>From phil@wubios.wustl.edu Fri Nov 12 16:36:04 1993 CDC HIV/AIDS SURVEILLANCE REPORT Third Quarter 1993 U.S. AIDS Cases Reported Through September 1993 Online Edition: Issued Monday, November 1, 1993 Report Description The U.S. AIDS case data presented below are extracted from the "HIV/AIDS/ Survillance Report", published each quarter by the Division of HIV/AIDS, Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333. In addition to the data presented here, the printed report contains maps, figures, and technical notes. Single copies of the printed report are available from: CDC National AIDS Clearinghouse P.O. Box 6003 Rockville, MD 20849-6003 1-800-458-5231 1-800-243-7012 (TTY/TDD) Table 1. AIDS cases and annual rates per 100,000 population, by state, reported October 1991 through September 1992, October 1992 through September 1993;(1) and cumulative totals, by state and age group, through September 1993,(2) United States Oct. 1991- Oct. 1992- Sept. 1992 Sep. 1993 State of residence No. Rate No. Rate Alabama 465 11.4 705 17.0 Alaska 18 3.2 60 10.2 Arizona 408 10.9 1,202 31.3 Arkansas 237 10.0 420 17.5 California 8,641 28.4 17,474 56.4 Colorado 415 12.3 1,193 34.5 Connecticut 538 16.3 1,693 51.4 Delaware 126 18.5 346 49.9 District of Columbia 724 121.0 1,370 232.3 Florida 5,007 37.7 9,613 70.6 Georgia 1,348 20.4 2,597 38.4 Hawaii 175 15.4 324 27.9 Idaho 36 3.5 71 6.6 Illinois 1,842 16.0 3,005 25.8 Indiana 370 6.6 831 14.6 Iowa 86 3.1 196 7.0 Kansas 188 7.5 335 13.3 Kentucky 207 5.6 316 8.4 Louisiana 829 19.5 1,172 27.4 Maine 50 4.0 126 10.2 Maryland 1,096 22.6 2,353 47.6 Massachusetts 767 12.8 2,532 42.4 Michigan 784 8.4 1,752 18.6 Minnesota 237 5.3 624 13.9 Mississippi 231 8.9 468 17.9 Missouri 650 12.6 1,679 32.3 Montana 22 2.7 35 4.3 Nebraska 68 4.3 179 11.1 Nevada 235 18.3 601 44.0 New Hampshire 48 4.3 99 9.0 New Jersey 2,051 26.4 4,390 56.3 New Mexico 90 5.8 307 19.4 New York 8,232 45.6 16,031 88.4 North Carolina 648 9.6 1,059 15.5 North Dakota 4 0.6 4 0.6 Ohio 696 6.4 1,490 13.5 Oklahoma 228 7.2 716 22.3 Oregon 283 9.7 732 24.4 Pennsylvania 1,338 11.2 2,556 21.2 Rhode Island 102 10.2 305 30.3 South Carolina 347 9.7 1,395 38.4 South Dakota 8 1.1 23 3.2 Tennessee 442 8.9 967 19.2 Texas 2,944 17.0 7,164 40.4 Utah 145 8.2 270 14.9 Vermont 26 4.6 60 10.5 Virginia 606 9.6 1,590 24.9 Washington 573 11.4 1,459 28.2 West Virginia 61 3.4 78 4.3 Wisconsin 224 4.5 700 13.9 Wyoming 4 0.9 36 7.7 Table 2. AIDS cases and annual rates per 100,000 population, by metropolitan area with 500,000 or more population, reported October 1991 through September 1992, October 1992 through September 1993;1) and cumulative totals, by area and age group, through September 1993, United States Oct. 1991- Oct. 1992- Sept. 1992 Sept. 1993 Metropolitan area of residence(2) No. Rate No. Rate Akron, Ohio 36 5.4 46 6.9 Albany-Schenectady, N.Y. 106 12.2 217 24.7 Albuquerque, N.M. 58 9.6 186 30.2 Allentown, Pa. 32 5.3 122 20.0 Ann Arbor, Mich. 29 5.8 63 12.4 Atlanta, Ga. 956 31.3 1,773 56.4 Austin, Tex. 241 27.6 586 65.0 Bakersfield, Calif. 50 8.8 161 27.3 Baltimore, Md. 669 27.7 1,628 66.6 Baton Rouge, La. 92 17.1 135 24.7 Bergen-Passaic, N.J. 267 20.9 677 52.8 Birmingham, Ala. 116 13.7 259 30.2 Boston, Mass. 659 11.6 2,268 40.2 Buffalo, N.Y. 69 5.8 198 16.5 Charleston, S.C. 70 13.4 259 47.9 Charlotte, N.C. 118 9.9 245 20.1 Chicago, Ill. 1,614 21.5 2,619 34.5 Cincinnati, Ohio 112 7.3 230 14.7 Cleveland, Ohio 199 9.0 458 20.6 Columbus, Ohio 158 11.5 336 24.1 Dallas, Tex. 759 27.7 1,805 64.4 Dayton, Ohio 67 7.0 132 13.7 Denver, Colo. 335 20.1 1,010 58.9 Detroit, Mich. 606 14.1 1,233 28.7 El Paso, Tex. 46 7.5 116 18.3 Fort Lauderdale, Fla. 848 65.9 1,165 88.4 Fort Worth, Tex. 160 11.5 404 28.2 Fresno, Calif. 99 12.7 173 21.5 Gary, Ind. 47 7.7 78 12.6 Grand Rapids, Mich. 37 3.9 126 13.0 Greensboro, N.C. 128 12.0 151 14.0 Greenville, S.C. 62 7.4 255 29.8 Harrisburg, Pa. 46 7.7 78 12.9 Hartford, Conn. 167 14.8 565 50.2 Honolulu, Hawaii 124 14.6 256 29.6 Houston, Tex. 1,023 29.8 2,587 72.8 Indianapolis, Ind. 170 12.1 397 27.7 Jacksonville, Fla. 327 35.0 910 94.7 Jersey City, N.J. 313 56.6 619 111.8 Kansas City, Mo. 314 19.6 736 45.4 Knoxville, Tenn. 35 5.8 78 12.7 Las Vegas, Nev. 180 19.5 468 46.9 Little Rock, Ark. 82 15.8 171 32.6 Los Angeles, Calif. 3,327 37.1 5,557 61.1 Louisville, Ky. 90 9.4 166 17.2 Memphis, Tenn. 174 17.1 414 40.1 Miami, Fla. 1,324 67.0 2,423 120.1 Middlesex, N.J. 217 21.1 354 34.2 Milwaukee, Wis. 127 8.8 361 24.8 Table 3. AIDS cases by age group, exposure category, and sex, reported October 1991 through September 1992, October 1992 through September 1993;(1) and cumulative totals, by age group and exposure category, through September 1993, United States Males Oct. 1991- Oct. 1992- Sept. 1992 Sept. 1993 Adult/adolescent exposure category No. (%) No. (%) Men who have sex with men 24,334 (61) 46,025 (56) Injecting drug use 8,621 (22) 19,142 (23) Men who have sex with men and inject drugs 2,638 ( 7) 5,353 ( 7) Hemophilia/coagulation disorder 317 ( 1) 990 ( 1) Heterosexual contact: 1,613 ( 4) 3,328 ( 4) Sex with injecting drug user 703 1,102 Sex with bisexual male - - Sex with person with hemophilia 3 10 Born in Pattern-II(3) country 271 607 Sex with person born in Pattern-II country 14 43 Sex with transfusion recipient with HIV infection 18 59 Sex with HIV-infected person, risk not specified 604 1,507 Receipt of blood transfusion, blood components, or tissue(4) 385 ( 1) 695 ( 1) Other/risk not identified(5) 1,925 ( 5) 6,174 ( 8) Adult/adolescent subtotal 39,833 (100) 81,707 (100) Pediatric (< 13 years old) exposure category Hemophilia/coagulation disorder 23 ( 6) 18 ( 4) Mother with/at risk for HIV infection: 329 (89) 397 (91) Injecting drug use 114 126 Sex with injecting drug user 54 68 Sex with bisexual male 7 5 Sex with person with hemophilia 5 1 Born in Pattern-II country 19 22 Sex with person born in Pattern-II country 3 3 Sex with transfusion recipient with HIV infection 1 1 Sex with HIV-infected person, risk not specified 31 45 Table 4. Male adult/adolescent AIDS cases by exposure category and race/ethnicity, reported October 1992 through September 1993,(1) and cumulative totals, through September 1993, United States White, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 30,094 (73) 125,392 (78) Injecting drug use 4,285 (10) 12,670 ( 8) Men who have sex with men and inject drugs 3,001 ( 7) 11,959 ( 7) Hemophilia/coagulation disorder 794 ( 2) 2,349 ( 1) Heterosexual contact: 607 ( 1) 1,654 ( 1) Sex with injecting drug user 227 804 Sex with person with hemophilia 6 13 Born in Pattern-II(2) country 1 8 Sex with person born in Pattern-II country 10 52 Sex with transfusion recipient with HIV infection 25 72 Sex with HIV-infected person, risk not specified 338 705 Receipt of blood transfusion, blood components, or tissue 431 ( 1) 2,519 ( 2) Risk not identified(3) 2,032 ( 5) 4,380 ( 3) Total 41,244 (100) 160,923 (100) Black, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Men who have sex with men 9,614 (37) 34,166 (42) Injecting drug use 9,667 (37) 29,762 (36) Men who have sex with men and inject drugs 1,568 ( 6) 5,974 ( 7) Hemophilia/coagulation disorder 110 ( 0) 260 ( 0) Heterosexual contact: 2,125 ( 8) 6,279 ( 8) Sex with injecting drug user 682 2,118 Sex with person with hemophilia 1 4 Born in Pattern-II(2) country 605 2,571 Sex with person born in Pattern-II country 31 86 Sex with transfusion recipient with HIV infection 26 51 Sex with HIV-infected person, risk not specified 780 1,449 Receipt of blood transfusion, blood components, or tissue 157 ( 1) 606 ( 1) Risk not identified(3) 2,807 (11) 5,127 ( 6) Table 5. Female adult/adolescent AIDS cases by exposure category and race/ethnicity, reported October 1992 through September 1993,(1) and cumulative totals, through September 1993, United States White, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 1,718 (46) 4,459 (43) Hemophilia/coagulation disorder 14 ( 0) 48 ( 0) Heterosexual contact: 1,387 (37) 3,595 (35) Sex with injecting drug user 586 1,703 Sex with bisexual male 199 627 Sex with person with hemophilia 50 140 Born in Pattern-II(2) country 3 5 Sex with person born in Pattern-II country 4 15 Sex with transfusion recipient with HIV infection 49 176 Sex with HIV-infected person, risk not specified 496 929 Receipt of blood transfusion, blood components, or tissue 223 ( 6) 1,398 (14) Risk not identified(3) 398 (11) 793 ( 8) Total 3,740 (100) 10,293 (100) Black, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Injecting drug use 3,861 (48) 11,386 (52) Hemophilia/coagulation disorder 7 ( 0) 15 ( 0) Heterosexual contact: 2,884 (36) 7,864 (36) Sex with injecting drug user 1,191 4,101 Sex with bisexual male 150 428 Sex with person with hemophilia 9 21 Born in Pattern-II(2) country 316 1,143 Sex with person born in Pattern-II country 26 110 Sex with transfusion recipient Table 6. Pediatric AIDS cases by exposure category and race/ethnicity, reported October 1992 through September 1993, and cumulative totals, through September 1993, United States White, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 13 ( 9) 141 (14) Mother with/at risk for HIV infection: 118 (84) 663 (68) Injecting drug use 38 290 Sex with injecting drug user 22 132 Sex with bisexual male 4 39 Sex with person with hemophilia 2 13 Born in Pattern-II1 country - 3 Sex with person born in Pattern-II country - - Sex with transfusion recipient with HIV infection 1 6 Sex with HIV-infected person, risk not specified 10 45 Receipt of blood transfusion, blood components, or tissue 6 29 Has HIV infection, risk not specified 35 106 Receipt of blood transfusion, blood components, or tissue 9 ( 6) 167 (17) Risk not identified(2) 1 ( 1) 9 ( 1) Total 141 (100) 980 (100) Black, not Hispanic Oct. 1992- Cumulative Sept. 1993 total Exposure category No. (%) No. (%) Hemophilia/coagulation disorder 1 ( 0) 24 (1) Mother with/at risk for HIV infection: 489 (97) 2,556 (95) Injecting drug use 153 1,133 Sex with injecting drug user 70 390 Sex with bisexual male 2 28 Sex with person with hemophilia - 5 Table 7. AIDS cases in adolescents and adults under age 25, by sex and exposure category, reported October 1991 through September 1992, October 1992 through September 1993,(1) and cumulative totals through September 1993, United States 13-19 years old Oct. 1991- Oct. 1992- Cumulative Sept. 1992 Sept. 1993 total Male exposure category No. (%) No. (%) No. (%) Men who have sex with men 36 (35) 91 (28) 319 (33) Injecting drug use 4 ( 4) 14 ( 4) 62 ( 6) Men who have sex with men and inject drugs 5 ( 5) 8 ( 2) 45 ( 5) Hemophilia/coagulation disorder 47 (46) 172 (52) 440 (45) Heterosexual contact: 3 ( 3) 13 ( 4) 29 ( 3) Sex with injecting drug user 1 6 11 Sex with person with hemophilia - 1 1 Born in Pattern-II(2) country - 1 8 Sex with person born in Pattern-II country - - 1 Sex with transfusion recipient with HIV infection - - - Sex with HIV-infected person, risk not specified 2 5 8 Receipt of blood transfusion, blood components, or tissue 5 ( 5) 12 ( 4) 42 ( 4) Risk not identified(3) 2 ( 2) 19 ( 6) 40 ( 4) Male subtotal 102 (100) 329 (100) 977 (100) Female exposure category Injecting drug use 12 (20) 14 ( 8) 86 (20) Hemophilia/coagulation disorder 1 ( 2) 1 ( 1) 5 ( 1) Table 8. AIDS cases by sex, age at diagnosis, and race/ethnicity, reported through September 1993,(1) United States White, not Black, not Hispanic Hispanic Hispanic Male Age at diagnosis (years) No. (%) No. (%) No. (%) Under 5 329 ( 0) 1,167 ( 1) 478 ( 1) 5-12 248 ( 0) 183 ( 0) 155 ( 0) 13-19 473 ( 0) 299 ( 0) 186 ( 0) 20-24 4,735 ( 3) 3,282 ( 4) 1,938 ( 4) 25-29 23,298 (14) 12,067 (14) 7,742 (16) 30-34 37,653 (23) 19,017 (23) 11,723 (24) 35-39 35,879 (22) 19,483 (23) 10,671 (22) 40-44 25,717 (16) 13,213 (16) 7,088 (15) 45-49 15,223 ( 9) 6,869 ( 8) 3,793 ( 8) 50-54 8,173 ( 5) 3,800 ( 5) 2,012 ( 4) 55-59 4,671 ( 3) 2,121 ( 3) 1,174 ( 2) 60-64 2,775 ( 2) 1,155 ( 1) 587 ( 1) 65 or older 2,328 ( 1) 869 ( 1) 437 ( 1) Male subtotal 161,502 (100) 83,525 (100) 47,984 (100) Female Age at diagnosis (years) Under 5 320 ( 3) 1,143 ( 5) 455 ( 5) 5-12 81 ( 1) 189 ( 1) 106 ( 1) 13-19 102 ( 1) 262 ( 1) 68 ( 1) 20-24 672 ( 6) 1,347 ( 6) 594 ( 7) 25-29 1,875 (18) 3,801 (16) 1,699 (19) 30-34 2,455 (23) 5,618 (24) 2,126 (24) 35-39 1,918 (18) 5,094 (22) 1,707 (19) 40-44 1,093 (10) 2,826 (12) 988 (11) 45-49 594 ( 6) 1,187 ( 5) 472 ( 5) 50-54 359 ( 3) 706 ( 3) 273 ( 3) 55-59 344 ( 3) 381 ( 2) 168 ( 2) 60-64 249 ( 2) 248 ( 1) 87 ( 1) 65 or older 632 ( 6) 258 ( 1) 91 ( 1) Female subtotal 10,694 (100) 23,060 (100) 8,834 (100) Total (2) 172,196 106,585 56,818 Asian/Pacific American Indian/ Islander Alaska Native Total(2) Male Age at diagnosis (years) No. (%) No. (%) No. (%) Under5 8 ( 0) 8 ( 1) 1,992 (1) 5-12 7 ( 0) 1 ( 0) 594 (0) 13-19 11 ( 1) 11 ( 2) 980 (0) Table 9. AIDS cases, case-fatality rates,(1) and deaths, by half-year and age group, through September 1993,(2) United States Adults/adolescents Cases diagnosed Case-fatality Deaths occurring Half-year during interval rate during interval Before 1981 92 81.5 30 1981 Jan. - June 98 89.8 37 July - Dec. 208 91.3 87 1982 Jan. - June 407 92.6 155 July - Dec. 707 91.1 290 1983 Jan. - June 1,312 93.2 526 July - Dec. 1,654 93.2 939 1984 Jan. - June 2,581 92.8 1,406 July - Dec. 3,408 92.8 1,981 1985 Jan. - June 4,970 92.0 2,825 July - Dec. 6,379 91.6 3,904 1986 Jan. - June 8,413 90.4 5,109 July - Dec. 10,026 88.3 6,568 1987 Jan. - June 13,115 88.6 7,613 July - Dec. 14,574 85.7 8,013 1988 Jan. - June 16,836 83.4 9,397 July - Dec. 17,425 83.1 10,764 1989 Jan. - June 20,096 78.7 12,379 July - Dec. 20,434 76.5 14,231 1990 Jan. - June 22,629 70.8 14,404 July - Dec. 22,128 66.3 15,265 1991 Jan. - June 25,769 58.7 15,902 July - Dec. 27,410 49.4 17,497 1992 Jan. - June 30,925 36.1 17,431 July - Dec. 31,177 23.4 17,555 Table 10. AIDS cases by year of diagnosis and definition category, diagnosed through September 1993,(1) United States Period of diagnosis Before Oct. 1989- Oct. 1990- Sept. 1989 Sept. 1990 Sept. 1991 Definition category No. (%) No. (%) No. (%) Pre-1987 definition 106,479 (79) 28,634 (64) 29,523 (58) 1987 definition 26,788 (20) 13,559 (30) 16,078 (31) 1993 definition(2) 1,610 ( 1) 2,402 ( 5) 5,467 (11) Severe HIV-related immunosuppression(3) 1,181 2,021 4,669 Pulmonary tuberculosis 362 333 706 Recurrent pneumonia 55 44 85 Invasive cervical cancer 16 8 13 Total 134,877 (100) 44,595 (100) 51,068 (100) Period of diagnosis Oct. 1991- Oct. 1992- Cumulative Sept. 1992 Sept. 1993 total Definition category No. (%) No. (%) No. (%) Pre-1987 definition 28,340 (47) 13,876 (29) 206,852 (61) 1987 definition 17,521 (29) 9,537 (20) 83,483 (25) 1993 definition(2) 15,032 (25) 24,404 (51) 48,915 (14) Severe HIV-related immunosuppression(3) 13,587 22,718 44,176 Pulmonary tuberculosis 1,195 1,115 3,711 Recurrent pneumonia 223 541 948 Invasive cervical cancer 38 48 123 Total 60,893 (100) 47,817 (100) 339,250 (100) 1 Includes 9 months of data collected under the 1993 AIDS surveillance case definition for adults and adolescents. 2 Persons who meet only the 1993 AIDS case definition and whose date of diagnosis is before January 1993 were diagnosed retrospectively. The sum of diagnoses listed for the four conditions under the 1993 definition do not equal the 1993 definition total because some persons have more than one diagnosis from the added conditions of pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer. 3 Defined as CD4+ T-lymphocyte count of less than 200 cells/uL or a CD4+ percentage less than 14 in persons with laboratory confirmation of HIV infection. Table 11. Health-care workers with documented and possible occupationally acquired AIDS/HIV infection, by occupation, reported through September 1993, United States(1) Documented Possible occupational occupational transmission(2) transmission(3) occupation No. No. Dental worker, including dentist - 6 Embalmer/morgue technician - 3 Emergency medical technician /paramedic - 8 Health aide/attendant 1 9 Housekeeper/maintenace worker 1 6 Laboratory technician, clinical 15 14 Laboratory technician,nonclinical 1 1 Nurse 13 15 Physician, nonsurgical 5 8 Physician, surgical - 2 Respiratory therapist 1 2 Technician, dialysis 1 1 Technician, surgical 1 1 Technician/therapist, other than those listed above - 3 Other health-care occupations - 2 Total 39 81 1 Health-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;41:823-5. 2 Health-care workers who had documented HIV seroconversion after occupational exposure: 34 had percutaneous exposure, 4 had mucocutaneous exposure, 1 had both percutaneous and mucocutaneous exposures. Thirty-six exposures were to blood from an HIV-infected person, 1 to visibly bloody fluid, 1 to an unspecified fluid, and 1 to a concentrated virus in a laboratory. Eleven of these health-care workers have developed AIDS. 3 These 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 lab oratory solutions containing HIV, but HIV seroconversion specifically resulting from an occupational exposure was not documented. Table 12. Adult/adolescent AIDS cases by single and multiple exposure categories, reported through September 1993, United States AIDS cases Exposure category No. (%) Single mode of exposure Men who have sex with men 176,793 (53) Injecting drug use 68,029 (20) Hemophilia/coagulation disorder 2,212 ( 1) Heterosexual contact 23,536 ( 7) Receipt of transfusion(1) 5,978 ( 2) Receipt of transplant of tissues/organs(2) 6 ( 0) Other(3) 16 ( 0) Single mode of exposure subtotal 276,567 (83) Multiple modes of exposure Men who have sex with men;injecting drug use 18,885 ( 6) Men who have sex with men; hemophilia/coagulation disorder 82 ( 0) Men who have sex with men;heterosexual contact 3,718 ( 1) Men who have sex with men;receipt of transfusion/transplant 2,554 ( 1) Injecting drug use;hemophilia/ coagulation disorder 88 ( 0) Injecting drug use;heterosexual contact 11,003 ( 3) Injecting drug use;receipt of transfusion/transplant 1,114 ( 0) Hemophilia/coagulation disorder; heterosexual contact 29 ( 0) Hemophilia/coagulation disorder; receipt of transfusion/transplant 704 ( 0) Heterosexual contact;receipt of transfusion/transplant 822 ( 0) Men who have sex with men; injecting drug use;hemophilia/ coagulation disorder 20 ( 0) Men who have sex with men;injecting drug use; heterosexual contact 1,764 ( 1) Men who have sex with men;injecting drug use; receipt of transfusion/transplant 392 ( 0) Men who have sex with men;hemophilia/coagulation disorder;heterosexual contact 4 ( 0) Men who have sex with men;hemophilia/coagulation disorder;receipt of transfusion/transplant 27 ( 0) Men who have sex with men;heterosexual contact; receipt of transfusion/transplant 163 ( 0) Injecting drug use;hemophilia/coagulation disorder;heterosexual contact 20 ( 0) Injecting drug use;hemophilia/coagulation disorder;receipt of transfusion/transplant 28 ( 0) Injecting drug use;heterosexual contact; receipt of transfusion/transplant 421 ( 0) Hemophilia/coagulation disorder;heterosexual contact;receipt of transfusion/transplant 18 ( 0) Men who have sex with men;injecting drug use; hemophilia/coagulation disorder;heterosexual contact 4 ( 0) Men who have sex with men;injecting drug use; hemophilia/coagulation disorder;