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HIV/AIDS Surveillance - General Epidemiology
L178 slide series
(through 2002)
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Slide 1 - Title: Estimated Incidence of AIDS and Deaths among Adults and Adolescents with AIDS, 1985–2002—United States The upper curve represents estimated AIDS incidence (number of new cases); the lower one represents the estimated number of deaths of adults and adolescents with AIDS. The peak in 1993 was associated with the expansion of the AIDS surveillance case definition implemented in January 1993. In recent years, AIDS incidence has leveled and deaths of persons with AIDS have declined. The overall decline in new AIDS cases and deaths of persons with AIDS are due in part to the success of highly active antiretroviral therapies, introduced in 1996. The data have been adjusted for reporting delays. Slide 2 - Title: AIDS Cases and Deaths Reported through 2002—United States From 1981 through 2002, a total of 859,000 cases of AIDS were reported to CDC. Of the 849,780 adults and adolescents reported with AIDS, 482,380 (57%) have died. Of the 9,220 children younger than 13 years reported with AIDS, 5,345 (58%) have died. Slides containing information on leading causes of death in the United States, including HIV infection and AIDS, are available at http://www.cdc.gov/hiv/graphics/mortalit.htm.
Slide 1
Estimated Incidence of AIDS and Deaths of Adults and Adolescents with AIDS, 1985 - 2002, United States
Slide 2
AIDS Cases and Deaths Reported through 2002—United States
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Slide 3 - Title: Persons Diagnosed with AIDS, by Age and Sex Reported through 2002—United States This slide shows the distribution of AIDS cases, by persons’ age at diagnosis and sex. From 1981 through 2002, a total of 859,000 cases of AIDS have been reported to CDC: 82% were in males and 18% in females. Most of the cases were diagnosed when the men and women were 25–44 years of age. Slide 4 - Title: Estimated Number of Adults and Adolescents Living with AIDS, by Sex, 1993–2002—United States This slide shows increases in the number of adults and adolescents living with AIDS from 1993 through 2002. The increase is due primarily to the widespread use of highly active antiretroviral therapy, introduced in 1996, which has delayed the progression of AIDS to death. At the end of 2002, approximately 381,012 adults and adolescents were living with AIDS; of these, 78% were males and 22% were females. The data have been adjusted for reporting delays.
Slide 3
Persons Diagnosed with AIDS, by Age and Sex, Reported through 2002—United States
 Slide 4
Estimated Number of Adults and Adolescents Living with AIDS, by Sex, 1993–2002—United States
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Slide 5 - Title: Estimated Number of Persons Living with AIDS by Race/Ethnicity, 1993–2002—United States The estimated number of adults and adolescents living with AIDS increased from 173,190 at the end of 1993 to 384,906 at the end of 2002. Increases in the number of persons living with AIDS occurred in all racial/ethnic groups. From 1993 through 2002, the number of non-Hispanic blacks living with AIDS increased from 60,451 to 162,412. At the end of 1997, the number of non-Hispanic blacks living with AIDS exceeded the number of non-Hispanic whites living with AIDS. From 1993 through 2002, the number of non-Hispanic whites living with AIDS increased from 79,943 to 140,835. The number of Hispanic persons living with AIDS increased from 30,927 to 76,052. (On slide 3, Asians/Pacific Islanders and American Indians/Alaska Natives are shown on a different scale.) The data have been adjusted for reporting delays. Slide 6 - Title: Estimated Number of Asians/Pacific Islanders and of American Indians/Alaska Natives Living with AIDS 1993–2002—United States On slide 2, the estimated number of Asians/Pacific Islanders and American Indians/Alaska Natives living with AIDS are shown with the other racial/ethnic groups; on this slide, a different scale is used for the vertical axis. From 1993 through 2002, the number of Asians/Pacific Islanders living with AIDS increased from 1,293 to 3,574. The number of American Indians/Alaska Natives living with AIDS increased from 576 to 1,450. The data have been adjusted for reporting delays. Slides containing more information on HIV and AIDS in racial and ethnic minorities are available at http://www.cdc.gov/hiv/graphics/minority.htm.
Slide 5
Estimated Number of Persons Living with AIDS by Race/Ethnicity, 1993–2002—United States
 Slide 6
Estimated Number of Asians/Pacific Islanders and of American Indians/Alaska Natives Living with AIDS 1993–2002—United States
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Slide 7 - Title: Estimated Number of Persons Living with AIDS, by Region 1993–2002—United States The estimated number of persons living with AIDS in each region of the United States increased from 1993 through 2002. This increase is due primarily to the widespread use of highly active antiretroviral therapy, introduced in 1996, which has delayed the progression of AIDS to death. In 2002, approximately 148,573 (39%) persons living with AIDS resided in the South,111,277 (29%) in the Northeast, 74,652 (19%) in the West, 39,516 (10%) in the Midwest, and 10,887 (3%) in US dependencies, possessions, and associated nations. The data have been adjusted for reporting delays. Slide 8 - Title: Proportion of AIDS Cases, by Race/Ethnicity and Year of Diagnosis, 1985–2002—United States The proportional distribution of AIDS cases among racial/ethnic groups has changed since the beginning of the epidemic. The proportion of AIDS cases in non-Hispanic whites has decreased while the proportions in non-Hispanic blacks and Hispanics have increased. The proportion of AIDS cases among Asians/Pacific Islanders and American Indians/Alaska Natives has remained relatively constant, at approximately 1% of all cases. Of persons diagnosed with AIDS in 2002, 50% were non-Hispanic black, 28% were non-Hispanic white, 20% were Hispanic, 1% were Asian/Pacific Islander, and less than 1% were American Indian/Alaska Native. The data have been adjusted for reporting delays. Slides containing more information on HIV and AIDS in racial and ethnic minorities are available at http://www.cdc.gov/hiv/graphics/minority.htm.
Slide 7
Estimated Number of Persons Living with AIDS, by Region 1993–2002—United States
 Slide 8
Proportion of AIDS Cases, by Race/Ethnicity and Year of Diagnosis, 1985–2002—United States
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Slide 9 - Title: Proportion of AIDS Cases among Adults and Adolescents, by Exposure Category and Year of Diagnosis 1985–2002 United States The proportional distribution of AIDS cases by exposure category has shifted since the beginning of the epidemic. In 1985, male-to-male sexual contact accounted for 65% of all AIDS cases; in 2002, they accounted for 40% of all AIDS cases. The proportion of AIDS cases attributed to injection drug use increased during 1985–1994 and then slightly decreased, accounting for 24% of cases in 2002. The proportion of AIDS cases attributed to heterosexual contact increased from 3% in 1985 to 30% in 2002. The remaining AIDS cases were those attributed to hemophilia or the receipt of blood or blood products and those in persons without an identified risk exposure. The data have been adjusted for reporting delays and estimated proportional redistribution of cases initially reported without risk. Slide 10 - Title: Proportion of AIDS Cases among Adults and Adolescents, by Sex and Exposure Category Diagnosed in 2002—United States Of AIDS cases diagnosed in 2002 for male adults and adolescents, 55% were attributed to male-to-male sexual contact and 22% were attributed to injection drug use. Approximately 16% of cases were attributed to heterosexual contact. Most (68%) of the AIDS cases diagnosed in 2002 for female adults and adolescents were attributed to heterosexual contact, and 29% were attributed to injection drug use. The data have been adjusted for reporting delays and estimated proportional redistribution of cases initially reported without risk.
Slide 9
Proportion of AIDS Cases among Adults and Adolescents, by Exposure Category and Year of Diagnosis 1985–2002 United States
 Slide 10
Proportion of AIDS Cases among Adults and Adolescents, by Sex and Exposure Category Diagnosed in 2002—United States
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Slide 11 - Title: AIDS Rates, Reported in 2002—United States For cases reported in 2002, AIDS rates (cases per 100,000 population) are shown for each state, Washington, DC, Puerto Rico, the US Virgin Islands, Guam, and the US Pacific Islands. Areas with the highest rates in 2002 were Washington, DC, New York, Maryland, Florida, Puerto Rico, and Louisiana. Every state reported some AIDS cases in 2002. Slide 12 - Title: Proportion of AIDS Cases and Population, by Race/Ethnicity 2002—United States The pie chart on the left illustrates the distribution of AIDS cases reported in 2002 among racial/ethnic groups. The pie chart on the right shows the distribution of the US population (excluding US dependencies, possessions and associated nations) in 2002. Non-Hispanic blacks and Hispanics are disproportionately affected by the AIDS epidemic in comparison with their proportional distribution in the general population. In 2002, non-Hispanic blacks made up 13% of the population but accounted for 51% of reported AIDS cases. Hispanics made up 13% of the population but accounted for 17% of reported AIDS cases. Non-Hispanic whites made up 69% of the US population but accounted for 31% of reported AIDS cases. More information on the HIV/AIDS epidemic and HIV prevention among blacks and Hispanics is available in a CDC fact sheet at http://www.cdc.gov/hiv/pubs/facts.htm
Slide 11
AIDS Rates, Reported in 2002—United States
 Slide 12
Proportion of AIDS Cases and Population, by Race/Ethnicity 2002—United States
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Slide 13 - Title: AIDS Cases and Rates for Male Adults and Adolescents by Race/Ethnicity, Reported in 2002 United States For male adults and adolescents, the rate (AIDS cases per 100,000 population) for non-Hispanic blacks (110) was more than 7 times higher than for non-Hispanic whites (14) and approximately 3 times higher for Hispanics (37). Relatively few cases were reported for Asian/Pacific Islander and American Indian/Alaska Native males, although the rate for American Indian/Alaska Native males (17) was higher than that reported for non-Hispanic white males. Slide 14 - Title: AIDS Cases and Rates for Female Adults and Adolescents by Race/Ethnicity, Reported in 2002 United States For female adults and adolescents, the rate (AIDS cases per 100,000 population) for non Hispanic blacks (49) was over 24 times higher than that for non-Hispanic whites (2). The number of AIDS cases reported in 2002 was similar for Hispanics and non-Hispanic whites, but the rate for Hispanics (11) was more than 5 times higher than for non-Hispanic whites. Relatively few cases were reported for Asian/Pacific Islander and American Indian/Alaska Native females.
Slide 13
AIDS Cases and Rates for Male Adults and Adolescents by Race/Ethnicity, Reported in 2002 United States
 Slide 14
AIDS Cases and Rates for Female Adults and Adolescents by Race/Ethnicity, Reported in 2002 United States
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Slide 15 - Title: Proportion of AIDS Cases among Adults and Adolescents, by Region and Size of Place of Residence, Diagnosed in 2002—United States In 2002, approximately 45% of all AIDS cases were in the South, followed by the Northeast (27%). In each region, most AIDS cases were in large metropolitan areas (populations of more than 500,000). States in the Midwest and the South had the largest proportion of AIDS cases from smaller metropolitan areas (populations of 50,000 to 500,000). In 2002, the South was the region with the largest proportion of AIDS cases from non-metropolitan areas. The data have been adjusted for reporting delays. Slide 16 - Title: Estimated Number and Proportion of AIDS Cases among Adults and Adolescents, by Exposure Category Diagnosed in 2002—United States This slide shows the distribution of exposure categories among AIDS cases diagnosed in 2002. The data have been adjusted for reporting delays, and the exposure category for cases initially reported without risk has been statistically redistributed. Approximately 40% of the 42,044 diagnoses of AIDS in 2002 for adults and adolescents were attributed to male-to-male sexual contact. An additional 5% of were attributed to male-to-male sexual contact and injection drug use. Injection drug use accounted for 24% of AIDS incidence, and heterosexual contact accounted for another 30%. The data have been adjusted for reporting delays and estimated proportional redistribution of cases initially reported without risk.
Slide 15
Proportion of AIDS Cases among Adults and Adolescents, by Region and Size of Place of Residence, Diagnosed in 2002—United States
 Slide 16
Estimated Number and Proportion of AIDS Cases among Adults and Adolescents, by Exposure Category Diagnosed in 2002—United States
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Slide 17 - Title: Estimated Number and Proportion of AIDS Cases Associated with Injection Drug Use, by Exposure Category Diagnosed in 2002—United States More than 14,500 AIDS cases diagnosed in 2002 were associated with injection drug use. Approximately 83% of AIDS cases associated with injection drug use were in persons who inject drugs. Approximately 17% of AIDS cases associated with injection drug use were in heterosexual partners of an injection drug user. A very small proportion (<1%) of AIDS cases associated with injection drug use were in perinatally infected children whose mothers were IDUs or sex partners of an IDU. The data have been adjusted for reporting delays and estimated proportional redistribution of cases initially reported without risk. Slide 18 - Title: Estimated Number and Proportion of AIDS Cases Associated with Injection Drug Use, by Race/Ethnicity Diagnosed in 2002—United States Approximately 14,474 AIDS cases diagnosed in 2002 were associated with injection drug use. This number includes cases in persons who were injection drug users (IDUs), sexual contacts of an IDU, or born to a mother who was an IDU or a sex partner of an IDU. More than half of the cases associated with injection drug use were in non-Hispanic blacks (56%). Most of the remaining cases were in non-Hispanic whites or Hispanics, although the percentage for Hispanics (21%) was almost equal to that of non-Hispanic whites (22%). American Indians/Alaska Natives and Asians/Pacific Islanders each accounted for approximately 1% of all cases. The data have been adjusted for reporting delays and estimated proportional redistribution of cases initially reported without risk.
Slide 17
Estimated Number and Proportion of AIDS Cases Associated with Injection Drug Use, by Exposure Category Diagnosed in 2002—United States
 Slide 18
Estimated Number and Proportion of AIDS Cases Associated with Injection Drug Use, by Race/Ethnicity Diagnosed in 2002—United States
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Slide 19 - Title: AIDS Cases in Children, Reported in 2001 In 2001, a total of 175 cases of AIDS in children younger than 13 years of age were reported, a decrease from 196 in 2000. Most of these cases were perinatally acquired. New York, Florida, California, and Pennsylvania reported the largest number of cases. In 2001, 22 states did not report any pediatric AIDS cases. Slide 20 - Title: Year of Initiation of Confidential HIV Case Surveillance, as of April 2002 AIDS incidence trends no longer reflect HIV incidence trends because effective antiretroviral therapy delays the progression of HIV infection to AIDS. Thus, HIV data are needed to meet federal, state, and local needs for monitoring trends and planning. As of April 2002, 33 states, Guam, the US Virgin Islands, and some US Pacific Islands had implemented confidential name-based HIV case surveillance of adults and adolescents. Connecticut had implemented HIV case surveillance for pediatric cases only. Several states had implemented HIV surveillance systems that are not based on names, and others were considering different HIV reporting systems.
Slide 19
AIDS Cases in Children, Reported in 2001
 Slide 20
Year of Initiation of Confidential HIV Case Surveillance, as of April 2002
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Slide 21 - Title: Cases of HIV Infection (not AIDS), Reported in 2002 In 2002, 39 US areas (including states, US dependencies, possessions, and associated nations) conducted HIV case surveillance and reported cases of HIV infection in adults, adolescents, and children to CDC. Connecticut reported only pediatric HIV cases. In 2002, more than 35,000 cases of HIV infection (not AIDS) were reported to CDC. In 2002, New York, Florida, Texas, New Jersey, and North Carolina reported the largest number of cases of HIV infection. Slide 22 - Title: Adolescents 13–19 Years of Age Living with HIV Infection (not AIDS) or with AIDS, Reported through 2002 At the end of 2002, a total of 2,120 persons, 13–19 years old, in the United States were reported as living with AIDS. In the areas with name-based HIV infection surveillance systems, 2,166 adolescents were reported as living with HIV infection (not AIDS).
Slide 21
Cases of HIV Infection (not AIDS), Reported in 2002
 Slide 22
Adolescents 13–19 Years of Age Living with HIV Infection (not AIDS) or with AIDS, Reported through 2002
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Slide 23 - Title: Age at Diagnosis of HIV Infection (not AIDS) or AIDS Reported through 2002—United States Through 2002, a total of 859,000 persons with AIDS were reported; 39% of these persons were aged 35-44 years at the time of diagnosis. A total of, 199,759 persons with HIV infection (not AIDS) had been reported from the 39 areas with name-based confidential HIV surveillance; 37% of these were aged 25-34 years at the time of diagnosis. Slide 24 - Title: Estimated Rates for Adults and Adolescents Living with HIV Infection (not AIDS) or with AIDS (per 100,000 population) 2002—United States In the 30 areas with confidential name-based HIV infection reporting since 1998, the prevalence rate of HIV infection (not AIDS) among adults and adolescents was 125.7 per 100,000 population at the end of 2002. The rate for adults and adolescents living with HIV infection (not AIDS) ranged from 12.8 per 100,000 in North Dakota to 229.7 per 100,000 in the US Virgin Islands. In the United States, at the end of 2002, the AIDS prevalence rate among adults and adolescents was 160.5 per 100,000. The rate ranged from 2.2 per 100,000 in the Pacific Islands to 1,685.8 per 100,000 in the District of Columbia. The data have been adjusted for reporting delays.
Slide 23
Age at Diagnosis of HIV Infection (not AIDS) or AIDS Reported through 2002—United States
 Slide 24
Estimated Rates for Adults and Adolescents Living with HIV Infection (not AIDS) or with AIDS (per 100,000 population) 2002—United States
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Slide 25 - Title: Estimated Rates for Children <13 years of Age Living with HIV Infection (not AIDS) or with AIDS (per 100,000 population) 2002—United States In the 30 areas with confidential name-based HIV infection reporting since 1998, the prevalence rate of HIV infection (not AIDS) among children <13 years of age was 5.6 per 100,000 population at the end of 2002. The rate for children living with HIV infection (not AIDS) ranged from 0.4 per 100,000 in Idaho to 20.0 per 100,000 in New Jersey. In the United States, at the end of 2002, the AIDS prevalence rate among children <13 years of age was 4.2 per 100,000. The rate ranged from 0.4 per 100,000 in Arizona, Colorado, Kansas, and Utah to 80.8 per 100,000 in the District of Columbia. The data have been adjusted for reporting delays. Slide 26 - Title: Proportion of Persons Surviving through 2002 by Number of Months after AIDS Diagnosis during 1994–2001 and by Year of Diagnosis—United States Slide 16 is limited to data for AIDS cases diagnosed between 1994–2001 to describe the survival of persons whose diagnoses was made during that time. Survival increased with the year of diagnosis for diagnoses made during 1994–1997, but year-to-year differences were small during 1997–2001. The data have been adjusted for reporting delays.
Slide 25
Estimated Rates for Children <13 years of Age Living with HIV Infection (not AIDS) or with AIDS (per 100,000 population) 2002—United States
 Slide 26
Proportion of Persons Surviving through 2002 by Number of Months after AIDS Diagnosis during 1994–2001 and by Year of Diagnosis—United States
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Slide 27 - Title: Proportion of Persons Surviving through 2002 by Number of Months after AIDS Diagnosis during 1994–2001 and by Race/Ethnicity—United States Slide 18 is limited to data for AIDS cases diagnosed during 1994–2001 to describe the survival of persons whose diagnoses was made during that time. For persons whose diagnosis was made during this period, the proportion surviving was least for non-Hispanic blacks: 55% were alive after 9 years compared with 61% of Hispanics, 64% of non-Hispanic whites, and 69% of Asians/Pacific Islanders. Results for American Indians/Alaska Natives should be interpreted with caution because the number of persons in this racial/ethnic category was small. The data have been adjusted for reporting delays. Slide 28 - Title: Proportion of Persons Surviving through 2002 by Number of Months after AIDS Diagnosis during 1994–2001 and by Age Group—United States Slide 17 is limited to data for AIDS cases diagnosed between 1994–2001 to describe the survival of persons whose diagnoses was made during that time. Persons aged 13–24 years who were diagnosed with AIDS during 1994–2001 had the highest survival than persons in any other age group: 67% lived 9 years or more after a diagnosis of AIDS, compared with 66% of those less than 13 years of age, 64% of those aged 25–34, 60% of those aged 35–44, 55% of those aged 45–54, and 45% of those aged 55 or over. The data have been adjusted for reporting delays.
Slide 27
Proportion of Persons Surviving through 2002 by Number of Months after AIDS Diagnosis during 1994–2001 and by Race/Ethnicity—United States
 Slide 28
Proportion of Persons Surviving through 2002 by Number of Months after AIDS Diagnosis during 1994–2001 and by Age Group—United States
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Last Updated: July 14, 2004
Centers for Disease Control & Prevention
National Center for HIV, STD, and TB Prevention
Divisions of HIV/AIDS Prevention
Surveillance Branch
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