CDC’s HIV Stats Higher Than Previously Thought

Jim Burroway

November 21st, 2007

We mentioned that UNAIDS revised their estimates downward for the number of people worldwide infected with HIV. The US Centers for Disease Control and Prevention (CDC) is grappling with the opposite problem. The Washington Blade reports that the CDC is trying to figure out how to break the news that the annual number of new HIV infections in America are as much as fifty percent higher than the 40,000 or so per year they had previously estimated:

According to AIDS advocacy groups familiar with the CDC, middle level officials at the disease prevention agency have quietly confided in colleagues in professional and scientific circles that the number of new HIV infections now appears to be as high as 58,000 to 63,000 cases in the most recent 12-month period.

…CDC officials have told leaders of AIDS advocacy groups that the new figures are being withheld while they are subjected to a rigorous peer review process by an unidentified scientific journal, which is expected to publish the findings within the next few months.

Others familiar with the CDC have said CDC would likely publish the new data in its own journal, Morbidity and Mortality Weekly Report.

As of this morning, the CDC’s web site still cites the 40,000 figure for HIV infections. This tracks the actual number of AIDS diagnoses that the CDC counts each year.

Part of what the CDC is trying to grapple with is the political dimension of HIV/AIDS. Headlines screaming about a fifty percent spike in HIV infections are sure to provide a bonanza for anti-gay extremists. With that crowd, this news will be like winning the lottery.

But according to the Blade, the CDC’s experts believe that the dramatic increase doesn’t reflect an actual increase in HIV infections, but are the result of new requirements that states accurately track and report HIV test results. There has been mandatory reporting of AIDS diagnoses since the mid-1980’s, but requirements for mandatory reporting of HIV infections didn’t begin until more recently.

Before the new regulations took effect, the CDC’s methods for estimating the HIV infection rate was based on actual AIDS diagnoses. But HIV infection and AIDS are two different things: HIV is the virus which leads to an AIDS diagnosis some ten years after infection on average. What the CDC used to do to estimate the rate of HIV infections was to take the actual count of AIDS diagnosis and work backwards from there to arrive at an estimate of HIV infections.

But with the average ten year latency period between infection and AIDS, along with the fact that Highly Active Anti-Retroviral Therapy (HAART) has lengthened this latency period for many people with HIV infection, the estimate has become grossly inaccurate. So now that states are required to report HIV infections as well as AIDS diagnosis, the CDC is getting a much better look at the actual rate of HIV infection.

Another factor which may be causing the HIV stats to rise could be the CDC’s latest recommendation that most adults in the US undergo an HIV test during routine doctor exams as well as hospital emergency room visits. This may be catching many people who either avoided HIV testing or who believed they weren’t at a significant risk for infection. So not only is the CDC now actually counting HIV infections instead of merely estimating them, their policies may have resulted in an increase in the number of people getting tested each year.

US AIDS Diagnoses, DeathsSo far, the CDC doesn’t believe these new numbers represent a significant increase in actual HIV infections. Yearly AIDS diagnoses has held relatively steady for the past eight years, which suggests that the number of HIV infections leading to those diagnoses was probably fairly stable through the 1990’s. If the number of yearly AIDS diagnoses holds steady over the next several years, then that should validate the belief that there is no actual spike in HIV infections.

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