virus in a laboratory. Twenty of these health-care workers developed AIDS. 3These health-care workers have been investigated and are without identifiable behavioral or transfusion risks; each reported percutaneous or mucocutaneous occupational exposures to blood or body fluids, or laboratory solutions containing HIV, but HIV seroconversion specifically resulting from an occupational exposure was not documented. Date: Wed, 20 Sep 1995 18:48:33 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 12. Adult/adolescent AIDS cases by single and multiple exposure categories, reported through June 1995, United States. AIDS cases Exposure category No. (%) Single mode of exposure Men who have sex with men 235,025 (50) Injecting drug use 97,574 (21) Hemophilia/coagulation disorder 3,024 ( 1) Heterosexual contact 34,597 ( 7) Receipt of transfusion1 7,118 ( 2) Receipt of transplant of tissues/organs or artificial insemination2 10 ( 0) Other3 52 ( 0) Single mode of exposure subtotal 377,400 (80) Multiple modes of exposure Men who have sex with men; injecting drug use 27,164 ( 6) Men who have sex with men; hemophilia/coagulation disorder 118 ( 0) Men who have sex with men; heterosexual contact 5,814 ( 1) Men who have sex with men; receipt of transfusion/transplant 3,009 ( 1) Injecting drug use; hemophilia/coagulation disorder 155 ( 0) Injecting drug use; heterosexual contact 18,841 ( 4) Injecting drug use; receipt of transfusion/transplant 1,384 ( 0) Hemophilia/coagulation disorder; heterosexual contact 55 ( 0) Hemophilia/coagulation disorder; receipt of transfusion/transplant 766 ( 0) Heterosexual contact; receipt of transfusion/transplant 1,086 ( 0) Men who have sex with men; injecting drug use; hemophilia/coagulation disorder 34 ( 0) Men who have sex with men; injecting drug use; heterosexual contact 3,170 ( 1) Men who have sex with men; injecting drug use; receipt of transfusion/transplant 509 ( 0) Men who have sex with men; hemophilia/coagulation disorder; heterosexual contact 12 ( 0) Men who have sex with men; hemophilia/coagulation disorder; receipt of transfusion/transplant 30 ( 0) Men who have sex with men; heterosexual contact; receipt of transfusion/transplant 223 ( 0) Injecting drug use; hemophilia/coagulation disorder; heterosexual contact 36 ( 0) Injecting drug use; hemophilia/coagulation disorder; receipt of transfusion/transplant 29 ( 0) Injecting drug use; heterosexual contact; receipt of transfusion/transplant 660 ( 0) Hemophilia/coagulation disorder; heterosexual contact; receipt of transfusion/transplant 27 ( 0) Men who have sex with men; injecting drug use; hemophilia/coagulation disorder; heterosexual contact 7 ( 0) Men who have sex with men; injecting drug use; hemophilia/coagulation disorder; receipt of transfusion/transplant 13 ( 0) Men who have sex with men; injecting drug use; heterosexual contact; receipt of transfusion/transplant 125 ( 0) Men who have sex with men; hemophilia/coagulation disorder; heterosexual contact; receipt of transfusion/transplant 4 ( 0) Injecting drug use; hemophilia/coagulation disorder; heterosexual contact; receipt of transfusion/transplant 15 ( 0) Men who have sex with men; injecting drug use; hemophilia/coagulation disorder; heterosexual contact; receipt of transfusion/transplant 2 ( 0) Multiple modes of exposure subtotal 63,288 (13) Risk not reported or identified4 29,600 ( 6) Total 470,288 (100) 1Includes 33 adult/adolescents who developed AIDS after receiving blood screened negative for HIV antibody. 2Ten adults developed AIDS after receiving tissue, organs, or artificial insemination from HIV-infected donors. Three of the 10 received tissue or organs from a donor who was negative for HIV antibody at the time of donation. See N Engl J Med 1992;326:726-32. 3See Table 11 and Figure 6 for a discussion of the "other" exposure category. "Other" also includes 25 persons who acquired HIV infection perinatally, but were diagnosed with AIDS after age 13. 4See Figure 6. Date: Wed, 20 Sep 1995 19:16:36 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 13. Estimated AIDS-opportunistic illness incidence, by region of residence and year of diagnosis, 1990 through 1994, United States1. Year of diagnosis Region of residence2 1990 1991 1992 1993 1994 Northeast 13,900 15,500 17,000 18,600 19,100 Midwest 4,600 5,500 6,300 6,300 6,500 South 15,000 17,400 20,400 21,000 23,500 West 10,600 12,200 13,000 12,500 13,200 Territories 1,700 2,100 2,100 2,200 2,000 Total3 45,800 52,500 58,800 60,600 64,300 1Estimates are adjusted for delays in the reporting of AIDS cases, but not for incomplete reporting of cases. Estimates are rounded to the nearest 100. Opportunistic illness refers to AIDS-defining opportunistic illnesses included in the 1993 AIDS surveillance case definition. See Technical Notes. 2See Technical Notes for a list of states or dependencies and possessions which comprise each region of residence. 3The sum of the regional estimates may not equal the total annual estimates because of rounding. Date: Thu, 21 Sep 1995 01:25:43 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 15. Estimated AIDS-opportunistic illness incidence, by age group, sex, exposure category, and year of diagnosis, 1990 through 1994, United States1 Year of diagnosis Male adult/adolescent exposure category 1990 1991 1992 1993 1994 Men who have sex with men 25,200 28,300 30,000 29,600 31,300 Injecting drug use 8,700 10,100 12,000 12,700 13,400 Men who have sex with men and inject drugs 3,200 3,500 3,800 3,600 3,500 Hemophilia/coagulation disorder 340 380 440 440 420 Heterosexual contact 1,100 1,500 2,100 2,600 3,100 Receipt of blood transfusion, blood components, or tissue 440 460 440 380 440 Risk not reported or identified 360 380 440 400 280 Male subtotal 39,300 44,700 49,200 49,700 52,400 Female adult/adolescent exposure category 1990 1991 1992 1993 1994 Injecting drug use 3,000 3,600 4,300 4,600 4,900 Hemophilia/coagulation disorder 10 20 10 20 20 Heterosexual contact 2,200 2,900 3,800 4,800 5,700 Receipt of blood transfusion, blood components, or tissue 320 320 320 340 400 Risk not reported or identified 120 190 200 150 110 Female subtotal 5,700 7,000 8,600 9,900 11,100 Pediatric (<13 years old) 1990 1991 1992 1993 1994 exposure category2 800 830 990 970 850 Total3 45,800 52,500 58,800 60,600 64,300 1Estimates are adjusted for delays in the reporting of AIDS cases and anticipated redistribution of cases initially reported with no identified risk, but not for incomplete reporting of cases. Adult/adolescent and total estimates of less than 200, 200 to 499, 500 to 999, and 1,000 or more are rounded to the nearest 10, 20, 50, and 100, respectively. Pediatric estimates are rounded to the nearest 10. Opportunistic illness refers to AIDS-defining opportunistic illnesses included in the 1993 AIDS surveillance case definition. See Technical Notes. 2Estimates are based on cases diagnosed using the 1987 definition, adjusted for reporting delays. The 1993 AIDS surveillance case definition affected only adult/adolescent cases, not pediatric cases. 3The sum of the exposure category estimates may not equal the subtotal and total annual estimates because of rounding. Date: Thu, 21 Sep 1995 02:01:30 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 16. HIV infection cases (not AIDS) by state, reported July 1993 through June 1994, July 1994 through June 1995; and cumulative totals, by state and age group, through June 1995; from states with confidential HIV infection reporting. State of residence July 1993- July 1994- Adults/ (Date HIV reporting June 1994 June 1995 adolescents initiated) Alabama (Jan. 1988) 527 559 3,764 Arizona (Jan. 1987) 366 366 3,087 Arkansas (July 1989) 220 316 1,298 Colorado (Nov. 1985) 484 461 5,248 Connecticut (July 1992)1 48 22 - Idaho (June 1986) 50 50 343 Indiana (July 1988) 544 411 2,563 Louisiana (Feb. 1993) 1,351 1,161 3,714 Michigan (April 1992) 676 1,277 2,679 Minnesota (Oct. 1985) 266 309 2,093 Mississippi (Aug. 1988) 433 604 2,893 Missouri (Oct. 1987) 554 656 3,289 Nevada (Feb. 1992) 344 417 1,944 New Jersey (Jan. 1992) 2,694 4,259 10,221 North Carolina (Feb. 1990) 980 1,427 5,659 North Dakota (Jan. 1988) 27 7 59 Ohio (June 1990) 677 575 2,992 Oklahoma (June 1988) 201 176 1,540 South Carolina (Feb. 1986) 771 736 5,444 South Dakota (Jan. 1988) 15 21 148 Tennessee (Jan. 1992) 725 1,075 2,989 Texas (Feb. 1994)1 44 145 - Utah (April 1989) 104 89 775 Virginia (July 1989) 1,239 1,000 5,623 West Virginia (Jan. 1989) 97 96 359 Wisconsin (Nov. 1985) 261 252 1,845 Wyoming (June 1989) 11 9 57 Subtotal 13,709 16,476 70,626 Persons reported from states with confidential HIV reporting who were residents of other states2 422 490 1,694 Total 14,131 16,966 72,320 Cumulative totals State of residence Children (Date HIV reporting <13 years old Total initiated) Alabama (Jan. 1988) 31 3,795 Arizona (Jan. 1987) 29 3,116 Arkansas (July 1989) 20 1,318 Colorado (Nov. 1985) 26 5,274 Connecticut (July 1992)1 93 93 Idaho (June 1986) 3 346 Indiana (July 1988) 23 2,586 Louisiana (Feb. 1993) 42 3,756 Michigan (April 1992) 73 2,752 Minnesota (Oct. 1985) 22 2,115 Mississippi (Aug. 1988) 35 2,928 Missouri (Oct. 1987) 36 3,325 Nevada (Feb. 1992) 20 1,964 New Jersey (Jan. 1992) 306 10,527 North Carolina (Feb. 1990) 46 5,705 North Dakota (Jan. 1988) - 59 Ohio (June 1990) 26 3,018 Oklahoma (June 1988) 9 1,549 South Carolina (Feb. 1986) 73 5,517 South Dakota (Jan. 1988) 5 153 Tennessee (Jan. 1992) 37 3,026 Texas (Feb. 1994)1 189 189 Utah (April 1989) 5 780 Virginia (July 1989) 57 5,680 West Virginia (Jan. 1989) 2 361 Wisconsin (Nov. 1985) 23 1,868 Wyoming (June 1989) - 57 Subtotal 1,231 71,857 Persons reported from states with confidential HIV reporting who were residents of other states2 26 1,720 Total 1,257 73,577 1Connecticut and Texas have confidential HIV infection reporting for pediatric cases only. 2Includes 347 persons reported from states with confidential HIV infection reporting, but whose state of residence is unknown. See Technical Notes. Date: Thu, 21 Sep 1995 02:36:42 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 17. Male adult/adolescent HIV infection cases (not AIDS) by exposure category and race/ethnicity, reported July 1994 through June 1995, and cumulative totals through June 1995, from states with confidential HIV infection reporting1. White, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 2,615 (57) 15,135 (60) Injecting drug use 559 (12) 2,274 ( 9) Men who have sex with men and inject drugs 283 ( 6) 2,103 ( 8) Hemophilia/coagulation disorder 48 ( 1) 308 ( 1) Heterosexual contact: 117 ( 3) 598 ( 2) Sex with an injecting drug user 36 179 Sex with person with hemophilia - 4 Sex with transfusion recipient with HIV infection - 16 Sex with HIV-infected person, risk not specified 81 399 Receipt of blood transfusion, blood components, or tissue 17 ( 0) 168 ( 1) Risk not reported or identified2 942 (21) 4,642 (18) Total 4,581 (100) 25,228 (100) Black, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 1,715 (28) 7,883 (31) Injecting drug use 1,403 (23) 5,646 (22) Men who have sex with men and inject drugs 210 ( 3) 1,272 ( 5) Hemophilia/coagulation disorder 10 ( 0) 72 ( 0) Heterosexual contact: 472 ( 8) 2,064 ( 8) Sex with an injecting drug user 139 558 Sex with person with hemophilia 2 5 Sex with transfusion recipient with HIV infection 7 30 Sex with HIV-infected person, risk not specified 324 1,471 Receipt of blood transfusion, blood components, or tissue 33 ( 1) 141 ( 1) Risk not reported or identified2 2,226 (37) 8,247 (33) Total 6,069 (100) 25,325 (100) Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 265 (29) 1,132 (35) Injecting drug use 306 (33) 964 (30) Men who have sex with men and inject drugs 27 ( 3) 203 ( 6) Hemophilia/coagulation disorder 1 ( 0) 8 ( 0) Heterosexual contact: 46 ( 5) 163 ( 5) Sex with an injecting drug user 14 61 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - 2 Sex with HIV-infected person, risk not specified 32 100 Receipt of blood transfusion, blood components, or tissue 2 ( 0) 18 ( 1) Risk not reported or identified2 281 (30) 749 (23) Total 928 (100) 3,237 (100) Asian/Pacific Islander July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 16 (47) 74 (50) Injecting drug use 3 ( 9) 14 (10) Men who have sex with men and inject drugs 1 ( 3) 3 ( 2) Hemophilia/coagulation disorder - - 3 ( 2) Heterosexual contact: 1 ( 3) 6 ( 4) Sex with an injecting drug user 1 3 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified - 3 Receipt of blood transfusion, blood components, or tissue 1 ( 3) 3 ( 2) Risk not reported or identified2 12 (35) 44 (30) Total 34 (100) 147 (100) American Indian/Alaska Native July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 17 (38) 150 (49) Injecting drug use 10 (22) 51 (17) Men who have sex with men and inject drugs 6 (13) 47 (15) Hemophilia/coagulation disorder - - 4 ( 1) Heterosexual contact: 2 ( 4) 10 ( 3) Sex with an injecting drug user 1 2 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 1 8 Receipt of blood transfusion, blood components, or tissue - - 3 ( 1) Risk not reported or identified2 10 (22) 44 (14) Total 45 (100) 309 (100) Cumulative totals3 July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Men who have sex with men 4,675 (39) 24,611 (44) Injecting drug use 2,296 (19) 9,028 (16) Men who have sex with men and inject drugs 529 ( 4) 3,655 ( 7) Hemophilia/coagulation disorder 61 ( 1) 400 ( 1) Heterosexual contact: 644 ( 5) 2,869 ( 5) Sex with an injecting drug user 193 811 Sex with person with hemophilia 2 9 Sex with transfusion recipient with HIV infection 7 48 Sex with HIV-infected person, risk not specified 442 2,001 Receipt of blood transfusion, blood components, or tissue 53 ( 0) 339 ( 1) Risk not reported or identified2 3,637 (31) 14,761 (27) Total 11,895 (100) 55,663 (100) 1See Table 16 for states with confidential HIV infection reporting. 2For HIV infection cases (not AIDS), "risk not reported or identified" refers primarily to persons whose mode of exposure was not reported and who have not been followed up to determine their mode of exposure, and to a smaller number of persons who are not reported with one of the exposures listed above after follow-up. See Technical Notes. 3Includes 1,417 men whose race/ethnicity is unknown. Date: Wed, 20 Sep 1995 19:43:41 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 1 Table 18. Female adult/adolescent HIV infection cases (not AIDS) by exposure category and race/ethnicity, reported July 1994 through June 1995, and cumulative totals through June 1995, from states with confidential HIV infection reporting1. White, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 291 (28) 1,286 (30) Hemophilia/coagulation disorder 1 ( 0) 7 ( 0) Heterosexual contact: 346 (34) 1,595 (38) Sex with an injecting drug user 120 614 Sex with a bisexual male 39 207 Sex with person with hemophilia 11 45 Sex with transfusion recipient with HIV-infection 4 23 Sex with HIV-infected person, risk not specified 172 706 Receipt of blood transfusion, blood components, or tissue 8 ( 1) 102 ( 2) Risk not reported or identified2 381 (37) 1,238 (29) Total 1,027 (100) 4,229 (100) Black, not Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 691 (22) 2,693 (25) Hemophilia/coagulation disorder 1 ( 0) 7 ( 0) Heterosexual contact: 891 (28) 3,660 (33) Sex with an injecting drug user 276 1,188 Sex with a bisexual male 72 295 Sex with person with hemophilia 3 24 Sex with transfusion recipient with HIV-infection 6 27 Sex with HIV-infected person, risk not specified 534 2,126 Receipt of blood transfusion, blood components, or tissue 53 ( 2) 188 ( 2) Risk not reported or identified2 1,507 (48) 4,425 (40) Total 3,143 (100) 10,973 (100) Hispanic July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 97 (26) 290 (29) Hemophilia/coagulation disorder - - - - Heterosexual contact: 113 (30) 382 (38) Sex with an injecting drug user 49 178 Sex with a bisexual male 5 17 Sex with person with hemophilia - 5 Sex with transfusion recipient with HIV-infection - 3 Sex with HIV-infected person, risk not specified 59 179 Receipt of blood transfusion, blood components, or tissue 2 ( 1) 18 ( 2) Risk not reported or identified2 159 (43) 308 (31) Total 371 (100) 998 (100) Asian/Pacific Islander July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 2 (13) 6 (14) Hemophilia/coagulation disorder - - - - Heterosexual contact: 4 (27) 15 (35) Sex with an injecting drug user 1 6 Sex with a bisexual male - - Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 3 9 Receipt of blood transfusion, blood components, or tissue - - 1 ( 2) Risk not reported or identified2 9 (60) 21 (49) Total 15 (100) 43 (100) American Indian/Alaska Native July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 7 (30) 40 (40) Hemophilia/coagulation disorder - - - - Heterosexual contact: 6 (26) 34 (34) Sex with an injecting drug user 5 22 Sex with a bisexual male - 6 Sex with person with hemophilia - - Sex with transfusion recipient with HIV infection - - Sex with HIV-infected person, risk not specified 1 6 Receipt of blood transfusion, blood components, or tissue 1 ( 4) 1 ( 1) Risk not reported or identified2 9 (39) 26 (26) Total 23 (100) 101 (100) Cumulative totals3 July 1994- Cumulative June 1995 total Exposure category No. (%) No. (%) Injecting drug use 1,094 (24) 4,340 (26) Hemophilia/coagulation disorder 2 ( 0) 14 ( 0) Heterosexual contact: 1,365 (29) 5,718 (34) Sex with an injecting drug user 451 2,015 Sex with a bisexual male 117 527 Sex with person with hemophilia 14 74 Sex with transfusion recipient with HIV infection 10 53 Sex with HIV-infected person, risk not specified 773 3,049 Receipt of blood transfusion, blood components, or tissue 64 ( 1) 316 ( 2) Risk not reported or identified2 2,120 (46) 6,253 (38) Total 4,645 (100) 16,642 (100) 1See Table 16 for states with confidential HIV infection reporting. 2For HIV infection cases (not AIDS), "risk not reported or identified" refers primarily to persons whose mode of exposure was not reported and who have not been followed up to determine their mode of exposure, and to a smaller number of persons who are not reported with one of the exposures listed above after follow-up. See Technical Notes. 3Includes 298 women whose race/ethnicity is unknown. Date: Thu, 21 Sep 1995 03:12:40 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 2 Table 21. HIV infection cases (not AIDS), by sex, age at diagnosis, and race/ethnicity, reported through June 1995, from states with confidential HIV infection reporting1. White, not Black, not Male Hispanic Hispanic Hispanic Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 116 ( 0) 321 ( 1) 63 ( 2) 5-12 74 ( 0) 59 ( 0) 19 ( 1) 13-19 558 ( 2) 712 ( 3) 51 ( 2) 20-24 3,744 (15) 3,546 (14) 415 (13) 25-29 6,579 (26) 5,477 (21) 833 (25) 30-34 6,041 (24) 5,703 (22) 813 (24) 35-39 3,975 (16) 4,759 (19) 571 (17) 40-44 2,199 ( 9) 2,831 (11) 322 (10) 45-49 1,100 ( 4) 1,180 ( 5) 137 ( 4) 50-54 546 ( 2) 607 ( 2) 46 ( 1) 55-59 239 ( 1) 254 ( 1) 21 ( 1) 60-64 131 ( 1) 133 ( 1) 17 ( 1) 65 or older 116 ( 0) 123 ( 0) 11 ( 0) Male subtotal 25,418 (100) 25,705 (100) 3,319 (100) Asian/Pacific American Indian/ Male Islander Alaska Native Total2 Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 2 ( 1) 3 ( 1) 511 ( 1) 5-12 - - 2 ( 1) 161 ( 0) 13-19 4 ( 3) 8 ( 3) 1,363 ( 2) 20-24 26 (17) 59 (19) 7,977 (14) 25-29 41 (28) 95 (30) 13,353 (24) 30-34 31 (21) 69 (22) 12,998 (23) 35-39 18 (12) 40 (13) 9,607 (17) 40-44 14 ( 9) 22 ( 7) 5,521 (10) 45-49 7 ( 5) 8 ( 3) 2,516 ( 4) 50-54 3 ( 2) 5 ( 2) 1,243 ( 2) 55-59 2 ( 1) 2 ( 1) 532 ( 1) 60-64 - - 1 ( 0) 287 ( 1) 65 or older 1 ( 1) - - 266 ( 0) Male subtotal 149 (100) 314 (100) 56,335 (100) White, not Black, not Female Hispanic Hispanic Hispanic Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 115 ( 3) 291 ( 3) 65 ( 6) 5-12 21 ( 0) 51 ( 0) 16 ( 1) 13-19 252 ( 6) 930 ( 8) 52 ( 5) 20-24 816 (19) 1,924 (17) 149 (14) 25-29 1,047 (24) 2,462 (22) 271 (25) 30-34 931 (21) 2,406 (21) 255 (24) 35-39 590 (14) 1,678 (15) 122 (11) 40-44 264 ( 6) 883 ( 8) 80 ( 7) 45-49 158 ( 4) 332 ( 3) 35 ( 3) 50-54 53 ( 1) 148 ( 1) 15 ( 1) 55-59 45 ( 1) 100 ( 1) 13 ( 1) 60-64 22 ( 1) 50 ( 0) 5 ( 0) 65 or older 51 ( 1) 60 ( 1) 1 ( 0) Female subtotal 4,365 (100) 11,315 (100) 1,079 (100) Total3 29,784 37,022 4,398 Asian/Pacific American Indian/ Female Islander Alaska Native Total2 Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 2 ( 4) 6 ( 6) 491 ( 3) 5-12 1 ( 2) 1 ( 1) 93 ( 1) 13-19 1 ( 2) 10 ( 9) 1,264 ( 7) 20-24 10 (22) 19 (18) 2,960 (17) 25-29 16 (35) 18 (17) 3,888 (23) 30-34 9 (20) 20 (19) 3,689 (21) 35-39 1 ( 2) 22 (20) 2,452 (14) 40-44 3 ( 7) 9 ( 8) 1,264 ( 7) 45-49 2 ( 4) 2 ( 2) 546 ( 3) 50-54 1 ( 2) 1 ( 1) 222 ( 1) 55-59 - - - - 160 ( 1) 60-64 - - - - 79 ( 0) 65 or older - - - - 118 ( 1) Female subtotal 46 (100) 108 (100) 17,226 (100) Total3 195 423 73,577 1See Table 16 for states with confidential HIV infection reporting. 2Includes 1,430 males and 313 females whose race/ethnicity is unknown. 3Includes 16 persons whose sex is unknown. Date: Thu, 21 Sep 1995 03:56:11 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 2 Table 22. Persons reported to be living with HIV infection (not AIDS) and with AIDS, by state and age group, reported through June 19951. State of residence Living with HIV (not AIDS)2 (Date HIV reporting Adults/ Children initiated) adolescents <13 years Total old Alabama (Jan. 1988) 3,673 31 3,704 Alaska - - - Arizona (Jan. 1987) 2,768 25 2,793 Arkansas (July 1989) 1,279 20 1,299 California - - - Colorado (Nov. 1985) 5,107 26 5,133 Connecticut (July 1992)4 - 86 86 Delaware - - - District of Columbia - - - Florida - - - Georgia - - - Hawaii - - - Idaho (June 1986) 275 3 278 Illinois - - - Indiana (July 1988) 2,475 22 2,497 Iowa - - - Kansas - - - Kentucky - - - Louisiana (Feb. 1993) 3,585 40 3,625 Maine - - - Maryland - - - Massachusetts - - - Michigan (April 1992) 2,382 62 2,444 Minnesota (Oct. 1985) 1,985 20 2,005 Mississippi (Aug. 1988) 2,820 35 2,855 Missouri (Oct. 1987) 3,203 36 3,239 Montana - - - Nebraska - - - Nevada (Feb. 1992) 1,849 19 1,868 New Hampshire - - - New Jersey (Jan. 1992) 9,224 295 9,519 New Mexico - - - New York - - - North Carolina (Feb. 1990) 5,374 45 5,419 North Dakota (Jan. 1988) 52 - 52 Ohio (June 1990) 1,911 13 1,924 Oklahoma (June 1988) 1,493 9 1,502 Oregon - - - Pennsylvania - - - Rhode Island - - - South Carolina (Feb. 1986) 5,189 71 5,260 South Dakota (Jan. 1988) 132 5 137 Tennessee (Jan. 1992) 2,918 37 2,955 Texas (Feb. 1994)4 - 181 181 Utah (April 1989) 760 5 765 Vermont - - - Virginia (July 1989) 5,453 55 5,508 Washington - - - West Virginia (Jan. 1989) 331 2 333 Wisconsin (Nov. 1985) 1,752 22 1,774 Wyoming (June 1989) 56 - 56 Subtotal 66,046 1,165 67,211 Guam - - - Pacific Islands, U.S. - - - Puerto Rico - - - Virgin Islands, U.S. - - - Total 66,046 1,165 67,211 State of residence Living with AIDS3 (Date HIV reporting Adults/ Children initiated) adolescents <13 years Total old Alabama (Jan. 1988) 1,431 18 1,449 Alaska 140 1 141 Arizona (Jan. 1987) 1,343 8 1,351 Arkansas (July 1989) 849 15 864 California 28,622 169 28,791 Colorado (Nov. 1985) 2,010 8 2,018 Connecticut (July 1992)4 3,016 75 3,091 Delaware 585 4 589 District of Columbia 3,086 62 3,148 Florida 19,202 495 19,697 Georgia 5,688 71 5,759 Hawaii 583 4 587 Idaho (June 1986) 120 - 120 Illinois 5,805 86 5,891 Indiana (July 1988) 1,477 14 1,491 Iowa 345 4 349 Kansas 569 3 572 Kentucky 578 8 586 Louisiana (Feb. 1993) 2,820 45 2,865 Maine 308 5 313 Maryland 4,889 131 5,020 Massachusetts 3,623 63 3,686 Michigan (April 1992) 2,706 28 2,734 Minnesota (Oct. 1985) 1,022 11 1,033 Mississippi (Aug. 1988) 882 19 901 Missouri (Oct. 1987) 2,580 15 2,595 Montana 63 1 64 Nebraska 247 3 250 Nevada (Feb. 1992) 996 11 1,007 New Hampshire 273 3 276 New Jersey (Jan. 1992) 9,102 242 9,344 New Mexico 466 2 468 New York 26,240 671 26,911 North Carolina (Feb. 1990) 2,363 42 2,405 North Dakota (Jan. 1988) 26 - 26 Ohio (June 1990) 2,496 30 2,526 Oklahoma (June 1988) 946 5 951 Oregon 1,260 4 1,264 Pennsylvania 5,725 115 5,840 Rhode Island 575 5 580 South Carolina (Feb. 1986) 2,248 23 2,271 South Dakota (Jan. 1988) 36 2 38 Tennessee (Jan. 1992) 2,044 14 2,058 Texas (Feb. 1994)4 13,174 129 13,303 Utah (April 1989) 458 6 464 Vermont 102 1 103 Virginia (July 1989) 2,623 70 2,693 Washington 2,618 11 2,629 West Virginia (Jan. 1989) 208 2 210 Wisconsin (Nov. 1985) 1,024 9 1,033 Wyoming (June 1989) 46 - 46 Subtotal 169,638 2,763 172,401 Guam 4 - 4 Pacific Islands, U.S. - - - Puerto Rico 5,851 153 6,004 Virgin Islands, U.S. 134 7 141 Total 175,627 2,923 178,550 State of residence Cumulative totals (Date HIV reporting Adults/ Children initiated) adolescents <13 years Total old Alabama (Jan. 1988) 5,104 49 5,153 Alaska 140 1 141 Arizona (Jan. 1987) 4,111 33 4,144 Arkansas (July 1989) 2,128 35 2,163 California 28,622 169 28,791 Colorado (Nov. 1985) 7,117 34 7,151 Connecticut (July 1992)4 3,016 161 3,177 Delaware 585 4 589 District of Columbia 3,086 62 3,148 Florida 19,202 495 19,697 Georgia 5,688 71 5,759 Hawaii 583 4 587 Idaho (June 1986) 395 3 398 Illinois 5,805 86 5,891 Indiana (July 1988) 3,952 36 3,988 Iowa 345 4 349 Kansas 569 3 572 Kentucky 578 8 586 Louisiana (Feb. 1993) 6,405 85 6,490 Maine 308 5 313 Maryland 4,889 131 5,020 Massachusetts 3,623 63 3,686 Michigan (April 1992) 5,088 90 5,178 Minnesota (Oct. 1985) 3,007 31 3,038 Mississippi (Aug. 1988) 3,702 54 3,756 Missouri (Oct. 1987) 5,783 51 5,834 Montana 63 1 64 Nebraska 247 3 250 Nevada (Feb. 1992) 2,845 30 2,875 New Hampshire 273 3 276 New Jersey (Jan. 1992) 18,326 537 18,863 New Mexico 466 2 468 New York 26,240 671 26,911 North Carolina (Feb. 1990) 7,737 87 7,824 North Dakota (Jan. 1988) 78 - 78 Ohio (June 1990) 4,407 43 4,450 Oklahoma (June 1988) 2,439 14 2,453 Oregon 1,260 4 1,264 Pennsylvania 5,725 115 5,840 Rhode Island 575 5 580 South Carolina (Feb. 1986) 7,437 94 7,531 South Dakota (Jan. 1988) 168 7 175 Tennessee (Jan. 1992) 4,962 51 5,013 Texas (Feb. 1994)4 13,174 310 13,484 Utah (April 1989) 1,218 11 1,229 Vermont 102 1 103 Virginia (July 1989) 8,076 125 8,201 Washington 2,618 11 2,629 West Virginia (Jan. 1989) 539 4 543 Wisconsin (Nov. 1985) 2,776 31 2,807 Wyoming (June 1989) 102 - 102 Subtotal 235,684 3,928 239,612 Guam 4 - 4 Pacific Islands, U.S. - - - Puerto Rico 5,851 153 6,004 Virgin Islands, U.S. 134 7 141 Totals 241,673 4,088 245,761 1Persons reported with vital status "alive" as of the last update. 2Includes only persons reported from states with confidential HIV reporting. Excludes 1,553 adults/adolescents and 26 children reported from states with confidential HIV infection reporting whose state of residence is unknown or are residents of other states. 3Includes 225 adults/adolescents and 2 children whose state of residence is unknown. 4Connecticut and Texas have confidential HIV infection reporting for pediatric cases only. Date: Wed, 20 Sep 1995 20:16:07 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC HIV/AIDS Surveillance Report, Part 2 Technical notes Surveillance of AIDS All 50 states, the District of Columbia, U.S. dependencies and possessions, and independent nations in free association with the United States1 report AIDS cases to CDC using a uniform surveillance case definition and case report form. The original definition was modified in 1985 (MMWR 1985;34:373-75) and 1987 (MMWR 1987;36[suppl no. 1S]:1S-15S). The case definition for adults and adolescents was modified again in 1993 (MMWR 1992;41[no. RR-17]:1-19; see also MMWR 1995;44:160-61,64-7). The revisions incorporated a broader range of AIDS-indicator diseases and conditions and used HIV diagnostic tests to improve the sensitivity and specificity of the definition. The laboratory and diagnostic criteria for the 1987 pediatric case definition (MMWR 1987;36:225-30,235) were updated in 1994 (MMWR 1994;43[no. RR-12]:1-19). For persons with laboratory-confirmed HIV infection, the 1987 revision incorporated HIV encephalopathy, wasting syndrome, and other indicator diseases that are diagnosed presumptively (i.e., without confirmatory laboratory evidence of the opportunistic disease). In addition to the 23 clinical conditions in the 1987 definition, the 1993 case definition for adults and adolescents includes HIV-infected persons with CD4+ T-lymphocyte counts of less than 200 cells/uL or a CD4+ percentage of less than 14, and persons diagnosed with pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer. All conditions added to the 1993 definition require laboratory confirmation of HIV infection. Persons who meet the criteria for more than one definition category are classified hierarchically in the following order: pre-1987, 1987, and 1993. Persons in the 1993 definition category meet only the 1993 definition. The pediatric case definition incorporates the revised 1994 pediatric classification system for evidence of HIV infection. Children with their first positive results on Western blot or HIV detection tests before October 1994 were categorized based on the 1987 classification system. Those tested during or after October 1994 are categorized under the revised 1994 pediatric classification system. For children of any age with an AIDS-defining condition that requires evidence of HIV infection, a single positive HIV-detection test (i.e., HIV culture, HIV PCR, or HIV antigen [p24]) is sufficient for a reportable AIDS diagnosis if the diagnosis is confirmed by a clinician. The 1994 pediatric definitions for HIV encephalopathy and HIV wasting syndrome reflect increased knowledge of these conditions in children, and replace the 1987 definitions. Although completeness of reporting of diagnosed AIDS cases to state and local health departments varies by geographic region and patient population, studies conducted by state and local health departments indicate that reporting of AIDS cases in most areas of the United States is more than 85 percent complete (J Acquir Immune Def Syndr, 1992;5:257-64 and Am J Public Health 1992;82:1495-99). In addition, multiple routes of exposure, opportunistic diseases diagnosed after the initial AIDS case report was submitted to CDC, and vital status may not be determined or reported for all cases. Included in this report are persons known to be infected with human immunodeficiency virus type 2 (HIV-2). See MMWR 1995;44:603-06. Surveillance of HIV infection (not AIDS) Through December 31, 1994, 25 states had laws or regulations requiring confidential reporting by name of all persons with confirmed HIV infection, in addition to reporting of persons with AIDS. Two other states, Connecticut and Texas, required reporting by name of HIV infection only for children less than 13 years of age. These states initiated reporting at various times after the development of serum HIV-antibody tests in 1985. Before 1991, surveillance of HIV infection was not standardized and reporting of HIV infections was based primarily on passive surveillance. Consequently, many cases reported before 1991 do not have complete information. Since then, CDC has assisted states in conducting active surveillance of HIV infection using standardized report forms and software. However, collection of demographic and risk information still varies greatly among states. HIV infection data should be interpreted with caution. HIV surveillance reports are not representative of all persons with HIV infection. Because many HIV-reporting states also offer anonymous HIV testing, confidential HIV infection reports are not representative of all persons being tested in these areas. Furthermore, many factors may influence testing patterns, including the extent that testing is targeted or routinely offered to specific groups and the availability and access to medical care and testing services. These data provide a minimum estimate of the number of persons known to be HIV infected in states with confidential HIV infection reporting. For this report, persons greater than 18 months of age were considered HIV infected if they had at least one positive Western blot or positive detection test (culture, antigen, or other detection test) or had a diagnosis of HIV infection documented by a physician. Before October 1994, children less than 15 months of age were considered HIV infected if they met the definition stated in the 1987 pediatric classification system for HIV infection (MMWR 1987;36:225-30,235). Beginning October 1994, children less than 18 months of age are considered HIV infected if they meet the definition stated in the 1994 pediatric classification system for HIV infection (MMWR 1994;43[no. RR-12]:1-10). This report also includes children who were diagnosed as HIV infected by a physician. Although many states monitor reports of children born to infected mothers, only those with documented diagnosis of HIV infection are included in this report. Because states initiated reporting on different dates, the length of time reporting has been in place will influence the number of HIV infection cases reported. For example, data presented for a given annual period may include cases reported during only a portion of the year. Prior to statewide HIV reporting, some states collected reports of HIV infection in selected populations. Therefore, these states have reports prior to initiation of statewide confidential reporting. Over time, persons with HIV infection will be diagnosed and reported with AIDS. HIV infection cases later reported with AIDS are deleted from the HIV infection tables and added to the AIDS tables. Persons with HIV infection may be tested at any point in the clinical spectrum of disease, therefore the time between diagnosis of HIV infection and AIDS will vary. In addition, because surveillance practices differ, reporting and updating of clinical and vital status of cases vary among states. Included in this report are persons known to be infected with human immunodeficiency virus type 2 (HIV-2). See MMWR 1995;44:603-06. Tabulation and presentation of HIV infection and AIDS data Data in this report are provisional. Each issue of this report includes information received by CDC through the last day of the reporting period. AIDS data are tabulated by date of report to CDC unless otherwise noted. Data for U.S. dependencies and possessions and for associated independent nations are included in the totals. Age group tabulations are based on the person's age at first documented positive HIV-antibody test result for HIV infection cases, and age at diagnosis of AIDS for AIDS cases. Adult/adolescent cases include persons 13 years of age and older; pediatric cases include children under 13 years of age. Age group tabulations for AIDS cases in Table 14 (year-end edition only) are based on age at death. Tabulations of persons living with HIV and AIDS (Table 22), include persons whose vital status was galiveg as of the last update; persons whose vital status is missing or unknown are not included. Caution should be used in interpreting these data because states vary in the frequency with which they review the vital status of persons reported with HIV infection and AIDS. In addition, some cases may be lost to follow-up. Table 12 (year-end edition only) tabulates AIDS-indicator conditions reported during the last year. These data are known to under report AIDS-indicator conditions and should be interpreted with caution. Reported conditions over represent initial AIDS-indicator illness because follow-up for subsequent indicator diseases is resource intensive and has not been systematic or standardized in most health departments. The 1993 AIDS surveillance case definition for adults and adolescents added reporting of HIV-infected persons with severe HIV-related immunosuppression (CD+ T-lymphocyte count of less than 200/uL or less than 14 percent). Since implementation of the 1993 definition, approximately half of all cases were reported based only on immunologic criteria; consequently, reporting of AIDS cases based on AIDS-defining opportunistic infections has decreased (see AIDS 1994;8:1489-93). Table 2 lists AIDS case counts for each metropolitan area with 500,000 or more population. AIDS case counts for metropolitan areas with 50,000 to 500,000 population are reported as a combined subtotal. On December 31, 1992, the Office of Management and Budget announced new Metropolitan Statistical Area (MSA) definitions, which reflect changes in the U.S. population as determined by the 1990 census. These definitions were updated most recently on July 1, 1994. The cities and counties which compose each metropolitan area listed in Table 2 are provided in the publication gMetropolitan Areas as of June 30, 1995g (available by calling the National Technical Information Service, 1-703-487-4650, and ordering accession no. PB95-208880). Standards for defining central and outlying counties of metropolitan areas were published in the Federal Register (see FR 1990;55:12154-60). The metropolitan areas definitions are the MSAs for all areas except the 6 New England states. For these states, the New England County Metropolitan Areas (NECMA) are used. Metropolitan areas are named for a central city in the MSA or NECMA, may include several cities and counties, and may cross state boundaries. For example, AIDS cases and annual rates presented for the District of Columbia in Table 1 include only persons residing within the geographic boundaries of the District. AIDS cases and annual rates for Washington, D.C., in Table 2 include persons residing within the several counties in the metropolitan area, including counties in Maryland, Virginia, and West Virginia. State or metropolitan area data tabulations are based on the person's residence at first positive HIV-antibody test result for HIV infection cases and residence at diagnosis of the first AIDS-indicator condition(s) for AIDS cases. Estimated AIDS-opportunistic illness In 1993, the AIDS surveillance case definition was expanded to include a laboratory measure of severe immunosuppression (CD4+ T-lymphocyte count of less than 200 cells/uL or a percent of total lymphocytes less than 14) and three additional clinical conditions (pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer). Before 1993, the surveillance definition included only opportunistic illnesses, and trends in the incidence of AIDS were evaluated by examining the number of AIDS opportunistic illnesses (AIDS-OIs) diagnosed per year or quarter (adjusted for reporting delays). Because most HIV-infected persons become severely immunosuppressed before the onset of AIDS-OIs, the addition of the CD4+ criteria has temporarily distorted observed trends in AIDS incidence. To examine trends over time, an additional adjustment is required to estimate when an AIDS-OI will develop in persons who were reported based on the CD4+ criteria. CDC has developed a procedure to estimate the incidence of AIDS-OIs among persons reported with AIDS based on the CD4+ criteria. Estimates of trends in AIDS-OIs are displayed in Tables 13, 14, and 15. The estimated AIDS-OI incidence is the sum of incidence in two groups. The first group is persons reported to AIDS surveillance with AIDS-OIs. Incidence in this group is estimated by adjusting reported cases for delays in case reporting. The second group is persons reported with AIDS based on a CD4+ count or percent. Most of these persons will eventually have an AIDS-OI diagnosed. CDC has estimated the number of persons who had or will have an AIDS-OI diagnosed after the date of the reported CD4+ count or percent, by month of AIDS-OI diagnosis. To do this, CDC used data from the Adult Spectrum of Disease Project (see JAMA 1992;267:1798-1805) to estimate the probability distribution of the time interval between a CD4+ count in a particular range (e.g., 0 to 29 cells/uL, 30 to 59 cells/uL, etc.) and the diagnosis of an AIDS-OI. This probability distribution is the proportion of persons with a CD4+ count in a given range who will have an AIDS-OI diagnosed 1 month, 2 months, etc., after the reported CD4+ count. The expected number of persons with an AIDS-OI diagnosed in each later month among persons whose CD4+ count was in a particular range during a given month is the product of the number of these persons and the proportion expected to have an AIDS-OI diagnosed in this later month. The estimate of the number of AIDS-OI diagnoses in a particular month among persons reported with AIDS based on the CD4+ criteria is the sum, over all combinations of CD4+ ranges and previous months, of the number of persons expected to be diagnosed with an AIDS-OI in the month for which the estimate is made. There is uncertainty in these estimates of AIDS-OI incidence. Some uncertainty is the result of the need to adjust for delays in reporting of AIDS cases. There is additional uncertainty because some persons reported with AIDS based on the CD4+ criteria die before an AIDS-OI is diagnosed and hence should not contribute to the AIDS-OI incidence estimate. Other persons reported with AIDS based on the CD4+ criteria have an unreported AIDS-OI diagnosis by the date of the CD4+ determination; the estimation procedure counts their contribution to AIDS-OI incidence later than it should. However, preliminary analyses show that these two sources of bias change estimated AIDS-OI incidence by only a few percentage points. Reporting delays were estimated by a maximum likelihood statistical procedure, taking into account possible differences in reporting delays among exposure, geographic, racial/ethnic, age, and sex categories, but assuming that reporting delays within these groups have not changed over time (see Lecture Notes in Biomathematics 1989;83:58-88). The regions of residence included in Table 13 are defined as follows. Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont; Midwest: Indiana, Illinois, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin; South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia; West: Alaska, Arizona, California, Colorado, Idaho, Hawaii, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming; Territories: Guam, Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific Islands listed on page 30. Exposure categories For surveillance purposes, HIV infection cases and AIDS cases are counted only once in a hierarchy of exposure categories. Persons with more than one reported mode of exposure to HIV are classified in the exposure category listed first in the hierarchy, except for men with both a history of sexual contact with other men and injecting drug use. They make up a separate exposure category. "Men who have sex with men" cases include men who report sexual contact with other men (i.e., homosexual contact) and men who report sexual contact with both men and women (i.e., bisexual contact). gHeterosexual contactg cases are in persons who report specific heterosexual contact with a person with, or at increased risk for, HIV infection (e.g., an injecting drug user). Adults/adolescents born, or who had sex with someone born, in a country where heterosexual transmission was believed to be the predominant mode of HIV transmission (formerly classified as Pattern-II countries by the World Health Organization) are no longer classified as having heterosexually acquired AIDS. Similar to case reports for other persons who are reported without behavioral or transfusion risks for HIV, these reports are now classified (in the absence of other risk information which would classify them into another exposure category) as "no risk reported or identified" (see MMWR 1994;43:155-60). Children whose mother was born, or whose mother had sex with someone born, in a Pattern-II country are now classified (in the absence of other risk information which would classify them into another exposure category) as "Mother with/at risk for HIV infection: has HIV infection, risk not specified." "No risk reported or identified" cases are in persons with no reported history of exposure to HIV through any of the routes listed in the hierarchy of exposure categories. Risk not identified cases include persons who are currently under investigation by local health department officials; persons whose exposure history is incomplete because they died, declined to be interviewed, or were lost to follow-up; and persons who were interviewed or for whom other follow-up information was available and no exposure mode was identified. Persons who have an exposure mode identified at the time of follow-up are reclassified into the appropriate exposure category. In general, investigations and follow up for modes of exposure by state health departments are conducted routinely for persons reported with AIDS and as resources allow for those reported with HIV infection. Therefore, the percentage of HIV infected persons with risk not reported or identified is substantially higher than for those reported with AIDS. As HIV-infected persons with risk not reported or identified are diagnosed and reported with AIDS, they are assigned higher priority for follow up to determine the mode(s) of exposure. Rates Rates are calculated on a 12-month basis per 100,000 population for AIDS cases only. Rates are not calculated for HIV infection reports because case counts for HIV infection are believed to be less complete than AIDS case counts. Population denominators for computing AIDS rates for the 50 states and the District of Columbia are based on official post-census estimates from the U.S. Bureau of Census. Denominators for U.S. dependencies and possessions are linear extrapolations of official 1980 and 1990 census counts. Each 12-month rate is the number of cases reported during the 12-month period, divided by the 1994 or 1995 population, multiplied by 100,000. The denominators for computing race-specific rates (Table 10, year-end edition only) are based on 1990 census projections published in U.S. Bureau of Census publication P25-1104, "Population Projections of the United States, by Age, Sex, Race, and Hispanic Origin: 1993 to 2050." Race-specific rates are the number of cases reported for a particular racial/ethnic group during the preceding 12-month period divided by the projected population for that race/ethnicity, multiplied by 100,000. Case-fatality rates are calculated for each half-year by date of diagnosis of AIDS. Each 6-month case-fatality rate is the number of deaths ever reported among cases diagnosed in that period (regardless of the year of death), divided by the number of total cases diagnosed in that period, multiplied by 100. Reported deaths are not necessarily caused by HIV-related disease. Caution should be used in interpreting case-fatality rates because reporting of deaths is incomplete (see Am J Public Health 1992;82:1500-05 and Am J Public Health 1990;80:1080-86). Reporting delays Reporting delays (time between diagnosis of HIV infection or AIDS and report to CDC) vary widely among exposure, geographic, racial/ethnic, age and sex categories, and have been as long as several years for some AIDS cases. About 50 percent of all AIDS cases were reported to CDC within 3 months of diagnosis, with about 20 percent being reported more than one year after diagnosis. Reporting delay for HIV infection cases is being evaluated.