Since its discovery over 30 years ago, HIV continues to be public health problem with an estimated 1.1 million people living with HIV in the United States alone (5). Even though the yearly number of new diagnoses in the past decade has remained stable (around 50,000), the number of new infections among young persons, especially younger people and black men has increased (1, 2, 5). Most troubling are the estimated 180,000 people (among the 1.1 million living with HIV) unaware of their infection (4). Many of those unaware of their infection remain undiagnosed until they present with AIDS-related conditions (11). Additionally, only 37% of the population aged 18-64 report ever receiving an HIV ...view middle of the document...
While Latinos represented 16% of the population, they made up 20% of the new HIV diagnoses (7, 8).
As the HIV epidemic has progressed, rural people are more affected than ever before. The southern states have the highest percentage (27%) of HIV-infected individuals living in rural areas as compared with other geographic areas (12). Additionally, people with HIV in rural settings are more likely than their urban counterparts to be diagnosed at a later stage of disease, suggesting missed opportunities for HIV testing (13).
[Talk about HIV testing]
Studies have found variability of the date of HIV diagnosis between sources including self-report, medical record and HIV/AIDS surveillance data (HARS). Medical record is widely considered the gold standard of HIV diagnoses among the medical community, and yet one study found that the diagnosis date in HARS occurs on average 9 months after the patient self-reported diagnosis date and medical record diagnosis date. In addition, researchers found that of all HIV/AIDS patients from 2000-2008 in a large North Carolina HIV/STD clinic based in a large academic hospital setting only 81% were successfully matched to records in the North Carolina HARS system. Some may have been from out of state and just not updated in North Carolina’s system, and 51% were diagnoses before 1995 when anonymous testing was still available (10).
Looking at early detection rates of HIV testing (early detection is first HIV diagnosis occurs more than five years before AIDS diagnosis) in Los Angeles County, researchers found that 52% of their study population were diagnoses with AIDS within 3 months of testing HIV positive. In addition, 59% of participants reported testing for HIV because of an illness and only 9% tested because they felt at risk. The study found that minorities, women, heterosexuals, young people and people with low education had less frequent early detection of HIV (9).
[Talk about HIV reporting and reporting issues.]
HIV surveillance varies from state to state even though all are based on recommendations made by the CDC and use name-based reporting (6).
1. Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006-2009. PLoS One. 2011;6:e17502.
2. Centers for Disease Control and...