USA HIV & AIDS Statistics Summary

Graphic Version of the Heading

Introduction

AIDS was first identified in the USA in 1981. The epidemic has now spread to every part of the USA and to all sectors of society.

It is thought that more than one million people are living with HIV in the USA and that more than half a million have died after developing AIDS.

American HIV surveillance data are not comprehensive so many statistics must be based on reports of AIDS diagnoses. In interpreting such AIDS statistics, it is important to remember that they do not correspond to new HIV infections. Most people live with HIV for several years before developing AIDS.

AIDS statistics

People living with AIDS

At the end of 2006, the CDC estimates that 448,871 people were living with AIDS in the USA. This number includes all people who have ever been diagnosed with an AIDS-defining condition and are believed to be alive, including many people who have recovered their health by taking antiretroviral therapy. The chart below shows the ethnicities of these people, revealing that black Americans have been disproportionately affected.

Graph of ethnicity living with AIDS in the USA

The charts below show how adults and adolescents (aged 13 and over) living with AIDS most likely became infected with HIV. Around 77% of adults and adolescents living with AIDS are men.

Graph of Men/Women living with AIDS in the USA

An estimated 3,775 children aged under 13 were living with AIDS at the end of 2006. The vast majority of these children acquired HIV from their mothers during pregnancy, labour, delivery or breastfeeding.

People with AIDS are surviving longer and are contributing to a steady increase in the number of people living with AIDS. This trend will continue as long as the number of new diagnoses exceeds the number of people dying each year.

AIDS diagnoses and deaths

In June 1981, the first cases of what is now known as AIDS were reported in the USA. During the 1980s, there were rapid increases in the number of AIDS cases and deaths of people with AIDS. Cases peaked with the 1993 expansion of the case definition1, and then declined. The most dramatic drops in both cases and deaths began in 1996, with the widespread use of combination antiretroviral therapy.

Since 2000 the annual numbers of AIDS diagnoses have been relatively constant, with an estimated 37,852 in 2006. In total, an estimated 1,014,797 people have been diagnosed with AIDS in America.

The death rate among people with AIDS has also remained relatively stable in recent years; there were an estimated 14,627 deaths in 2006. Since the beginning of the epidemic, an estimated 565,927 people with AIDS have died in the USA.

Who is affected by AIDS?

During the 1990s, the epidemic shifted steadily toward a growing proportion of AIDS cases among black people and Hispanics and in women, and toward a decreasing proportion in MSM, although this group remains the largest single exposure group. Black people and Hispanics have been disproportionately affected since the early years of the epidemic. In absolute numbers, blacks have outnumbered whites in new AIDS diagnoses and deaths since 1996, and in the number of people living with AIDS since 1998.

During 2006 there were an estimated 38 paediatric AIDS diagnoses, compared to 195 in 1999 and 896 in 1992. The decline in paediatric AIDS incidence is associated with more HIV testing of pregnant women and the use of antiretroviral drugs such as zidovudine (AZT) by HIV-infected pregnant women and their newborn infants.

The age group 35-49 years accounted for 52% of all AIDS cases diagnosed in 2006. Nearly three-quarters of all people who have died with AIDS did not live to the age of 45.

HIV statistics

At the end of 2006, the CDC estimates that there were 509,681 people living with HIV/AIDS in the 38 areas that have a history of confidential name-based HIV reporting, based on reported diagnoses and deaths2. However, the total number of people living in the USA with HIV/AIDS is thought to be between 1,039,000 and 1,185,0003. The discrepancy between these figures is due to several factors including:

  • confidential name-based reporting of HIV diagnoses has not yet been implemented in all states4
  • anonymous tests, including home tests, are excluded from case reports
  • one in every four people living with HIV has not even had their infection diagnosed, let alone reported.5

During 2006, an estimated 36,817 new diagnoses of HIV infection were reported from the 38 areas with a history of confidential name-based reporting, a number that has remained relatively stable since 2001. Of these cases, 73% were among adult or adolescent males, 26% were among adult or adolescent females, and less than 1% were among children under 13 years of age. Recent HIV reports represent a mixture of people with recent infection and others who may have been infected in the past but are only now being diagnosed.

Interpreting HIV & AIDS statistics for the USA

In order to monitor the spread of the American epidemic and to assess the need for services and resources, there is a need for accurate surveillance. In the USA, statistics on both HIV and AIDS are collected by the Centers for Disease Control and Prevention (CDC) and published in an annual report. The latest report was published in March 2008, and contains data up to the end of 2006.

The CDC surveillance report includes data on the number of people diagnosed with AIDS, the number living with AIDS and the number of people with AIDS who have died. Such AIDS statistics include not only the 50 states and the District of Columbia but also Puerto Rico, Guam, the US Pacific Islands and the US Virgin Islands. However, around 97.5% of the total number of people living with AIDS reside within the 50 states or the District of Columbia.

In recent years, the use of antiretroviral therapy has slowed the progression of HIV in many infected persons and hence contributed to a decline in AIDS incidence. This means that AIDS surveillance data are less able to represent trends in the incidence of HIV infection or the impact of the epidemic on the health-care system. In response, more states are now implementing HIV case reporting. This enables state and local areas to better estimate the size of the population living with HIV/AIDS and to predict the services and resources needed.

The CDC reports HIV diagnoses and the number of people living with HIV, using only data collected through confidential name-based reporting. By the end of 2006, confidential name-based reporting of adult and child HIV cases had been implemented by 45 states plus Puerto Rico, Guam, American Samoa, the Northern Mariana Islands and the US Virgin Islands. Of these 50 areas, only 38 have been reporting since at least 2003.

Estimates and reporting delays

There is often a delay between the time of diagnosis of HIV or AIDS, or the time of death, and the time at which the event is reported. Moreover, this delay may differ among different categories of people. For this reason the CDC estimates the number of diagnoses, deaths and people living with HIV or AIDS by adjusting for reporting delays, taking into account the differences between categories. The CDC also redistributes cases into exposure categories if none was initially reported. No adjustment is made for incomplete reporting. On this page, all numbers are CDC estimates unless stated otherwise.

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Written by Rob Noble.

Sources

Notes and references

  1. The CDC case definition lists medical conditions that determine an AIDS diagnosis. The most significant feature of the 1993 expansion of the definition was the inclusion of CD4 criteria. For the first time, an HIV-positive person could be diagnosed with AIDS on the basis of an extremely low CD4 cell count. The majority of such people would have gone on to develop one of the other AIDS-defining conditions, so would eventually have been included in the figures anyway. However, the expansion resulted in many people being diagnosed sooner than they would otherwise have been. This caused only a temporary distortion of the figures, which by 1996 had ceased to have a significant effect on trends.
  2. Since 2003, the following 38 areas have had laws or regulations requiring confidential name-based HIV infection reporting: Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the US Virgin Islands. Reports from Florida include only the diagnoses made during July 1997 or later.
  3. Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003. National HIV Prevention Conference; June 2005; Atlanta
  4. According to the number of reported AIDS cases, the 38 areas with a history of confidential name-based reporting of HIV infection represent approximately 64% of the US epidemic.
  5. Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003. National HIV Prevention Conference; June 2005; Atlanta

Last updated April 07, 2008